Tresfon Jaco, Langeveld Kirsten, Brunsveld-Reinders Anja H, Hamming Jaap
Leiden University Medical Centre, Zuid-Holland, The Netherlands.
Glob Qual Nurs Res. 2023 Jan 24;10:23333936221148816. doi: 10.1177/23333936221148816. eCollection 2023 Jan-Dec.
Physical restraints are viewed as potentially dangerous objects for patient safety. Contemporary efforts mainly focus on preventing bad outcomes in restraint use, while little attention is paid under what circumstances physical restraints are applied harmlessly. The aim of this research was to understand how physical restraints are used by neurology/neurosurgery ward nurses in relation to the protocol. In ethnographic action research, the Functional Resonance Analysis Method (FRAM) was used to map and compare physical restraints as part of daily ward care against the protocol of physical restraints. Comparison between protocol and actual practice revealed that dealing with restlessness and confusion is a collective nursing skill vital in dealing with physical restraints, while the protocol failed to account for these aspects. Supporting and maintaining this skillset throughout this and similar nursing teams can prevent future misguided application physical restraints, offering valuable starting point in managing patient safety for these potentially dangerous objects.
身体约束被视为对患者安全存在潜在危险的物品。当代的努力主要集中在防止约束使用中的不良后果，而对于在何种情况下身体约束能无害使用却很少关注。本研究的目的是了解神经内科/神经外科病房护士如何根据协议使用身体约束。在人种志行动研究中，功能共振分析方法（FRAM）被用于将身体约束作为日常病房护理的一部分进行映射和比较，并对照身体约束协议。协议与实际做法的比较表明，应对躁动和意识混乱是处理身体约束时至关重要的集体护理技能，而协议未能考虑到这些方面。在这个及类似的护理团队中支持并维持这一技能组合可以防止未来身体约束的错误应用，为管理这些潜在危险物品的患者安全提供有价值的起点。
