Lach Helen W, Leach Kathy M, Butcher Howard K
J Gerontol Nurs. 2016 Feb;42(2):17-26. doi: 10.3928/00989134-20160113-04.
Physical restraints continue to be used in acute care settings, despite the challenges and calls to reduce this practice. The current guideline on restraint use is updated with evidence that includes critical care settings and issues related to restraint use in acute care units. Nurses play a significant role in the use of restraints. Factors such as nurse's knowledge and patient characteristics combined with the culture and resources in health care facilities influence the practice of physical restraint use. Nurses can identify patients at high risk for restraint use; assess the potential causes of unsafe behaviors; and target interventions in the areas of physiological, psychological, and environmental approaches to address those unsafe behaviors. Members of the interdisciplinary team can provide additional consultation, and institutions can provide resources and education and implement monitoring processes and quality improvement practices to help reduce the practice of physical restraint use. [Journal of Gerontological Nursing, 42(2), 17-26.].
尽管存在挑战且各方呼吁减少这种做法,但身体约束措施仍在急性护理环境中被使用。当前关于约束措施使用的指南已根据包括重症监护环境以及与急性护理病房中约束措施使用相关问题的证据进行了更新。护士在约束措施的使用中发挥着重要作用。护士的知识、患者特征等因素,再加上医疗保健机构的文化和资源,会影响身体约束措施的使用实践。护士能够识别有高约束使用风险的患者;评估不安全行为的潜在原因;并针对生理、心理和环境等方面采取干预措施来应对这些不安全行为。跨学科团队的成员可以提供额外的咨询,机构可以提供资源和教育,并实施监测流程和质量改进措施,以帮助减少身体约束措施的使用。[《老年护理杂志》,42(2),17 - 26。]