以质量求发展，以服务铸品牌

Journal of Nursing ›› 2020, Vol. 27 ›› Issue (19): 41-46.doi: 10.16460/j.issn1008-9969.2020.19.041

Previous Articles     Next Articles

Evidence-based Nursing Practice of Physical Restraint Standardized Management in Neurosurgery Department

XU Ni-na1, YANG Zhong-shan1, LIU Ning2, LE Ge-fen1, ZHAN Yu-xin1, WU Yan-ni3, WANG Huan1   

  1. 1. Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China;
    2. Zhuhai Campus, Zunyi Medical University, Zhuhai 519041, China;
    3. Nanfang Hospital, Southern Medical University,Guangzhou 510515, China
  • Received:2020-05-22 Online:2020-10-10 Published:2020-11-11

PDF (PC)

318

Like

Abstract: Objective To develop the standardized physical restraint strategy for neurosurgery department, to promote the application of the best evidence of physical restraint and improve the quality of physical restraint nursing.Methods We conducted the study based on JBI clinical evidence practice application model and there were three stages: baseline review before evidence application, change of evidence application, and effect review after evidence application. The best evidence was converted into 12 audit criteria through structural discussion then the criteria were applied in neurosurgical ward. Physical restraint rate, complication rate, nurses’ KAP (knowledge, attitude, practice) regarding physical restraint and audit criteria execution rate were compared before and after evidence application.Results After the application of evidence, the physical restraint rate decreased from 7.69% to 2.91%. The incidence of unplanned extubation showed no statistical significance (P>0.05).Patients’ experience on physical restraint was improved, which was statistically significantly (P<0.05) nurses’ KAP regarding physical restraint was enhanced (P<0.05). Of the audit criteria execution rate of the 12 audit criteria,the execution rate of all the criteria except that of NO.10 was improved(P<0.05).Conclusion Evidence-based standardized physical restraint management strategy can lower the rate of physical constraint in neurosurgery, improve the level of physical restraint knowledge of nurses and regulate their behaviors, so as to improve the outcome of patients and improve the quality of nursing.

Key words: physical restraint, management, neurosurgery, evidence-based practice

CLC Number: 

