The characteristics of ICU physical restraint use and related influencing factors in China: a multi-center study

Background: The use of physical restraint has been a common phenomenon in clinical practice. However, the current status of physical restraints in intensive care unit (ICU) patients and related potential factors in China remains unclear. We aimed to evaluate the status of physical restraint use of patients in ICU, and to identify the potential factors affecting the physical restraint use. Methods: Patients in 16 ICUs of five hospitals from September 15 to October 15, 2019 were included. The ICU Patients' Physical Restraint Evaluation Scale was used for survey investigation. The basic information, the behavioral, treatment and muscle strength level with 35 detailed items were collected and evaluated. Multivariate logistic regression analyses were performed to identify the potential risks of physical restraint use. Results: A total of 386 ICU patients were included, the incidence of physical restraint use was 59.07%. The incidence of physical restraint uses in patients with irritability, unconsciousness and disorientation, Richmond agitation-sedation scale (RASS) >= 2 or -3< RASS <2 were significantly higher that other conditions (all P<0.05); the incidence of physical restraint uses in patients with continuous renal replacement therapy (CRRT), temporary pacemaker, intracranial pressure (ICP) monitor, invasive blood pressure monitoring, tracheotomy, central venous catheter (CVC), extracorporeal membrane oxygenation (ECMO), peripheral intravenous infusion were significantly higher that other conditions (all P<0.05); the male gender, mechanical ventilation, retained catheters or tubes with level II or irritability were the independently influencing factors for the physical restraint use (all P<0.05). Conclusions: The incidence of physical restraint use is rather high in ICU, clinical attentions are needed especially for those patients with male gender, mechanical ventilation, retained catheters or tubes with level II or irritability.