住院患者身体约束临床实践指南的内容分析
|
摘要
目的对身体约束临床实践指南进行内容分析,为临床开展基于证据的身体约束合理化实践和构建适于我国国情的临床实践指南提供参考。方法计算机检索国内外数据库、指南网站,检索时限从建库至2018年5月,纳入已发布的身体约束临床实践指南或共识,采用内容分析法对纳入指南的相关内容进行分析。结果最终纳入8部指南,析出适用原则、身体约束实践建议、减少约束策略3个层面20项身体约束推荐意见。结论现有的身体约束指南对临床实践有一定的指导意义,但其部分推荐意见不明确,且未能及时更新,可能会造成身体约束的不合理应用。应以我国国情为基础,整合证据,构建出适合我国国情的身体约束临床实践指南。
Objective To analyze the content of clinical practice guidelines regarding the use of physical restraints,and to provide references for clinical practice of evidence-based physical restraints utilization and the construction of clinical practice guidelines suitable for China's national conditions. Methods We searched clinical practice guidelines or consensus statement regarding the use of physical restraints published as of May 2018 in electronic databases and guideline websites. Then the included clinical practice guidelines or consensus statement on physical restraints were analyzed by content analysis method. Results Eight guidelines were included,and three themes were extracted: applicable principles,practice suggestions on physical restraints,and strategies for reducing use of restraints,totaling 20 recommendations. Conclusion The existing physical restraints guidelines are helpful to guide clinical practice,but some of their recommendations are unclear and not updated in time,which may lead to inappropriate application of physical restraints. Based on China's national conditions,the evidence should be integrated to construct a clinical practice guideline of physical constraints suitable for China's national conditions.
Objective To analyze the content of clinical practice guidelines regarding the use of physical restraints,and to provide references for clinical practice of evidence-based physical restraints utilization and the construction of clinical practice guidelines suitable for China's national conditions. Methods We searched clinical practice guidelines or consensus statement regarding the use of physical restraints published as of May 2018 in electronic databases and guideline websites. Then the included clinical practice guidelines or consensus statement on physical restraints were analyzed by content analysis method. Results Eight guidelines were included,and three themes were extracted: applicable principles,practice suggestions on physical restraints,and strategies for reducing use of restraints,totaling 20 recommendations. Conclusion The existing physical restraints guidelines are helpful to guide clinical practice,but some of their recommendations are unclear and not updated in time,which may lead to inappropriate application of physical restraints. Based on China's national conditions,the evidence should be integrated to construct a clinical practice guideline of physical constraints suitable for China's national conditions.
引文
[1]Benbenbishty J,Adam S,Endacott R.Physical restraint use in intensive care units across Europe:the PRICE study[J].Intensive Crit Care Nurs,2010,26(5):241-245.
[2]Chang L Y,Wang K W,Chao Y F.Influence of physical restraint on unplanned extubation of adult intensive care patients:a case-control study[J].Am J Crit Care,2008,17(5):408-415.
[3]Curry K,Cobb S,Kutash M,et al.Characteristics associated with unplanned extubations in a surgical intensive care unit[J].Am J Crit Care,2008,17(1):45-51.
[4]Evans D,Wood J,Lambert L.Patient injury and physical restraint devices:a systematic review[J].J Adv Nurs,2003,41(3):274-282.
[5]Jones C,Bckman C C,Capuzzo M,et al.Precipitants of post-traumatic stress disorder following intensive care:a hypothesis generating study of diversity in care[J].Intensive Care Med,2007,33(6):978-985.
[6]么莉,冯志仙,朱宗蓝,等.护理敏感质量指标实用手册(2016版)[M].北京:人民卫生出版社,2016:138-156.
[7]邹菲.内容分析法的理论与实践研究[D].武汉:武汉大学,2004.
