ICU成人患者规范化身体约束证据总结  

Evidence summary for standardized physical restraint for adult patients in Intensive Care Unit

作　　者：曹锐[1] 胡芬[1] 朱小平[2] 靳英辉 王玲[4] 程晓琳[5] 邓澜[1] 丁新波[1] 李锦 谢博钦[6] CAO Rui;HU Fen;ZHU Xiaoping;JIN Yinghui;WANG Ling;CHENG Xiaolin;DENG Lan;DING Xinbo;LI Jin;XIE Boqin(Intensive Care Unit, Zhongnan Hospital of Wuhan University, Wuhan,430071, China)

机构地区：[1]武汉大学中南医院重症医学科,武汉市430071 [2]武汉大学中南医院护理部,武汉市430071 [3]武汉大学中南医院循证与转化医学中心,武汉市430071 [4]武汉大学中南医院过敏反应科,武汉市430071 [5]武汉大学中南医院呼吸内科,武汉市430071 [6]复旦大学护理学院

出　　处：《中国护理管理》2018年第12期1600-1607,共8页Chinese Nursing Management

基　　金：复旦大学循证护理中心证据转化与临床应用项目(Fudanebn201820)

摘　　要：目的 :检索、评价和总结ICU成人患者规范化身体约束的最佳证据,为临床医疗机构和医护人员开展规范化约束实践提供依据。方法 :检索国内外指南网、相关机构网站及数据库等,发表于2008-2018年的所有证据,包括指南、证据总结、推荐实践及系统评价,按照纳入和排除标准进行筛选,采用临床指南研究与评价系统(AGREEⅡ)与系统评价方法学质量评价工具AMSTAR 2进行质量评价。结果 :共筛选文献8篇,包括指南2篇、证据总结1篇、系统评价5篇,从决策层面、实施层面、教育层面和管理层面汇总证据共23条。结论:临床机构和医护人员应结合所在机构环境,规范患者身体约束管理,开展规范化约束实践,保证患者安全和降低患者身体约束使用率。Objective: To retrieve, assess and summarize the best available evidence on standardized physical restraint for adult patients in intensive care unit. Methods: We searched the NICE Guidance, Scottish Intercollegiate Guidelines Network (SIGN), Registered Nurses' Association of Ontario (RNAO), Guidelines International Network (GIN), National Guideline Clearinghouse (NGC), Society of Critical Care Medicine (SCCM), Pubmed, UpToDate, BMJ best practice, Cochrane Library, CNKI, Wanfang Data and OVID. The literature including guidelines, evidence summary, recommended practice and systematic review between 2008-2018 were collected. Results: Eight references were enrolled including two guidelines, one evidence summary and five systematic reviews. Four areas including 23 items of evidence were summarized, including decision-making, implementation, education and management. Conclusion: Healthcare organizations and clinical staff should make relevant policy for implementing physical restraint and carry out standardized intervention to ensure patients' safety as well as decreasing the rate of physical restraint applications.

关 键 词：重症监护室 身体约束 循证护理 证据总结 

分 类 号：R47[医药卫生—护理学]