神经外科身体约束管理的系统评价

Systematic review of physical restraint management in neurosurgery

目的系统评价神经外科身体约束相关文献,为神经外科医务人员规范化身体约束提供参考。方法计算机检索Cochrane Library、PubMed、Web of Science、CINAHL、WANFANG、CNKI、CBM等中英文数据库,收集关于神经外科身体约束的原始研究。采用2017版JBI相关原始研究质量评价标准进行文献质量评价,进行描述性汇总分析。结果纳入16篇文献:5篇随机对照试验,4篇类实验研究,5篇现况调查,1篇队列研究,1篇质性研究。分析结果显示,神经外科身体约束率高(19.7%~76.5%),身体约束评估工具有待统一,身体约束对病人造成身心不良影响,护士巡视、记录的意识需加强,神经外科护士和病人的身体约束知信行有待提高。结论神经外科身体约束的管理有待加强,需根据循证证据结合临床具体情况完善身体约束相关制度,提高神经外科身体约束护理质量,改善患者结局。

Objective To provide a standard management of the patients'physical restraint for neurosurgical staffs.Methods The databases including Cochrane Library,PubMed,CINAHL and so on were systematically searched for the original studies about the physical restraint in neurosurgery.The quality of the original studies was assessed by the original research quality evaluation criteria of JBI(2017).The descriptive summary analysis was performed.Results Of 16 original studies were acquired from the above-mentioned databases,5 were randomized controlled trials,4 quasi-experimental studies,5 prevalence surveys,1 cohort study and 1 qualitative study.The physical restraint rate in the neurosurgery ranged from 19.7%to 76.5%.The inconsistent physical restraint assessment tools were used by the original studies.The studies showed that the physical restraint had some adverse physical and mental effects on the patients.Nurses'awareness of inspection and recording needed to be strengthened.The neurosurgical nurses needed to be improved in the and patients,knowledge and practice of physical restraint.Conclusions The management of physical restraints in the neurosurgical department needs to be strengthened.It is necessary to improve the systems related to the physical restraints according to the best evidence combined with the specific department'conditions in order to improve the quality of the physical restraint nursing and the patients`outcomes in the neurosurgery.