| Objective1. Investigation and Analysis on the status quo of the use of ICU patients with hospital physical restraint, aims to explore the management countermeasures for solving the existing problems of clinical physical restraint appliance.2. Differences between the application and comparison of two constraint method in critically ill patients, to choose more comfortable and effective restraint appliance for critically ill patients.Method1 A survey on a third-grade hospital constraints using status:ICU were treated by ICU patients restraint appliance usage status designed questionnaire, the main contents include:the patient's gender, age, specialty, constraints on the use of location, time of constraint and use frequency and sedative drugs usage during physical restraint (drug restraint), complications, the indications for the use of constraints and related nursing records.2. Manufacture and application of the improved upper limb restraint:the traditional upper limb restraint have modified to be a improved upper limb restraint; observation and recording methods were used to compare the differences of effect of application between the traditional upper limb physical restraints and the improved upper limb, intended for clinical promotion of the improved upper limb restraint.Results1. A level three hospital patients with ICU constraint appliance was used in 44.78%.General anesthesia patients in unawake accounted for 58.06% in all patients of using restraint appliance; Patients with tracheal intubation accounted for 77.41% in all physical restraint patients; Department of neurosurgery patients accounted for 72.05% in patients with divisions constitute of ICU. The average time constraint for the use of was (34.2+21.5) hours, and the average time of ICU retention was for (70.6+32.5) hours. The time of constrained patients hospitalized time accounted for ICU 3.5%-100%, and the average was 63.4%; the night patients using physical restraint was accounted for 88.71% in all physical restraint patients; the use of sedative was accounted for 79.84% in all physical restraint patients. Physical restraint for upper limbs was accounted for 82.26% of the all parts of the body during the ICU constraint; 93.54% of the all physical restraint patients had communication and signed the use of informed consent before constraint; Nursing management during the use of constraint was less standardized; Restraint complications happened in 18 cases, including the accidental extubation, constraint skin injury, poor circulation and extremity edema aggravated and joint dysfunction.2. Through the use of improved upper limb restraint with (control group) with traditional constraint upper limb with (observation group) of ICU patients in comparison, patients in the observation group pipeline accident pulled out the number of cases is 1 cases, the observation group line non plan cupping the number of cases is 9 cases, there was significant difference between two groups (P<0.01) the observation group; other constraints related complications occurred in 2 cases,11 cases occurred in the control group, two groups compare x 2=6.67, P<0.01, with significant difference.Conclusion1. ICU physical restraint usage rate was 44.78%, so there are still falling space.Physical restraints had some remarkable characteristics:patients in the Department of Neurosurgery had the largest usage; The main type of physical restraints was the upper limb restraint; Nurse preferred to use physical restraints in shift night; The rate of physical restraint combined with sedation therapy was in 79.84%.2. The usage of physical restraints needs to be further standardized. The complications of physical restraints should be reduced.We should be actively looking for or creating new type of physical restraints or substitution method of physical restraint.3. The complications of the improved upper limb physical restraint had significant change compared with the traditional upper physical restraint. It was worthwhile for spreading in clinical practice. |
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