• 제목/요약/키워드: Physical restraint

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신체적 억제대 지침 개발 및 사용 효과 (Development of physical restraints guidelines and use effect)

  • 정윤중;김혜현;김은한;김지연;차세정;김유진;강정은;정연화;정영선;김영환;경규혁;홍석경
    • 한국의료질향상학회지
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    • 제20권1호
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    • pp.42-57
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    • 2014
  • Objective: The objective of this research was to develop a guideline for more effective use of physical restraint on patients in the intensive care unit and training the nurses on it and applying it on clinical practice to assess its effectiveness. Method: This research analyzed the before and after effect of the development of a guideline for physical restraint by dividing the category into nurse and patient. In the case of nurse, a comparison of knowledge and nursing service regarding the use of physical restraint from before the training on physical restraint guideline(Jan. 2011) and after the training on physical restraint guideline(Dec. 2011) was made. In the case of patient, a comparison of physical restraint usage rate and average usage time, the number of unplanned extubation cases were compared from before the use of physical restraint (Jan.~Apr. 2011) and after the use of physical restraint (Sep.~Dec. 2011) were made. Result: After the training on the physical restraint guideline, the knowledge of the nurse and the nursing practice showed notable improvement by (p<0.000) and (p<0.048) respectively and in patient, physical restraint usage rate and average time of usage decreased by (p<0.001) and (p<0.001) respectively. And despite the decrease in the number of cases in which the physical restraint was used, the number of unplanned extubation cases remained the same. Conclusion: Physical restraint guideline training and guideline usage can be stated to have brought out positive effect in both the nurse and patient. In order to maintain such positive effects, continuous training is necessary and continuous revaluation is necessary, regarding knowledge and nursing practices.

병원 간호현장에서의 억제대 사용실태에 관한 연구 (The Physical Restraint Use in Hospital Nursing Situation)

  • 김기숙;김진희;이선희;차혜경;신수정;지성애
    • 대한간호학회지
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    • 제30권1호
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    • pp.60-71
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    • 2000
  • This research is a field investigation to collect basic information about the safe and efficient use of physical restraint in hospitals and for the ultimate minimization of restraint use. The objects of this study were sixty-four patients. They were restrained physically. Add their 32 family members, 24 nurses of two university hospitals in Seoul were also involved in the study. From April 16, to May 27, 1999. Research data were collected throughout the observation and interview process. Also, the data was analyzed using frequencies and field study notes that were invented by researchers. Results of this study were as follows: 1. According to the sex and age distinction; male's restraint use was 75%, female's was 25% and pre-schoolage children 39.1%, middle age 26.5%, and senior citizens 20.3%. According to the disease distinction; neuro-system was 35.9%, respiratory system was 21.9%. In the Ward, 40.6% of ICU patients were restrained and 39.0% of pediatric ward children were also to restraint. 70.3% of patients were restrained under 5days, while 10.9% were restrained 10days. 2. Types of physical restraints were wrist restraint (45.21%), arm board (35.62%), leg restraint (8.22%), chest restraint (6.85%), elbow restraint (2.74%) and mitten restraint (1.37%). 3. The percentage was 3.5%, which was in 64 restrained out of 1828 hospitalized people. At 1st investigation, the ratio was 3.5%, the 2nd was 3.0% and the 3rd was 3.9%. 4. The reasons of using the physical restraint were 'to protect implements' (72.84%), 'to protect patients' (18.52%), 'to protect an operative site' (8.64%). 5. The result of the patients; family and nurses' response analysis was: 'It seems to be safe', 'It uses properly', 'It is convenient for relatives and nurses', 'It is helpful to treatment', 'Objective think it is not restraint' were 79.9%. 'It is discomfort and stuffy', 'The implement is ineffective' were 21.1%. However in interview of the patients who can do verbally communication, 6 of 7 was responded that 'It is stuffy and uncomfortable'. 6. When restraint is used, the main decision is usually made by the nurses 42.2% of the time. The statistics read as thus: nurses and the physician in charge 31.3%, nurses and family 12.5%, physician's order 7.8%, only family 6.2%. Although the record of restraint was only 15.6% so that only 10 cases out of all the 26 ICU patients restrained. This study shows that physical restraints which of infringe independent-right of patients, are used without using criterion, explaining the agreement. Also, subjective decision of physician, nurses, and family make the decision of using restraint. So development of practice manuals and rules for restraint implementation is urgent.

