基于循证护理方案的急诊ICU患者身体约束实施现状与启示  

Implementation status and enlightenment of physical restraint of emergency ICU patients based on evidence-based nursing program

作　　者：范华[1] 张华[2] 孙育红 保晶[4] 赵朋朋 裴秀芝 王美英 李信欣 张洪波[2] 张国强[2] 张留伟[5] 孙力超[2] FAN Hua;ZHANG Hua;SUN Yuhong;BAO Jing;ZHAO Pengpeng;PEI Xiuzhi;WANG Meiying;LI Xinxin;ZHANG Hongbo;ZHANG Guoqiang;ZHANG Liuwei;SUN Lichao(Emergency Department,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院儿科门急诊,北京100029 [2]中日友好医院急诊科,北京100029 [3]中日友好医院护理部,北京100029 [4]中日友好医院SICU,北京100029 [5]北京体育大学运动人体科学学院体质与健康教研室,北京100084

出　　处：《中国急救复苏与灾害医学杂志》2022年第5期663-667,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：国家科技课题(编号:2017zx10204401003003)。

摘　　要：目的探讨重症监护病房(ICU)患者身体约束循证实践护理方案在急诊科ICU患者的应用效果。方法采用目的抽样法,选取北京市中日友好医院急诊科ICU于2019年1月1日—2020年6月30日入院的患者为研究对象,按照循证护理方案“入门培训-巩固提高-专业加强”三阶梯推进规划分为入门组、巩固组和加强组,在约束率、替代约束率、替代方法等方面进行比较研究。结果三组间在约束率和替代约束率上差异有统计学意义(P<0.05),约束率分别为22.49%、16.96%、10.11%,替代约束率分别为12.44%、12.61%、13.48%;2019年1—6月组约束患者中清醒患者比例最高,为31.91%;2020年1-6月组替代约束方式最多,为8种。结论ICU患者身体约束循证实践护理方案在急诊科ICU的应用有效降低了患者约束率,提高了替代约束率。但在解除约束的动态评估、患者镇痛镇静管理和替代约束多样化方面存在不足,后续需进一步加强。Objective To explore the application effect of body restraint evidence-based practice nursing program for ICU patients in emergency department.Methods Objective sampling method was used to select the patients admitted to ICU of emergency department of Beijing China-Japan Friendship Hospital from January 1,2019 to June 30,2020 as the research objects.According to the three-step promotion plan of"introduction training consolidation improvement professional strengthening",the patients were divided into January June 2019 group,July December 2019 group and January June 2020 group A comparative study was conducted.Results There were significant differences in restraint rate and substitution constraint rate among the three groups(P<0.05),the restraint rate was 22.49%,16.96%and 10.11%,and the replacement restraint rate was 12.44%,12.61%and 13.48%respectively;the proportion of conscious patients in the restraint group from January to June in 2019 was the highest,which was 31.91%;in the January June 2020 group,the substitution restraint mode was the most,with 8 kinds.Conclusion The application of evidence-based practice nursing program of physical restraint for ICU patients in emergency department has effectively reduced the restraint rate of patients and improved the replacement restraint rate.However,there are some deficiencies in the dynamic evaluation of constraint release,patient analgesia and sedation management and alternative restraint diversity,which need to be further strengthened in the future.

关 键 词：循证护理 急诊 身体约束 

分 类 号：R473.6[医药卫生—护理学]