Via-Clavero G, Claramunt-Domènech L, García-Lamigueiro A, Sánchez-Sánchez M M, Secanella-Martínez M, Aguirre-Recio E, Sandalinas-Mulero I, Ortega-Guerrero Á, Yuste-Bustos F, Delgado-Hito P
Unidad de Cuidados Intensivos, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España; Departamento de Enfermería Fundamental y Médico-Quirúrgica, Facultad de Medicina y Ciencias de la Salud, Universitat de Barcelona, Barcelona, España; Grup de Recerca Infermera GRIN-IDIBELL, L'Hospitalet de Llobregat, Barcelona, España.
Unidad de Cuidados Intensivos, Hospital Universitari Joan XXIII, Tarragona, España.
Enferm Intensiva (Engl Ed). 2019 Apr-Jun;30(2):47-58. doi: 10.1016/j.enfi.2018.09.003. Epub 2018 Dec 23.
To determine nurses' knowledge level regarding physical restraint use in intensive care units and its associated factors.
A cross-sectional multicentre study was carried out in 12 critical care units of 8 hospitals in Spain (n=354 nurses). An 'ad-hoc' knowledge survey was developed, and their content was validated by experts. The survey obtained a test-retest stability of ICC=.71 (95% CI: .57-.81) in a previous pilot study. A final 8-item tool was designed. Sociodemographic and professional variables from the participants were collected; as well as structural and clinical variables from the units analyzed. A descriptive and association analysis between variables was performed. A p-value <.05 was deemed statistically significant.
Two hundred and fifty nurses answered the survey (70.62%). Mean age of the participants was 36.80 (SD 9.54) with 10.75 (SD 8.38) years of professional experience in critical care. Seventy-three point six percent had never received previous training about physical restraints. Knowledge mean value was 4.21 (SD 1.39) (range 0-8). Knowledge level was associated with the referral hospital (p<.001). Nurses with a higher knowledge level are more likely to work in units with informed consent sheets for physical restraint use (p<.001); flexible family visiting (p<.001); analgo-sedation protocol (p=.011), and units in which nurses had autonomy to manage analgo-sedation (p<.001). Individual sociodemographic and professional data was not associated with knowledge level.
Further training regarding physical restraint use is needed for critical care nurses. The work environment where nursing care is given has a great influence on nurses' knowledge level about this intervention.
确定护士在重症监护病房使用身体约束方面的知识水平及其相关因素。
在西班牙8家医院的12个重症监护病房开展了一项横断面多中心研究（n = 354名护士）。编制了一份“特设”知识调查问卷，其内容经专家验证。在前一项试点研究中，该调查问卷的重测稳定性为组内相关系数（ICC）= 0.71（95%置信区间：0.57 - 0.81）。设计了一个最终包含8个条目的工具。收集了参与者的社会人口学和专业变量；以及所分析病房的结构和临床变量。对变量进行了描述性和关联性分析。p值<0.05被视为具有统计学意义。
250名护士回答了调查问卷（70.62%）。参与者的平均年龄为36.80岁（标准差9.54），在重症监护方面有10.75年（标准差8.38）的专业经验。73.6%的人以前从未接受过关于身体约束的培训。知识均值为4.21（标准差1.39）（范围0 - 8）。知识水平与转诊医院相关（p<0.001）。知识水平较高的护士更有可能在有身体约束使用知情同意书的病房工作（p<0.001）；有灵活的家属探视制度（p<0.001）；有镇痛镇静方案（p = 0.011），以及护士有自主管理镇痛镇静的病房（p<0.001）。个体社会人口学和专业数据与知识水平无关。
重症监护护士需要接受关于身体约束使用的进一步培训。提供护理的工作环境对护士关于这种干预措施的知识水平有很大影响。
