摘要
目的探讨基于指南构建的重症患者身体约束循证实践护理方案在ICU患者中的应用效果。方法采用目的抽样法,选取2019年2月—2020年7月中日友好医院外科重症监护室(SICU)、内科重症监护室(MICU)、冠心病重症监护室(CCU)、急诊重症监护室(EICU)收治的4663例患者为研究对象。将基于《促进安全:实施约束的替代方法》指南构建的重症患者身体约束循证实践护理方案进行临床应用,记录方案实施后重症患者的约束时长、约束率、替代约束率,比较方案实施前后ICU护士对身体约束知识、态度、行为得分的差异。结果4663例患者中,871例患者接受约束,约束率为18.68%,约束时长为(102.35±82.67)h;替代约束例数为421例,替代约束率为9.03%。SICU、MICU、CCU、EICU约束发生率分别为23.68%(475/2006)、28.26%(219/775)、7.29%(97/1331)、14.52%(80/551),各科室约束率两两比较差异均有统计学意义(P<0.05)。方案实施前后,ICU护士对身体约束知识、态度、行为的维度得分和总分比较,差异均有统计学意义(P<0.05)。结论基于指南构建的重症患者身体约束循证实践护理方案有效降低了ICU患者的身体约束率和约束时间,提高了替代约束率,规范了ICU患者的身体约束实践,保障了患者安全。
ObjectiveTo explore the effect of the evidence-based practice nursing program for severe patients with physical constraints based on the guideline in Intensive Care Unit(ICU)patients.MethodsFrom February 2019 to July 2020,4663 patients in the Surgical Intensive Care Unit(SICU),Medicine Intensive Care Unit(MICU),Coronary Care Unit(CCU),and Emergency Intensive Care Unit(EICU)of the China-Japan Friendship Hospital were selected as the research object by purposive sampling.The evidence-based practice nursing program for severe patients with physical constraints based on the guideline of Promoting Safety:Alternative Approaches to the Use of Restraints was applied in clinical practice.We recorded the constraint duration,constraint rate,and substitution constraint rate of severe patients after the implementation of the program,and compared the differences in ICU nurses'scores on physical constraint knowledge,attitude,and practice before and after the implementation of the program.ResultsOut of 4663 patients,871 received restraint,with a restraint rate of 18.68%and a restraint duration of(102.35±82.67)hours.The number of substitution constraint cases was 421,and the substitution constraint rate was 9.03%.The constraint rates in SICU,MICU,CCU and EICU were 23.68%(475/2006),28.26%(219/775),7.29%(97/1331)and 14.52%(80/551),respectively,and the differences in constraint rates among different departments were statistically significant(P<0.05).Before and after the implementation of the program,there were statistically significant differences in the scores of ICU nurses on physical constraint knowledge,attitude,and practice dimensions and total scores(P<0.05).ConclusionsThe evidence-based practice nursing plan program for severe patients with physical constraints based the guideline effectively reduces the rate and duration of physical constraint of ICU patients,improves the substitution constraint rate,standardizes the practice of physical constraint of ICU patients,and ensures patient safety.
作者
保晶
王莎莎
李月
李信欣
范华
李灿
林芳
王建
申艳玲
孙育红
Bao Jing;Wang Shasha;Li Yue;Li Xinxin;Fan Hua;Li Can;Lin Fang;Wang Jian;Shen Yanling;Sun Yuhong(General Surgery Department&Liver Transpant Center&DepartmentⅡof Hepatobiliary and Pancreatic Surgery,China-Japan Friendship Hospital,Beijing 100029,China;Nursing Department,China-Japan Friendship Hospital,Beijing 100029,China)
出处
《中华现代护理杂志》
2023年第22期2969-2973,共5页
Chinese Journal of Modern Nursing
关键词
重症监护病房
身体约束
循证实践
证据应用
证据转化
Intensive Care Unit
Restraint,physical
Evidence-based practice
Evidence application
Evidence transformation
