Construction Of Standardized Physical Restraint Nursing Knowledge System For ICU Patients

ObjectiveTo know the current situation of ICU nurses’ demands on the knowledge of physical restraint for patients,construct a standardized physical restraint knowledge system for ICU patients in line with China’s national conditions,so as to provide reference for the training and evaluating of physical restraint knowledge and skills for ICU nurses in the future.Methods1.Literature review method: set up the team,at home and abroad by querying the guidelines regarding nursing " physical restraints",meta-analysis,RCT research sites,and other various types of literature and teaching through the repeated reading guide,literature,and related courses,watch and in-depth analysis,extracting physical restraint nursing knowledge system constitute the items.2.Qualitative interview:Through the objective sampling and Snowball sampling method,nursing managers and nurses in the intensive care department were selected to conduct semi-structured in-depth interviews,and Colaizzi’s seven-step method was used to analyze the relevant contents of the interview in detail,so as to supplement and improve the items pool of the knowledge system of standardized physical restrained nursing for ICU patients.3.Delphi : the experts who meet the selection requirements are asked by Delphi expert letter by way of filling in and sending out e-mails on site;Excel and SPSS21.0software were used to sort out,input and analyze the recovered data.According to the positive coefficient,authority degree,opinion concentration degree and coordination degree of the expert letter consultation to judge the scientific and feasibility of the expert letter consultation,use the analytic hierarchy process,determine the weight of each item,and finally form the ICU patients standardized physical restraint nursing knowledge system.Result1.By reading and analyzing the guidelines and relevant literature,and taking ePsychNurse.Net’s knowledge about physical restraint courses as a reference,the entry pool of ICU patients’ standardized physical restraint nursing knowledge system containing5first-level indicators,20 second-level indicators and 78 third-level indicators was screened.2.In the semi-structured interview,five themes are extracted from the interview of nursing managers: the training of the basic knowledge of restraints(the concept of restraints、 the purpose of restraints、and the alternative measures of restraints);Training on restraint assessment;Restraint implementation training(restraint parts、restraint tools);improve the personal ability of nurse(the ability of humanistic care 、communication);Training in restraining ethics.There are three themes were extracted from the interview:Nurses lack of constraint ability(need to conduct training on constraint cognition,skills training on constraint implementation,skills training on constraint evaluation,skills training on communicationin constraints);Nurse ethics awareness is insufficient;Lack of perfect constraint management system.3.The results of two rounds of expert consultation show that the enthusiasm of experts is 88% and 85% respectively,and the degree of expert authority is 0.895 and0.915;In the first round of expert letter consultation,the mean value of importance of each item ranged from 3.43 to 5.0 and the coefficient of variation ranged from 0.04 to0.34.In the second round of expert letter consultation,the mean value of importance of each item ranged from 4.24 to 5.0 and the ranged of coefficient variation from 0 to0.18.The first round expert letter consult’s Kendall’W of the first-level,second-level and third-level expert were 0.253,0.206 and 0.200,respectively.The second round expert letter consult’s Kendall’W of first-level,second-level and third-level items were0.247,0.269 and 0.270.The weights of the first-level items were 0.076 for restraint basic knowledge,0.217 for restrainl assessment,0.360 for restrainl implementation,0.157 for communication and support,and 0.190 for ethics and law,respectively,and the CR value was0.031.Secondary item weight range between 6.01% ～ 52.47%,CR value is between0.023 ～ 0.056,the combination weights in the top three,respectively is Ⅲ-2(0.124),Ⅲ-3(0.124),Ⅱ-2(0.112);Level 3 items weight range of 0.02 ～ 1,CR range of 0.000 ～0.052,weights in the top three,respectively is Ⅰ-2-1(1.00),the Ⅲ-4-1(1.00),the Ⅴ-2-1(1.00).Conclusion1.Nurses had a higher demand for physical restraint training;2.In ePsychNurse.Net course and module standardization training method to build under the guidance of the ICU patients nursing knowledge,physical constraints include five level one entry,entry of 21 two class,80 level three items,has certain scientific nature,reliability and practicability,for ICU nurses to provide content to the physical constraints education and can be selected according to the existing knowledge of nurse nurse grasp of knowledge points to form a targeted training content.