[8]Australian and New Zealand Society for Geriatric Medicine.Australian and New Zealand Society for Geriatric Medicine Position Statement-Physical restraint use in older people[EB/OL].(2016-05-25)[2018-05-01].http://www.anzsgm.org/documents/PositionStatementNo2 PhysicalRestraintuseinOlderPeopleRevise dSept2012_000.pdf.
[9]Bray K,Hill K,Robson W,et al.British Association of Critical Care Nurses position statement on the use of restraint in adult critical care units[J].Nurs Crit Care,2004,9(5):199-212.
[10]Maccioli G A,Dorman T,Brown B R,et al.Clinical practice guidelines for the maintenance of patient physical safety in the intensive care unit:use of restraining therapiesAmerican College of Critical Care Medicine Task Force2001-2002[J].Crit Care Med,2003,31(11):2665-2676.
[11]Lach H W,Leach K M,Butcher H K.Evidence-based Practice Guideline:changing the practice of physical restraint use in acute care[J].J Gerontol Nurs,2016,42(2):17-26.
[12]Registered Nurses'Association of Ontario(RNAO).Promoting safety:alternative approaches to the use of restraints[EB/OL].(2016-05-04)[2018-05-01].https://rnao.ca/bpg/guidelines/promoting-safety-alternative-approaches-use-restraints.
[13]Hartford Institute for Geriatric Nursing.Physical restraints and side rails in acute and critical care settings(EB/OL)//Evidence-based geriatric nursing protocols for best practice.(2012-07-01)[2018-05-01].https://consultgeri.org/geriatric-topics/physical-restraints#deeper-reading.
[14]Joanna Briggs Institute.Best Practice Evidence Based Practice Information Sheets for Health Professionals Physical Restraint[EB/OL].(2002-06-03)[2018-05-01].http://ovidsp.tx.ovid.com.lib.ym.edu.tw/sp3.31.1b/ovidweb.cgi?&S=OPEJFPI-AEEDDJJAFNCEKHDLBEAGCAA00&Link+Set=.
[15]Mental Health Commission.Code of practice on the use of physical restraint in approved centres[EB/OL].(2009-10-04)[2018-05-01].https://www.mhcirl.ie/for_H_Prof/codemha2001/Use_of_Physical_Restraint/.
[16]Nunno M A,Holden M J,Tollar A.Learning from tragedy:a survey of child and adolescent restraint fatalities[J].Child Abuse Negl,2006,30(12):1333-1342.
[17]丁泓帆,杨楠,邓围,等.WHO指南制定的基本原则和方法[J].中国循证医学杂志,2016,16(4):471-477.
[18]杨春凤,王海燕,李萍,等.三甲医院ICU护士对患者实施身体约束护理现状调查[J].护理学杂志,2017,32(18):64-67.
[19]朱胜春,金钰梅,徐志红,等.ICU患者身体约束使用特征及护理现状分析[J].中华护理杂志,2009,44(12):1116-1118.
[20]王玲,朱小平,张春华,等.ICU护士对患者实施身体约束体验的质性研究[J].护理学杂志,2015,30(17):56-58.
[21]Turgay A S,Sari D,Genc R E.Physical restraint use in Turkish intensive care units[J].Clin Nurse Spec,2009,23(2):68-72.
[22]Shehabi Y,Riker R R,Bokesch P M,et al.Delirium duration and mortality in lightly sedated,mechanically ventilated intensive care patients[J].Crit Care Med,2010,38(12):2311-2318.
[2]Chang L Y,Wang K W,Chao Y F.Influence of physical restraint on unplanned extubation of adult intensive care patients:a case-control study[J].Am J Crit Care,2008,17(5):408-415.
[3]Curry K,Cobb S,Kutash M,et al.Characteristics associated with unplanned extubations in a surgical intensive care unit[J].Am J Crit Care,2008,17(1):45-51.
[4]Evans D,Wood J,Lambert L.Patient injury and physical restraint devices:a systematic review[J].J Adv Nurs,2003,41(3):274-282.
