降低ICU患者身体约束缺陷的循证实践

Evidence-Based Practices to Reduce Physical Restraint Defects in ICU Patients

摘要: 目的：应用基于循证的最佳实践以降低ICU患者身体约束缺陷发生率。方法：采用循证护理的方法获取最佳实践证据，将证据应用于本院两院区的EICU，其中老院区EICU为观察组、新院区EICU为对照组，比较两院区EICU患者一般资料、身体约束使用率、缺陷发生率(非计划拔管、水肿、谵妄)。结果：两组身体约束患者性别、年龄、是否使用中枢神经系统兴奋药、约束部位间差异比较无统计学意义(P > 0.05)，在约束用具方面比较差异具有统计学意义(P < 0.05)。两组患者身体约束率比较，差异有统计学意义(χ² = 4.521, P = 0.033)，两组身体约束患者非计划拔管率及比较，差异无统计学意义(P > 0.05)，两组患者谵妄发生率及水肿发生率比较，差异具有统计学意义(P < 0.05)。结论：基于循证的规范化身体约束管理策略应用于EICU患者后，能够降低患者身体约束率，同时能够降低约束缺陷如水肿、谵妄发生率等，在一定程度上提高了护理质量，改善了患者就医体验。

Abstract: Objective: To apply evidence-based best practices to reduce the incidence of body restraint defects in ICU patients. Methods: The evidence-based nursing method was used to obtain evidence-based best practices, and the evidence was applied to the two EICUs in the hospital, with the old EICU as the observation group and the new EICU as the control group. The general information, body restraint use rate, and defect incidence (unplanned extubation, edema, delirium) of patients in the two EICUs were compared. Results: There was no significant difference in gender, age, use of central nervous system stimulants, and restraint site between the two groups (P > 0.05), but there was a significant difference in restraint equipment (P < 0.05). There was a significant difference in the rate of restraint use between the two groups (chi-square = 4.521, P = 0.033), but there was no significant difference in the incidence of unplanned extubation and comparison between the two groups (P > 0.05). There was a significant difference in the incidence of delirium and edema between the two groups (P < 0.05). Conclusion: After the evidence-based standardized body restraint management strategy was applied to EICU patients, it was found that the rate of body restraints on patients was reduced, while the incidence of constraints defects such as edema and delirium was also reduced. To a certain extent, it improved nursing quality and improved the patients’ medical experience.