看護とケアのジャーナル

Physical Restraints in Critical Care Units: Impact of a Training Program on Nurses' Knowledge and Practice and on Patients' Outcomes

Abstract

Nadia M Taha and Zeinab H Ali

The use of physical restraints is a common practice in various clinical settings, especially in intensive care units (ICUs). The aim of this study was to improve nurses’ knowledge and practice regarding physical restraining, with the ultimate goal of reducing the number of consequent complications among ICU patients. A quasi-experimental design with pre-post assessment was used on 38 nurses working in the ICUs and Critical Care Medicine at the Zagazig University Hospitals and 100 patients under their care. A self-administered questionnaire was used to assess nurses’ knowledge, an observation checklist for their practice, and a physical assessment sheet for patients. The researcher developed a training intervention based on analysis of assessment data and using pertinent literature to teach nurses guidelines for dealing with restrained patients. This was delivered to nurses in 7 sessions. Evaluation was done immediately (post-test), and two months after implementation (follow-up), along with evaluation of the patients. The results showed marked deficiencies in nurses’ knowledge and practices before the program, with significant improvements at the post and follow-up evaluations. Additionally, statistically significant improvements were revealed in patients’ signs and physical findings, with much less complications. Therefore, a relatively short-term in-service training in guidelines can significantly improve nurses’ knowledge and practice concerning physical restraining of ICU patients, with subsequent reductions in the frequency of related complications among these patients. Therefore, these guidelines should be adopted and its booklet should be available in each department using restraint in the hospital.