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중환자실 간호사의 신체보호대 간호수행의 영향요인 (Factors Influencing Nursing Practice for Physical Restraints among Nurses in the Intensive Care Unit)

  • 김다은;민혜숙
    • 중환자간호학회지
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    • 제15권3호
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    • pp.62-74
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    • 2022
  • Purpose : This study aimed to identify the factors influencing physical restraint-related practice among nurses working in the intensive care unit (ICU). Methods : The participants consisted of 169 ICU nurses in three general hospitals in B and U cities. Data were collected from December 2021 to January 2022 through a structured self-administered questionnaire. Demographic characteristics, physical restraint-related practice, Person-centered Critical Care Nursing (PCCN), work environment, and attitudes toward physical restraint use were measured. For data analyses, hierarchical multiple regressions were conducted using SPSS/WIN 25.0. Results : Clinical careers in the ICU, better work environments, higher PCCN levels, and more positive attitudes toward physical restraint use were associated with a better practice of physical restraints, which together explained 35.5% of the total variance of the outcome. Conclusion : Our findings suggest that to promote a safe physical restraint-related practice among ICU nurses, it is important to improve the nursing environment, prepare guidelines for applying PCCN, and provide education for endorsing positive attitudes toward the use of physical restraints.

중환자실 환자의 억제대 경험과정 (ICU Patients' Experience Process of Physical Restraint)

  • 김미영
    • 성인간호학회지
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    • 제19권4호
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    • pp.583-592
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    • 2007
  • Purpose: The purposes of this study were to explore and describe the use of restraint on patients and to generate a grounded theory of how the use of restraint affects patients who have been restrained. Methods: Interview data from seven patients with physical restraint was analyzed using the Strauss and Corbin's grounded theory method. Data were collected and analyzed simultaneously. Unstructured and in-depth interviews were conducted retrospectively with patients recalling their memories of ICU following their transfer to general unit. Results: 'Safety belt' was emerged as a core category and it reflected that physical restraint provided a sense of security to patients. On the basis of core category, a model of the experience process of restrained patients in ICU was developed. The experience process were categorized into four stages: resistance, fear, resignation, and agreement. Stages of these proceeds appeared to have been influenced by the nurses' attitude and caring behavior such as the frequency of nurse-patient interaction, repetition of explanation, and empathetic understanding. Conclusion: These findings indicate that patients have mixed feelings towards restraint use, although negative feelings were stronger than positive ones. The result of this study will help nurses make effective nursing intervention.

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신체억제대에 대한 일반인의 인식, 태도, 지식 및 교육경험과 교육요구도 조사 (Recognition, attitudes, knowledge, education experience, and education demand regarding physical restraint among laypersons)

  • 한다연;김철태
    • 한국응급구조학회지
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    • 제22권2호
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    • pp.7-22
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    • 2018
  • Purpose: This study aimed to investigate recognition, attitudes, knowledge, education experience, and education demand regarding physical restraint among laypersons. Methods: A self-reported questionnaire was completed by 105 randomly recruited laypersons in D city. Excluding 2 incomplete answers, 103 data were analyzed by frequency analysis, t-test, ANOVA, and chi-square test using SPSS 23.0. Results: Laypersons' recognition of physical restraints was rated at 3.37 out of 5 points, and showed a positive perspective. Knowledge on physical restraints was rated at 13.68 out of 18 points and was affected by age and education level (F = 2.845, p = .028)(F = 3.126, p = .029) A majority of the participants had no education on physical restraints. Nevertheless, participants showed intention to receive education in physical restraint to reach further understanding. Conclusion: Education on physical restraints is necessary for lay persons. However, there were education limits for people living in modern times. As an intervention addressing this problem, observing videos on the internet is recommended. Moreover, for advertising/educational purposes, accessing the internet and using smart-phone applications are suggested.

일 대학병원 중환자실의 억제대 사용실태 (A Study on the Application of Physical Restraints in Intensive Care Units)

  • 김미연;박정숙
    • 기본간호학회지
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    • 제17권2호
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    • pp.177-186
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    • 2010
  • 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.

중환자실 환자의 팔꿈치 억제대 개발 및 적용 평가 (The Development and Evaluation of the Elbow Restraint on Patients in Intensive Care Unit)

  • 이지은;구미옥
    • 임상간호연구
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    • 제17권1호
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    • pp.90-100
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    • 2011
  • Purpose: This paper was to develop an elbow restraint which can reduce the side effects of the wrist restraint which was frequently used in an intensive care unit and to evaluate its application. Methods: A nonequivalent control group non-synchronized design was used. Subjects were 38 patients (elbow restraint group: 18, wrist restraint group: 20) and 20 nurses who used both restraints in medical intensive care unit at G National University Hospital. Restraints were applied to subjects for 72 hours. Data were collected from December 1, 2009 through March 31, 2010. The data collected were analyzed using $x^2-test$, Fisher's exact test, t-test, and ANCOVA using SPSS 12.0 program. Results: Elbow restraint significantly decreased range of wrist motion reduction, swelling and significantly increased the convenience of wearing restraint compared to wrist restraint. Conclusion: The new elbow restraint are more efficient than the old wrist restraint, which have been used in an intensive care unit, in terms of convenience of restraint application, range of joint motion and prevention of swelling.