[5]Jones C,Bckman C C,Capuzzo M,et al.Precipitants of post-traumatic stress disorder following intensive care:a hypothesis generating study of diversity in care[J].Intensive Care Med,2007,33(6):978-985.
[6]么莉,冯志仙,朱宗蓝,等.护理敏感质量指标实用手册(2016版)[M].北京:人民卫生出版社,2016:138-156.
[7]邹菲.内容分析法的理论与实践研究[D].武汉:武汉大学,2004.
[8]Australian and New Zealand Society for Geriatric Medicine.Australian and New Zealand Society for Geriatric Medicine Position Statement-Physical restraint use in older people[EB/OL].(2016-05-25)[2018-05-01].http://www.anzsgm.org/documents/PositionStatementNo2 PhysicalRestraintuseinOlderPeopleRevise dSept2012_000.pdf.
[9]Bray K,Hill K,Robson W,et al.British Association of Critical Care Nurses position statement on the use of restraint in adult critical care units[J].Nurs Crit Care,2004,9(5):199-212.
[10]Maccioli G A,Dorman T,Brown B R,et al.Clinical practice guidelines for the maintenance of patient physical safety in the intensive care unit:use of restraining therapiesAmerican College of Critical Care Medicine Task Force2001-2002[J].Crit Care Med,2003,31(11):2665-2676.
[11]Lach H W,Leach K M,Butcher H K.Evidence-based Practice Guideline:changing the practice of physical restraint use in acute care[J].J Gerontol Nurs,2016,42(2):17-26.
[12]Registered Nurses'Association of Ontario(RNAO).Promoting safety:alternative approaches to the use of restraints[EB/OL].(2016-05-04)[2018-05-01].https://rnao.ca/bpg/guidelines/promoting-safety-alternative-approaches-use-restraints.
[13]Hartford Institute for Geriatric Nursing.Physical restraints and side rails in acute and critical care settings(EB/OL)//Evidence-based geriatric nursing protocols for best practice.(2012-07-01)[2018-05-01].https://consultgeri.org/geriatric-topics/physical-restraints#deeper-reading.
[14]Joanna Briggs Institute.Best Practice Evidence Based Practice Information Sheets for Health Professionals Physical Restraint[EB/OL].(2002-06-03)[2018-05-01].http://ovidsp.tx.ovid.com.lib.ym.edu.tw/sp3.31.1b/ovidweb.cgi?&S=OPEJFPI-AEEDDJJAFNCEKHDLBEAGCAA00&Link+Set=.
[15]Mental Health Commission.Code of practice on the use of physical restraint in approved centres[EB/OL].(2009-10-04)[2018-05-01].https://www.mhcirl.ie/for_H_Prof/codemha2001/Use_of_Physical_Restraint/.
[16]Nunno M A,Holden M J,Tollar A.Learning from tragedy:a survey of child and adolescent restraint fatalities[J].Child Abuse Negl,2006,30(12):1333-1342.
[17]丁泓帆,杨楠,邓围,等.WHO指南制定的基本原则和方法[J].中国循证医学杂志,2016,16(4):471-477.
[18]杨春凤,王海燕,李萍,等.三甲医院ICU护士对患者实施身体约束护理现状调查[J].护理学杂志,2017,32(18):64-67.
[19]朱胜春,金钰梅,徐志红,等.ICU患者身体约束使用特征及护理现状分析[J].中华护理杂志,2009,44(12):1116-1118.
[20]王玲,朱小平,张春华,等.ICU护士对患者实施身体约束体验的质性研究[J].护理学杂志,2015,30(17):56-58.
[21]Turgay A S,Sari D,Genc R E.Physical restraint use in Turkish intensive care units[J].Clin Nurse Spec,2009,23(2):68-72.
[22]Shehabi Y,Riker R R,Bokesch P M,et al.Delirium duration and mortality in lightly sedated,mechanically ventilated intensive care patients[J].Crit Care Med,2010,38(12):2311-2318.