Physical restraint: experiences, attitudes and opinions of adult intensive care unit nurses

Background Evidence indicates that open visitation in adult intensive care units is a best practice for patient- and family-centered care, and nurses substantially influence such visitation patterns. However, it is unclear whether intensive care units in Magnet and Pathway to Excellence (MPE) facilities nationwide implement this in practice. Objective To describe current national visitation practices in adult intensive care units and determine whether they have changed since the last national study, which used data from 2008 to 2009. Methods From February through April 2018, websites of MPE hospitals were reviewed in order to identify their adult intensive care unit visitation policy. If this information was unavailable online, the hospital was telephoned to obtain the policy. From May through August 2018, follow-up telephone calls were made to hospitals that reported open visitation, during which intensive care unit nurses at the hospitals were asked to verify that the policy did not restrict visiting hours or the number, type, or age of visitors. Results Among the 536 MPE hospitals contacted, 51% (n = 274) indicated that they allowed open visitation. Further examination, however, revealed that 64% (n = 175) restricted the number (68.2%), age (59.5%), or type (4.4%) of visitors, or visiting hours (19.8%). Only 18.5% of MPE hospitals (n = 99) allowed unrestricted visitation. Conclusion This study suggests a lack of progress toward implementing open visitation in adult intensive care units nationwide. Research on MPE hospitals that have adopted truly open visitation policies is needed to identify successful methods for implementing and sustaining open visitation.

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Physical Restraint in Adult Intensive Care Unit - Why and how are they used?

Bangladesh Critical Care Journal ◽

10.3329/bccj.v4i2.30027 ◽

2016 ◽

Vol 4 (2) ◽

pp. 110-113

Author(s):

Sushil Khanal ◽

Subhash Prasad Acharya

Keyword(s):

Intensive Care Unit ◽

Patient Safety ◽

Intensive Care ◽

Patient Autonomy ◽

Physical Restraint ◽

Evidence Based ◽

Adult Intensive Care Unit ◽

Risk Of Injury ◽

Ensure Patient Safety ◽

Evidence Based Guidelines

Background: Physical restraint is preferred practice in adult critical care to reduce the risk of injury and ensure patient safety. However, data on the extent of restraint practice intensive care unit is unknown in our setting to develop evidence based guidelines to promote the scientific use of this modalityMethods: This observational study was conducted for determining the prevalence, motives and ongoing practices of physical restraint. Data were collected from direct observation of physically restrained patients, review of patients record and from the nursing staff.Results: The results revealed that physical restraint was commonly used to prevent device dislodgment and to ensure patient safety. The results illustrated a lack of documentation on initiation and monitoring of use physical restraint.Conclusion: For a better care of patients, it is very important to develop a restraint policy for rational use of physical restrain respecting the patient autonomy and freedom.Bangladesh Crit Care J September 2016; 4 (2): 110-113

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Knowledge, attitude and practice of intensive care unit nurses about physical restraint

Nursing in Critical Care ◽

10.1111/nicc.12303 ◽

2017 ◽

Vol 22 (5) ◽

pp. 264-269 ◽

Cited By ~ 15

Author(s):

Mohammad Suliman ◽

Sami Aloush ◽

Khitam Al-Awamreh

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Physical Restraint ◽

Attitude And Practice ◽

Intensive Care Unit Nurses ◽

Knowledge Attitude And Practice

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Accuracy of delirium risk factors in adult intensive care unit patients

Revista da Escola de Enfermagem da USP ◽

10.1590/1980-220x-reeusp-2021-0222 ◽

2022 ◽

Vol 56 ◽

Author(s):

Luciana Aparecida Costa Carvalho ◽

Marisa Dibbern Lopes Correia ◽

Ráisa Camilo Ferreira ◽

Micnéias Lacerda Botelho ◽

Elaine Ribeiro ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Physical Restraint ◽

Tissue Perfusion ◽

Accurate Identification ◽

Adult Intensive Care Unit ◽

Sample Characterization ◽

American Society ◽

Predictive Risk

Abstract Objective: To assess the accuracy measurements for predisposing and precipitating Risk Factors for delirium in an adult Intensive Care Unit. Method: Cohort, prospective study with patients over 18 who had been hospitalized for over 24 hours and were able to communicate. The patients were assessed once a day until the onset of delirium or permanence in the Intensive Care Unit. Instruments were employed to track delirium, characterize the sample, and identify the risk factors. Descriptive statistics was employed for sample characterization and accuracy tests for risk factors. Results: The included patients amounted to 102, 31 of which presented delirium. The predisposing predictive risk factors were hypoalbuminemia, American Society of Anesthesiology over three, severity, altered tissue perfusion, dehydration, and being a male, whereas precipitating predictive factors were physical restraint, infection, pharmacological agent, polypharmacy, anemia, altered renal function, dehydration, invasive devices, altered tissue perfusion and altered quality and quantity of sleep. Conclusion: An accurate identification of predisposing and precipitating risk factors may contribute to planning preventive measures against delirium.

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The evaluation of intensive care unit nurses' opinions on physical restraint application

Van Medical Journal ◽

10.5505/vtd.2018.78941 ◽

2018 ◽

Vol 25 (1) ◽

pp. 11-16 ◽

Cited By ~ 1

Author(s):

Gülşen Kılıç ◽

Sevinç Kutlutürkan ◽

Banu Çevik ◽

Bülent Erdoğan

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Physical Restraint ◽

Intensive Care Unit Nurses

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Empowering critical care nurses to improve Compliance with protocols in the intensive care unit

American Journal of Critical Care ◽

10.4037/ajcc2007.16.2.153 ◽

2007 ◽

Vol 16 (2) ◽

pp. 153-156 ◽

Cited By ~ 13

Author(s):

Gerald Plost ◽

Delores Privette Nelson

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Compliance Rate ◽

Critical Care Nurses ◽

Evidence Based ◽

Audit Tool ◽

Adult Intensive Care Unit ◽

Improve Compliance ◽

Intensive Care Unit Nurses

•Background Practitioners often do not comply with evidence-based protocols. •Objective To improve compliance with evidence-based protocols in an intensive care unit. •Methods A baseline compliance range was obtained by using a sampling of 9 protocols for a 100% audit of 35 beds in an adult intensive care unit. Nurses were given positive rewards to promote an initiative to improve compliance with protocols. The original audit tool was used to assess compliance at intervals during a trial period and for a follow-up audit 3 years after implementation of the initiative. •Results One month after the initiative was started, compliance with protocols increased from a range of 62% to 77% to a compliance of almost 90%. Within 4 months, the compliance rate increased to a mean of more than 95%. Three years later, the compliance rate was greater than 90%. •Conclusion Extrinsic rewards improved compliance with protocols and resulted in a change in the culture in the intensive care unit that had a cumulative outcome.

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