Development of Nursing Protocol for Preventing Discontinuation of Treatments by Methods Other than Physical Restraint during Acute Exacerbation of Chronic Heart Failure in Patients with Impaired Cognitive Function  

作　　者：Haruka Otsu Shiori Fujimoto Nozomi Murakami Tatsuki Ohhara Yoko Takeya Tatsuya Ohno Chieko Suzuki Sanae Takahashi 

机构地区：[1]Graduate School of Health Sciences, Hirosaki University, Hirosaki City, Japan [2]Japan Community Health Care Organization, Shiga Hospital, Shiga, Japan [3]Akita Prefecture Health Agricultural Cooperative Association, Hiraka General Hospital, Yokote, Japan [4]Akita Prefecture Health Agricultural Cooperative Association, Koto Kosei Hospital, Hachirogata, Japan [5]Aomori Prefectural Central Hospital, Aomori, Japan [6]Medical Corporation Association Seikokai, Hirano Synthesis Hospital, Gifu, Japan [7]Ugo Municipal Hospital, Ugo, Japan [8]Omagari Nakadori Hospital, Omagari, Japan

出　　处：《Health》2018年第6期789-815,共27页健康（英文）

摘　　要：The purpose of this study is to prepare a nursing protocol for preventing discontinuation of treatments using a method other than physical restraint during acute exacerbation of chronic heart failure in patients with impaired cognitive function. For the first stage of the study, we prepared a draft of the nursing protocol based on a basic survey. For the second stage, semi-structured interviews were conducted with 5 nurses specialized in chronic heart failure and 10 nurses in dementia case to ensure content validity of the draft protocol. For the third stage, we examined the possibility of clinical application of the revised version of the protocol draft prepared in the second stage of the study. For assessment items, significant points of nursing care, and specific nursing care practice in this revised version, 154 subjects (93.9%) considered effective for patients, in terms of prevention of treatment discontinuation using a method other than physical restraint. All items and contents were considered useful by more than 60% of the nurses. Considering that the nurses working in the clinical setting reported 93.9% of usefulness, we concluded that this nursing protocol remained valid at a certain level. We also received a comment from the certified nurses that we should include the basic contents for newly graduated nurses. We consider that this nursing protocol will be also useful for newly graduated nurses to acquire knowledge. It helped to standardize nursing care in order to predict potential risks for patients with impaired cognitive function.The purpose of this study is to prepare a nursing protocol for preventing discontinuation of treatments using a method other than physical restraint during acute exacerbation of chronic heart failure in patients with impaired cognitive function. For the first stage of the study, we prepared a draft of the nursing protocol based on a basic survey. For the second stage, semi-structured interviews were conducted with 5 nurses specialized in chronic heart failure and 10 nurses in dementia case to ensure content validity of the draft protocol. For the third stage, we examined the possibility of clinical application of the revised version of the protocol draft prepared in the second stage of the study. For assessment items, significant points of nursing care, and specific nursing care practice in this revised version, 154 subjects (93.9%) considered effective for patients, in terms of prevention of treatment discontinuation using a method other than physical restraint. All items and contents were considered useful by more than 60% of the nurses. Considering that the nurses working in the clinical setting reported 93.9% of usefulness, we concluded that this nursing protocol remained valid at a certain level. We also received a comment from the certified nurses that we should include the basic contents for newly graduated nurses. We consider that this nursing protocol will be also useful for newly graduated nurses to acquire knowledge. It helped to standardize nursing care in order to predict potential risks for patients with impaired cognitive function.

关 键 词：DEMENTIA IMPAIRED Cognitive Function Acute EXACERBATION of Chronic Heart Failure Physical Restraint NURSING PROTOCOL 

分 类 号：R5[医药卫生—内科学]