危重病人身体约束核查单的设计及在ICU中的应用

Design of physical restraint checklist for critical patients and its application in ICU

目的:设计危重病人身体约束核查单,并观察其在重症加强护理病房(ICU)中的应用效果。方法:通过查阅指南及相关文献,设计危重病人身体约束核查单。随机选取60例住院病人作为研究对象,其中2017年10-12月30例病人作为对照组,2018年1-3月30例病人作为观察组。对照组由责任护士根据工作经验、留置管道、病人躁动等实际情况,预见性的为病人选择合适的约束工具及约束部位;观察组由责任护士根据核查单评估病人基本情况后,给予病人实施规范化、合理化的身体约束。比较2组病人身体约束使用率、约束部位皮肤损伤情况及约束时间。结果:运用核查单评估后,观察组病人身体约束使用率、约束部位皮肤损伤发生率、约束时间均较对照组下降(P<0.05)。结论:将核查单应用于ICU病人身体约束的质量管理中,可减少危重病人的身体约束时间和约束部位皮肤损伤的发生,降低病人的身体约束使用率,值得在临床推广和应用。

Objective:To design the physical crestraint checklist for critical patients,and observe its application effect in intensive care unit(ICU).Methods:The physical crestraint checklist in critical patients was designed by consulting the guide and related literature.Thirty inpatients from October to December 2017 and 30 patients from January to March 2018 were divided into the control group and observation group,respectively.In the control group,the responsible nurses predictably selected suitable restraint tools and restraint sites for the patients according to their work experience,indwelling pipelines,patients′agitation and other actual conditions.In the observation group,the responsible nurses assessed the basic situation of the patients according to the checklist,and then gave the patients standardized and rationalized physical restraint.The usage rate of physical restraint,skin injury at restraint site and duration of physical restraint between two groups were compared.Results:After the effects of using checklist was assessment,the usage rate of physical restraint,skin injury at restraint site and duration of physical restraint in observation group decreased compared with the control group(P<0.05).Conclusions:The application of physical restraint checklist in the quality management of ICU patients′physical restraint can reduce the time of physical restraint,occurrence of skin injury at restraint site and usage rate of physical restraint in critical patients,which is worthy of clinical promotion and application.