중환자실에서 피부손상을 감소시키기 위한 억제대 개발 및 적용효과 (Effect of a New Developed Physical Restraint to Reduce Skin Injury in Intensive Care Units)

  • 문정숙;이경남;이동숙
    • 기본간호학회지
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    • 제18권1호
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    • pp.28-36
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    • 2011
  • Purpose: The purpose of this study were to develop a new restraint for the intensive care units (ICU) and to investigate the application effect in comparison with a control group using existing restraints. Method: A non-equivalent control group non-synchronized quasi-experimental research design was used. The participants were 40 (control 20, experimental 20) patients who were recruited by convenience sampling the ICU of a university hospital. To avoid contamination of the experiment, data for the control group were collected prior to the experimental group. Measurement variables were edema and skin damage (redness and abrasion) at the application site, and nurses' perceived convenience in applying restraints. Results: Three days after applying the restraint, amount of edema at the application site was small and incidence of skin damage decreased in the experimental group in comparison with the control group. Also, score for application convenience measured by the nurses was higher in for the newly developed restraint than for existing restraints. Conclusion: Results indicate that the newly developed restraint has lower effects such as edema and skin damage and is more convenient compared with existing restraints, and is therefore recommended for patients in the ICU.

중환자실 환자의 물리적 억제대 적용 여부에 따른 신체손상, 정서반응, 우발적 치료기구 자가 제거 발생 비교 (Comparison of Physical Injury, Emotional Response and Unplanned Self-Removal of Medical Devices According to Use of Physical Restraint in Intensive Care Unit Patients)

  • 이미미;김금순
    • 임상간호연구
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    • 제18권2호
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    • pp.296-306
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    • 2012
  • Purpose: This study was done to compare the physical injury, emotional response and unplanned self-removal of medical devices in patients with physical restraints and patients not restrained. Methods: Eighty patients admitted to the intensive care unit (ICU) of a university hospital in Seoul participated in this study. Forty patients made up each group and the group not restrained was matched with the restraint group for age and history of smoking and alcohol consumption. Data on occurrence of physical injury, intensity of anxiety, stage of agitation and unplanned self-removal of medical devices were collected by observation and medical chart review using a structured instrument. Statistical processing of collected data was done with the SPSS WIN 17.0 program. Results: The physically restrained group experienced more physical injuries and recorded significantly higher levels of anxiety and agitation than the unrestrained group. However, there were no significant differences between the groups in occurrence of unplanned self-removal of medical devices. Conclusion: Results indicate a need for critical care nurses to carefully monitor physical injuries and emotional responses of physically restrained patients and to develop nursing interventions to prevent adverse effects associated with restraint use. There is also a need to develop patient safety guidelines when using physical restraints.

중소병원 간호사의 신체 억제대 사용에 대한 인식 (A Study on perceptions about physical restraint use of nurse in small and medium sized hospitals)

  • 김남석
    • 디지털융복합연구
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    • 제15권12호
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    • pp.581-590
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    • 2017
  • 본 연구는 300병상 미만 중소병원 간호사의 신체 억제대 사용에 대한 인식을 확인하기 위한 서술적 조사 연구이다. SPSS 통계프로그램을 사용하여 서술통계, t-test, ANOVA, factor analysis로 연구 분석을 하였다. 연구결과 간호사의 신체 억제대 사용 인식에 대한 전체 평균은($3.91{\pm}0.54$)으로 높은 인식률을 나타내었다. 요인분석 결과 '문제행동관리($3.81{\pm}0.67$)', '의료적 처치 유지($4.11{\pm}0.60$)', '환자안전($4.13{\pm}0.63$)' 3개의 요인으로 분류되었다. 신체 억제대를 사용하는 이유 중 가장 중요하다고 인식하는 항목은 침대에서 떨어지지 않도록 환자를 보호하기 위해($4.37{\pm}0.68$)로 환자안전이었다. 중소병원에서 근무하는 간호사의 신체 억제대 사용에 대한 특성과 요인을 파악하고, 신체 억제대 사용에 대한 정확한 이해를 바탕으로 최소한의 신체적 억제대 사용 및 환자의 안전과 권리보장에 대한 인식 필요하다. 그러므로 이를 위해 다양한 상황에서 사용하는 신체 억제대에 대한 직무교육이 필요하며, 간호업무 실정에 맞도록 교육 및 중재프로그램 개발이 요구된다.