基于团体标准的约束干预策略在ICU患者中的应用

Effects of restraint strategy based on group standards in ICU patients

目的探讨基于团体标准的约束干预策略在ICU患者中的应用效果。方法采用便利抽样法,选取2020年12月—2021年4月入住河南省人民医院的385例ICU患者为研究对象。将2020年12月—2021年1月入住的202例患者设为对照组,将2021年2—4月入住的183例患者设为观察组。对照组实施常规的身体约束干预,观察组实施基于团体标准的约束干预策略。比较两组患者身体约束情况、约束相关不良事件发生率及身体约束措施改进后ICU护士的身体约束实践行为问卷和身体约束认知问卷的评分情况。结果观察组患者的身体约束时间短于对照组,身体约束率、肢端水肿发生率、肢端淤紫发生率、不良事件总发生率均低于对照组,差异均有统计学意义(P<0.05)。身体约束措施改进后,ICU护士的身体约束实践行为问卷、身体约束认知问卷评分均高于改进前,差异均有统计学意义(P<0.05)。结论基于团体标准的约束干预策略可提高ICU护士对患者身体约束的实践能力及认知水平,可有效缩短ICU患者身体约束时间,减少不必要的身体约束,降低不良事件的发生率,在ICU患者身体约束管理中的应用效果良好。

Objective To explore the effect of restraint strategies based on group standars in Intensive Care Unit(ICU)patients.Methods From December 2020 to April 2021,385 ICU patients admitted to Henan Provincial People's Hospital were selected by convenience sampling as the research object.The 202 patients admitted from December 2020 to January 2021 were set as the control group,and the 183 patients admitted from February to April 2021 were set as the observation group.The control group implemented routine physical restraint,and the observation group carried out the restraint strategy based on group standards.The physical restraint,the incidence of restraint-associated adverse events between the two groups,the scores of ICU nurses'Physical Restraint Practice Behavior Questionnaire and Physical Restraint Cognition Questionnaire after the improvement of physical restraint measures were compared.Results The physical restraint time of patients in the observation group was shorter than that in the control group,and the physical restraint rate,the incidence of acral edema,the incidence of acral bruising,and the total incidence of adverse events were all lower than those in the control group,and the differences were statistically significant(P<0.05).After the improvement of the physical restraint measures,the scores of ICU nurses'Physical Restraint Practice Behavior Questionnaire and Physical Restraint Cognitive Questionnaire were higher than those before the improvement,and the differences were statistically significant(P<0.05).Conclusions The restraint strategy based on group standards can improve the practical ability and cognitive level of ICU nurses on physical restraint of patients,and can effectively shorten the physical restraint time of ICU patients,reduce unnecessary physical restraints and the incidence of adverse events.It has a good effect in the management of ICU patients'physical restraint.