  • R47
[1] 国家卫生计生委医院管理研究所护理中心.护理敏感质量指标实用手册(2016版)[M].北京:人民卫生出版社,2016:138-139.
[2] 李静逸,洪洋,宋春梅, 等.ICU护士对患者身体约束体验的Meta整合[J].中华护理杂志,2018,53(10):1249-1255.
[3] Wilson C, Rouse L, Rae S, et al.Is Restraint A ‘Necessary Evil’ in Mental Health Care? Mental Health Inpatients’ and Staff Members’ Experience of Physical Restraint[J].Int J Ment Health Nurs, 2017, 26(5):500-512.DOI:10.1111/inm.12382.
[4] Bellenger E, Ibrahim JE, Bugeja L, et al.Physical Restraint Deaths in a 13-year National Cohort of Nursing Home Residents[J].Age Ageing,2017,46(4):688-693.DOI:10.1093/ageing/afw246.
[5] 丁艳.自制约束手套在神经外科躁动患者中的应用[J].现代临床护理,2012,11(3):82-83.
[6] 吴孟航,刘帆,王琼.神经ICU意外拔管护理风险防范策略[J].现代预防医学,2014, 41(11):2110-2112.
[7] Eskandari F, Abdullah KL, Zainal NZ, et al.Incidence Rate and Patterns of Physical Restraint Use Among Adult Patients in Malaysia[J].Clin Nurs Res,2018, 27(3):278-295.DOI:10.1177/1054773816677807.
[8] 庄晓艳,许勤,朱妹芹,等.神经外科ICU患者身体约束相关非计划拔管影响因素研究[J].护理学杂志,2014, 29(2):15-17.DOI:10.3870/hlxzz.2014.02.015.
[9] Lach HW, Leach KM, Butcher HK.Evidence-based Practice Guideline: Changing the Practice of Physical Restraint Use in Acute Care[J].J Gerontol Nurs,2016, 42(2):17-26.DOI:10.3928/00989134-20160113-04.
[10] 杨中善,许妮娜,詹昱新,等.住院患者规范化身体约束管理最佳证据总结[J].护理学报,2019, 26(4):31-36.DOI:10.16460/j.issn1008-9969.2019.04.031.
[11] 王季芳,洪怡莉,周行涛,等.眼科日间手术术前管理的循证实践[J].中华护理杂志,2018, 53(3):276-271.DOI:10.3761/j.issn.0254-1769.2018.03.002.
[12] 张晓静,张会芝,李葆华.非计划性拔管信息化管理系统的建立及应用研究[J].中华护理杂志,2018, 53(11):1360-1362.DOI:10.3761/j.issn.0254-1769.2018.11.016.
[13] 谭媛,白建萍,王海英.神经外科患者留置管道的风险分级管理体会[J].护理学报, 2014, 21(3):28-30.
[14] Scheepmans K, Dierckx de Casterlé, Bernadette, Paquay L, et al.Restraint Use in Older Adults in Home Care: A Systematic Review[J].Int J Nurs Stud,2018, 79(3):122-136.DOI:10.1016/j.ijnurstu.2017.11.008.
[15] Dikiciyan J, Sabangan B, Katz B,et al.Australian and New Zealand Society for Geriatric Medicine Position Statement -physical Restraint Use in Older People[J].Australas J Ageing, 2016, 35(3):225.DOI:10.1111/ajag.12224.
[16] 李佳星,任之珺,张紫君,等.缩减约束方案对预ICU气管插管非计划性拔管的效果研究[J].中华护理杂志,2017,52(5):549-553.DOI:10.3761/j.issn.0254-1769.2017.05.008.
[17] 潘燕彬,郝巍巍,张晶晶,等.住院患者身体约束真实体验研究的系统评价[J].中国护理管理,2016,16(8):1033-1040.DOI:10.3969/j.issn.1672-1756.2016.08.007.
[18] Ertugrul B, Ozden D.The Effect of Physical Restraint on Neurovascular Complications in Intensive Care Units[J].Aust Crit Care,2019,9(5):98-101.DOI:10.1016/j.aucc.2019.03.002.
[19] 邹丽燕,曹梅娟.国内外灵性健康测评工具的研究进展[J].护理学杂志,2017, 32(9):98-101.DOI:10.3870/1.issn.1001-4152.2017.09.098.
[20] Fariña-López E, Estévez-Guerra GJ, Polo-Luque ML, et al.Physical Restraint Use with Elderly Patients: Perceptions of Nurses and Nursing Assistants in Spanish Acute Care Hospitals[J].Nurs Res,2018, 67(1):55-59.DOI:10.1097/NNR.0000000000000252.
[21] 孙龙凤,周冬洁,王爱平.身体约束规范化培训在内科重症监护病房中的应用与效果[J].中华护理教育, 2014,11(9):694-696.DOI:10.3761/j.issn.1672-9234.2014.09.015.
[1] JI Xue-li, LI Mei, ZHANG Li, ZHANG Yang-chun, JIANG Li-li, ZHANG Jin-song. Application and Management of Emergency Negative-pressure Room in Critically Ill Patients Suspected with COVID-19 [J]. Journal of Nursing, 2020, 27(9): 55-58.
[2] ZHANG Xiao-xue, HE Chao-zhu, WU Jie-hua, HE Liang, LIU Hai-jia. Influence of Drinking Small Amount of Ice Water to Relieve Thirst in Patients with Oral Tracheal Intubation Based on Safety Protocol for Thirst Management [J]. Journal of Nursing, 2020, 27(8): 47-50.
[3] WANG Yan, ZHU Gui-lin. Effect of Nursing Intervention based on Behaviour Change Wheel for Patients after Enterostomy [J]. Journal of Nursing, 2020, 27(8): 54-58.
[4] CHEN Meng-yun, LIN Dan-zhu, XU Jin-wei, XIE Man. Triage and Epidemic Prevention of COVID-19 at Fever Clinic [J]. Journal of Nursing, 2020, 27(6): 39-43.
[5] MING Yao-hui, MI Yuan-yuan, NIE Tao, XIANG Cheng-lin, HUANG Hai-yan, YUAN Shi-ying. Establishment of Management System for COVID-19 Prevention in Intensive Care Unit and Its Effect [J]. Journal of Nursing, 2020, 27(5): 55-59.
[6] XIAO Mei-hui, XI Ming-xia, QU Jing, LIU Shan. Application of Closed-loop Infusion Monitoring System in Safety Management of Clinical Infusion [J]. Journal of Nursing, 2020, 27(3): 14-17.
[7] WANG Hai-yan, WANG Li, ZHANG Chao-ting, SUN Zhu-hua, ZOU Dan-feng, LI Yu-mei, WU Hong-lun, ZHU Bi-li. Evidence Summary of Optimal Postural Management Strategy after Lumbar Anesthesia [J]. Journal of Nursing, 2020, 27(20): 32-37.
[8] SONG Jie, QU Gui-yu, LIN Yun-ying, HOU Shan-shan, WU Bing-yi. Construction of Evaluation Index System for Safety Management of Elderly People in Nursing Home Integrating Pension Service with Medical Service [J]. Journal of Nursing, 2020, 27(2): 1-5.
[9] GUO Su-yun, DAI Ying, SHI Lan-lai, XI Run, YAN Jing-ying, YE Xiu-juan. Evidence-based Practice of Enhanced Recovery after Surgery for Patients with Hemorrhoids [J]. Journal of Nursing, 2020, 27(2): 43-47.
[10] SHI Dong-li, LI Na, ZHANG Zhen-mei. Establishment and Practice of Case Management Model for Patients with Deep Venous Thrombosis [J]. Journal of Nursing, 2020, 27(15): 17-20.
[11] LIU Chao-han, FU Mo, DING Juan, YAN Yu-jiao. Best Evidence Summary for In-hospital Transport of Critically Ill Patients [J]. Journal of Nursing, 2020, 27(15): 33-38.
[12] ZHOU Jin-ping, YUE Li-qing. Multi-department Grid Management in General Hospital during COVID-19 Epidemic [J]. Journal of Nursing, 2020, 27(14): 49-53.
[13] WANG Yu-xiu, ZHANG Rui-ke. Nursing Management in Psychiatric Inpatient Department in Prevention and Control of COVID-19 [J]. Journal of Nursing, 2020, 27(14): 54-58.
[14] LU Shu-ying, LIU Ning, Wei Lu-hua, Liang Dong-mei, LI Yan. Best Evidence Summary Regarding Prevention and Management of Postpartum Hemorrhage [J]. Journal of Nursing, 2020, 27(12): 18-22.
[15] ZHANG Ai-qin, CHEN Jun-shan, YU Jin-tian. Guidelines on Non-pharmacological Management of Delirium in ICU Patients：A Systematic Review [J]. Journal of Nursing, 2020, 27(11): 26-32.
Viewed
Full text


