Prevalence of and factors associated with physical restraint use in the intensive care unit: a multicenter prospective observational study in Japan

被引:12
作者
Kawai, Yusuke [1 ]
Hamamoto, Miya [2 ]
Miura, Atsuko [3 ]
Yamaguchi, Mayumi [4 ]
Masuda, Yukari [5 ]
Iwata, Maiko [6 ]
Kanbe, Miki [1 ]
Ikematsu, Yuko [7 ]
机构
[1] Fujita Hlth Univ Hosp, Dept Nursing, 1-98 Dengakugakubo,Kutsukake Cho, Toyoake, Aichi 4701192, Japan
[2] Tosei Gen Hosp, Dept Nursing, 160 Nishioiwake Cho, Seto, Aichi 4898642, Japan
[3] Toyohashi Municipal Hosp, Intens Care Unit, 50 Aza Hachiken Nishi,Aotake Cho, Toyohashi, Aichi 4418570, Japan
[4] Aichi Canc Ctr Hosp, Intens Care Unit, Chikusa Ku, 1-1 Kanokoden, Nagoya, Aichi 4648681, Japan
[5] Nagoya Med Ctr, Natl Hosp Org, Naka Ku, 4-1-1 Sannomaru, Nagoya, Aichi 4600001, Japan
[6] Nagoya City Univ Hosp, Dept Nursing, Mizuho Ku, 1 Kawasumi Mizuho Cho, Nagoya, Aichi 4678602, Japan
[7] Nagoya Univ, Grad Sch Med, Dept Nursing, Higashi Ku, 1-1-20 Daiko Minami, Nagoya, Aichi 4618673, Japan
关键词
Physical restraint; Intensive care unit (ICU); Prevalence; Associated factors;
D O I
10.1007/s11739-021-02737-5
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Physical restraint is widely used in the intensive care unit (ICU) to ensure patient safety despite its ethical implications. We performed a prospective observational study in six ICUs in Japan to determine the prevalence of and factors associated with physical restraint use in the ICU, a phenomenon that has not yet been reported on in Japan. Data were collected on 10 random days between November 2018 and February 2019. We evaluated physical restraint use in ICU patients aged >= 20 years during the data collection days. Among the 787 observations, the prevalence of physical restraint use was 32.9%; however, it was 41.5% in patients receiving invasive mechanical ventilation (IMV). The average age of patients was 68.5 years, and the average Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) II score was 19.4. Among the included patients, 52.1% received IMV, and 17.2% were diagnosed with delirium. Logistic regression analysis revealed that the independent factors [odds ratio (95% confidence interval)] associated with physical restraint use were age [1.02 (1.00-1.05)], APACHE II score [1.05 (1.01-1.09)], IMV [2.15 (1.16-4.01)], central venous catheter indwelling [2.66 (1.46-4.85)], sedative medication [2.98 (1.72-5.17)], agitation [7.83 (2.96-20.8)], and delirium [4.16 (2.37-7.29)]. Approximately one-third of the ICU patients required physical restraint in Japan. In addition, physical restraint use was influenced by disease severity, mental condition, and the medical apparatus used. Based on these findings, further investigations are imperative to develop strategies to reduce physical restraint use.
引用
收藏
页码:37 / 42
页数:6
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