Study On Establishing Interventions For Preventing And Reducing The Use Of Restraints On The Basis Of Evidence-Based Nursing In Psychiatric Nursing Care

Objective:To establish interventions for reducing the use of restraints in psychiatric wards and to provide the reference for clinical practice.Methods:The study is to establish interventions for reducing the use of restraints by searching Cochrane, Pubmed, CINAHL, Elsevier, www.guideline.gov, CBM, Wan Fang and other databases.By reading literatures on reducing the use of restraints and using"AND","OR",we utilized keywords:English keywords (restraint; physical restraint; intervention; prevention; inpatient (s); psych*;), Chinese keywords(约束,身体的)to search literatures in5years. Under inclusion and exclusion criteria,literatures were evaluated by the Johns Hopkins evidence level and quality evaluation method.The interventions for reducing the use of restraints consisted of41components initially measured. Then we utilized Delphi expert consultation to find out the importance and operability of the items of the interventions,we also to examine the reliability and representation of expert consultation. Results:A total of85literatures were included.17literatures were grade1,2literatures were grade Ⅱ, grade Ⅲ were43,7literatures were grade Ⅳ,16were grade Ⅴ, all literatures are included in the quality grade A or B. Interventions were finally constructed, including four dimensions of management, education, using of alternatives and restraint as a last resort,which consisted of41components after surveys. In two rounds of surveys, the rates of questionnaire retrieve were82.22%and94.12%,respectively.The authoritative coefficients were0.826and0.834,respectively. The coordination coefficients of the importance of indicaters were0.215and0.162,respectively. The coordination coefficients of the operation of indicaters were0.275and0.254, respectively.Conclusion:The interventions for reducing restraints based on evidence were reliable and scientific, which can act as a reference for clinical practice to reduce the use of restraints.