Abstract

Cited
  Shared   
[1] XIAO Su-qin, LIU Fen, HUANG Ya-lian, WANG Jia-jia, LI Na, FANG Yan-chun. Risk Factors of Fear of Childbirth Based on Decision Tree Model and Logistic Regression Model[J]. Journal of Nursing, 2020, 27(18): 1 -5 .
[2] . [J]. Journal of Nursing, 2020, 27(18): 6 -10 .
[3] . [J]. Journal of Nursing, 2020, 27(18): 11 -14 .
[4] LI Xi-lin, ZHANG Yan, TAO Yan-ling, YE Zi-wen, WANG Hui-zhen. Construction of Evaluation Index System of Graduation Practice Bases for Nursing Undergraduates in Guangdong Based on Context, Input, Process, Product Model[J]. Journal of Nursing, 2020, 27(18): 15 -20 .
[5] . Quality of Life, Its Influence Factors of the Elderly in Nursing Homes via Chinese Version of Continuity Assessment Record, Evaluation[J]. Journal of Nursing, 2020, 27(19): 1 -5 .
[6] . Influence of Perceived Professional Benefits on Career Planning of Nurses in One Tertiary Grade-A Hospital[J]. Journal of Nursing, 2020, 27(19): 6 -10 .
[7] . Establishment, Evaluation of Risk Prediction Model of Major Adverse Cardiac Events in Patients with Acute Coronary Syndrome One Year after Percutaneous Coronary Intervention[J]. Journal of Nursing, 2020, 27(19): 11 -16 .
[8] . [J]. Journal of Nursing, 2020, 27(19): 17 -22 .
[9] . [J]. Journal of Nursing, 2020, 27(19): 23 -28 .
[10] . Best Evidence Summary for Early Enteral Nutrition in Patients with Acute Pancreatitis[J]. Journal of Nursing, 2020, 27(19): 29 -34 .