Prevalence of use of physical restraints in pediatric intensive care units and correlated variables: A Spanish multicenter study

IF 4.9 2区医学 Q1 NURSING Intensive and Critical Care Nursing Pub Date : 2024-08-07 DOI:10.1016/j.iccn.2024.103788

Alejandro Bosch Alcaraz , Sylvia Belda Hofheinz , Jesús Corrionero Alegre , José Miguel García Piñero , Sonia Gil Domínguez , Rocío Fernández Lorenzo , María Mata Ferro , Ainhoa Martín Gómez , Marta Serradell Orea , Patricia Luna Castaño , M. Ángeles Saz Roy , Esperanza Zuriguel Pérez , Marta Martínez Oliva , Susana González Rivas , Nerea Añaños Montoto , María José Espildora González , Elena Martín-Peñasco Osorio , Eva Carracedo Muñoz , Eduardo López Fernández , Gema Lozano Almendral , Pedro Piqueras Rodríguez

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Abstract

Objective

To calculate the prevalence of physical restraint (PR) use in Spanish PICUs and (2) to analyze the correlation between the prevalence of PR use and the sociodemographic, clinical variables of the patients and the PICU structural and organizational variables.

Methods

We conducted a multicenter prevalence study from January 2022 to January 2023 in Spanish PICUs. The method of data collection was by direct observation, review of the patient’s medical history, and asking the professionals involved in the patient’s care. Three weekly 24-hour prevalence observations (morning, afternoon, and night) were conducted for 6 months.

Results

A total of 336 patients were included in the study, obtaining an overall crude prevalence of PR use of 16 % (95 %CI: 15 %-17.7 %). Pediatric patients with respiratory pathology received the highest number of hours of PR, with significant differences observed when comparing respiratory cases with post-surgical cases. Statistical significance was also observed when comparing the mean scores of hours of PR according to admission diagnosis (p = 0.01), with respiratory patients being the ones who were restrained the longest (24 h [20–24]) and infectious patients the least (15 h [14–20]). Patients who receive PR upon admission remain in this situation for more hours (24 h [15–24] and in the PICUs that specifically recorded PR application, fewer hours of PR occurred (20 h [4–24]).

Conclusions

The use of PR is still present in the PICUs analyzed, with a crude prevalence of 16%. Factors such as the reason for admission, the use of respiratory support, and the reason for application of PR were linked to the hours of use of PR.

Implications for clinical practice

Knowing the prevalence of PR use will make professionals aware that it is still necessary to implement policies that avoid its use to prevent the side effects they have in pediatric patients.

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儿科重症监护室使用人身限制措施的普遍性及相关变量：一项西班牙多中心研究。

目的计算西班牙 PICU 中使用物理约束（PR）的流行率；（2）分析使用物理约束的流行率与患者的社会人口学、临床变量以及 PICU 结构和组织变量之间的相关性：我们于 2022 年 1 月至 2023 年 1 月在西班牙 PICU 开展了一项多中心流行率研究。数据收集方法包括直接观察、回顾患者病史和询问参与患者护理的专业人员。在为期 6 个月的时间里，每周进行三次 24 小时流行观察（上午、下午和夜间）：研究共纳入 336 名患者，使用 PR 的总粗流行率为 16%（95%CI：15%-17.7%）。患有呼吸系统疾病的儿科患者接受 PR 的小时数最多，呼吸系统病例与手术后病例相比差异显著。根据入院诊断比较 PR 的平均时长也有统计学意义（p = 0.01），呼吸系统患者被限制的时间最长（24 小时 [20-24]），而感染性患者被限制的时间最少（15 小时 [14-20]）。入院时接受 PR 的患者被限制的时间更长（24 小时 [15-24]），而在专门记录 PR 使用情况的 PICU 中，被限制的时间更短（20 小时 [4-24]）：结论：在所分析的 PICU 中，仍存在使用 PR 的情况，粗略流行率为 16%。入院原因、使用呼吸支持和使用 PR 的原因等因素与使用 PR 的时数有关：对临床实践的启示：了解 PR 的使用率将使专业人员意识到，仍有必要实施避免使用 PR 的政策，以防止其对儿科患者产生副作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Intensive and Critical Care Nursing NURSING-

CiteScore

6.30

自引率

15.10%

发文量

144

审稿时长

57 days

期刊介绍： The aims of Intensive and Critical Care Nursing are to promote excellence of care of critically ill patients by specialist nurses and their professional colleagues; to provide an international and interdisciplinary forum for the publication, dissemination and exchange of research findings, experience and ideas; to develop and enhance the knowledge, skills, attitudes and creative thinking essential to good critical care nursing practice. The journal publishes reviews, updates and feature articles in addition to original papers and significant preliminary communications. Articles may deal with any part of practice including relevant clinical, research, educational, psychological and technological aspects.