神经内外科重症监护病房患者身体约束使用的现状及特征的调查分析

A survey of status and characteristics of physical restraints in ICU of neurosurgery department

目的了解神经重症监护室身体约束的使用现状,分析影响患者约束的患者自身因素,为规范临床护士身体约束的使用提供依据。方法采用便利抽样法,于2018年8月至11月对本院神经内外科患者一般资料进行调查,并分析影响因素。结果128例患者中103例受到身体约束,神经监护室总体身体约束率为80.5%,以双上肢约束为主(73.8%),护士约束理由以预防患者意外拔管为主(40.7%);多因素分析结果显示,入科格拉斯哥昏迷评分越高、住院时间越长和有高危管道的患者接受身体约束可能性更高。结论神经重症监护室约束使用率较高,ICU护士需对入科患者意识状态、活动能力进行早期科学评估和决策,以促进约束的合理使用。

Objective To understand the current situation of physical restraints in ICU of neurosurgery department and analyze the influencing factors so as to provide a basis for standardizing physical restraints.Methods A prospective survey was conducted in neurosurgery department of a general hospital during August to November,2018.Data on age,gender,GCS score,sedative drug use,patient restraint sites and nurses'restraint motivation were collected.Univariate and multivariate logistic analyses were done to look into the individual factors affecting patient restraint.Results 103 of 128 patients were restrained.The overall physical restraint rate was 80.5%in the ICU,with upper limb restraint as the main reason(73.8%).The purpose for nurse restraint was to prevent accidental extubation(40.7%).Multivariate analysis showed that patients with higher GCS score and longer hospitalization time were more likely to be treated with physical restraint.Conclusions The utilization rate of restraint in ICU of neurosurgery department is high.ICU nurses need to make early scientific evaluation and decision on the consciousness and activity ability of patients in order to promote the rational use of restraint.