Browse > Article

A Study on the Application of Physical Restraints in Intensive Care Units  

Kim, Mi-Yeon (Neurosurgical ICU, Dongsan Hospital of Keimyung University)
Park, Jeong-Sook (College of Nursing, Keimyung University)
Publication Information
Journal of Korean Academy of Fundamentals of Nursing / v.17, no.2, 2010 , pp. 177-186 More about this Journal
Abstract
Purpose: The purpose of this descriptive study was to investigate the application of physical restraints in ICUs of a university hospital. Method: Data were collected from August 1 to October 1 2009, using a recording tool from Electric Nursing Records and an observation tool for physical restraints and related factors. Frequency, percentage, and paired t-test with the SPSS/WIN 16.0 program were used to analyze the data. Results: The application rate for physical restraints in 5 ICUs was 34.3%, the highest application rate was 48.4% in the neurosurgical ICU. The mean frequency for physical restraint application per patient was 1.14, and the mean hours of restraint application per incident was 113.01 hours. The most common complications of physical restraints were bruising and edema. Conclusion: Many ICU nurses use physical restraints when caring for patients who are at high risk for falls, including patients have high levels of acuity, decreased level of consciousness or increased irritability. When physical restraints are applied, patients show resistance against the use resulting in side effects of bruising and edema. Therefore, nurses should observe changes in restrain sites, perform nursing interventions to prevent complications, and minimize the use of physical restraints.
Keywords
Physical restraint; Intensive care units;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Minnick, A. F., Mion, L. C., Leipzig, R., Lamb, K., & Palmer, R. M. (1998). Prevalence and patterns of physical restraint use in the acute care setting. The Journal of Nursing Administration, 28(11), 19-24.   DOI   ScienceOn
2 Lee, Y. G., Cho, Y. H., Kim, S. A., Kim, J. K., Kim, H. M., Kim, H. E., et al. (2003). The study on physical restraint use in intensive care unit, Journal of Korean Clinical Nursing Reserch, 8(2), 117-130.
3 Lofgren, R. P., Macpherson, D. S., Granieri, R., Myllenbeck, S., & Sprafka, J. M. (1989). Mechanical restraints on the medical wards: Are protective devices safe? American Journal of Public Health, 79(6), 735-738.   DOI   ScienceOn
4 Minnick, A. F., Mion, L. C., Johnson, M. E., Catrambone, C., & Leipzig, R. (2007). Prevalence and variation of physical restraint use in acute care settings in the US. Journal of Nursing Scholarship, 39(1), 30-37.   DOI   ScienceOn
5 Sullivan-Marx, E. M. (2001). Achieving restraint-free care of acutely confused older adults. Journal of Gerontological Nursing, 27(4), 56-61.
6 Korean Association of Critical Care Nurse. (2005). Development and application of serious patient classification. KACN publication resource room No.1, Retrieved December 2, 2009, from http://www.kacn.or.kr/publicationlresource.php
7 Park, M. H. (1997). Study on the ICU nurses' intention to use restraints and related factors. Unpublished master's thesis, Keimyung University, Daegu.
8 Park, M. H., & Lee, B. S. (1998). Study on the ICU nurses' intention to use restraints and related factors. Korean lournal of Health Policy and Administration, 8(2). 191-215.
9 Parkes, J. (2002). A review of the literature on positional asphyxia as a possible cause of sudden death during restraint. British Journal of Forensic Practice, 4(1), 24-30.   DOI   ScienceOn
10 Korean Neurological Association. (2007), Neurology, Seoul:Koonja.
11 Lee, S. H. (2006). Useful characteristic evaluation of the serious case classification tool which it applies in ICU patients. Unpublished master's thesis, Kyungpook National University, Daegu.
12 Akansel, N. (2007). Physical restraint practices among ICU nurses in one university hospital in western Turkey. Health Science Journal, 1(4), Retrieved November 30, 2009, fromhttp://www.hsj.gr/volumellissue4/turkey(o).pdf
13 Joint Commission on the Accreditation of Healthcare Organizations (JCAHO). (2000). Automated comprehensive accreditation manual for behavioral health care. Oakbrook Terrace, IL: Author.
14 Moore, K., & Haralambous, B. (2007). Barriers to reducing the use of restraints in residential elder care facilities. Journal of Advanced Nursing, 58(6), 532-540.   DOI   ScienceOn
15 Kim, J. S., & Oh, H. Y. (2006). Perceptions and attitude on use of physical restraints among caregivers in long term care facilities. Journal of Korea Gerontological Nursing, 26(2), 347-360.
16 Kim, K. S., Kim, J. H., Lee, S. H., Cha, H. K., Shin, S. J., & Chi, S. A. (2000). The physical restraint use in hospital nursing situation. Journal of Korean Academy of Nursing, 30(1), 60-71.
17 Hamers, J. P., & Huizing, A. R. (2005). Why do we use physical restraints in the elderly. Zeitschrift fur Gerontologie und Geriatrie, 38(1), 19-25.   DOI   ScienceOn
18 Evans, D., & FitzGerald, M. (2002). Reasons for physically restraining patients and residents: a systematic review and content analysis. International Journal of Nursing Studies. 39(7). 735-743.   DOI   ScienceOn
19 Cho, Y. A., Kim, J. S., Kim, N. R., Choi, H. J., Cho, J. G., Lee, H. J., et al. (2006). A Study on the use of physical restraints in ICDs. Journal of Korean Academy of Adult Nursing, 18(4), 543-552.
20 Choi, E. H. (1999). A study on the use of physical restraint in an ICU. Unpublished master's thesis, Seoul National University, Seoul.
21 Janeli, L. M., Stamps, D., & Delles, L. (2006). Physical restraint use: A nursing perspective. Journal of the Academy of Medical-Surgical Nurses, 15(3). 163-167.
22 Kim, S., Lee, Y., Kim, D., Kim, S. Y., Ahn, H. Y., & Yu, S. J. (2009). Perception, attitude, and knowledge about physical restraints among nursing personnel in long term care facilities. The Journal of Korean Academic Society of Nursing Education, 15(1), 62-71.   과학기술학회마을   DOI
23 Health Care Financing Administration. (2001). Rules and regulation: Federal Register, 66(14), 7148-7164.
24 Hospital Nurses Association. (2005). Fall prevention guideline and summary. Retrieved November 13, 2009, from http://www.khna.or.kr/bbs/datalresource/khna_Fcare.pdf
25 Craven, R. F., & Hirnle, C. J.. (2008). Fundamentals of nursing. Philadelphia: Lippincott Williams & Wilkins.
26 Hamers, J. P., Meyer, G., Kopke, S., Lindenmann, R., Groven, R., & Huizing, A. R. (2009). Attitudes of dutch, german and swiss nursing staff towards physical restraint use in nursing home residents, a cross-sectional study. International Journal of Nursing studies, 46(2), 248-255.   DOI   ScienceOn
27 Demir, A. (2007). Nurses' use of physical restraints in four Turkish hospitals. Journal of Nursing Scholarship, 39(1), 38-45.   DOI   ScienceOn
28 Choi, E., & Song, M. (2003). Physical restraint use in Korean ICU. Journal of Clinical Nursing, 12(5), 651-659.   DOI   ScienceOn