Nursing Course, School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan.
Chiba Faculty of Nursing, Tokyo Healthcare University, Funabashi, Chiba, Japan.
PLoS One. 2024 Jul 10;19(7):e0306920. doi: 10.1371/journal.pone.0306920. eCollection 2024.
Nursing management activities are important in influencing staff nurses' action to prevent or withdraw physical restraints. However, limited studies have been conducted empirically to determine the nursing management activities required for minimizing physical restraints. Therefore, there is a need for basic standards of nursing management activities to minimize physical restraints in acute care settings. This study aimed to develop nursing management indicators to minimize physical restraint (MaIN-PR) in hospitalized older adult patients in an acute care setting. It was conducted between June and October 2021 in Japan using a Delphi consensus approach. Fifty nurses working at top or middle management levels or as certified nurse specialists in gerontological nursing enrolled as participants. The potential indicators obtained from the literature review and interviews were organized inductively to develop two types of draft indicators: (1) 35 items for top management and (2) 33 items for middle management. We asked the nursing managers and certified nurse specialists in gerontological nursing to assess the validity of each indicator in three rounds. Of the 50 initial panelists, 12 from top management and 13 from middle management continued till the third round. MaIN-PR contained 35 indicators for top management and 28 indicators for middle management and were classified into the following six metrics: planning, motivating, training, commanding, organizing, and controlling. To the best of our knowledge, the current MaIN-PR are the first set of nursing management indicators for minimizing physical restraint, including perspectives on geriatric nursing in acute care settings. These indicators could guide both top and middle nursing management, thus supporting staff nurses' judgment in minimizing physical restraints to enhance the quality of older adult patient care.
护理管理活动对于影响护士预防或解除身体约束的行为非常重要。然而，目前仅有有限的实证研究确定了最小化身体约束所需的护理管理活动。因此，在急性护理环境中需要有最小化身体约束的护理管理活动基本标准。本研究旨在为急性护理环境中的住院老年患者制定最小化身体约束的护理管理指标（MaIN-PR）。研究于 2021 年 6 月至 10 月在日本进行，采用德尔菲共识法。50 名在高层或中层管理岗位工作或具有老年护理认证护士专家资格的护士作为参与者参加了研究。从文献回顾和访谈中获得的潜在指标被归纳为两种类型的草案指标：（1）高层管理的 35 项指标，（2）中层管理的 33 项指标。我们要求护理经理和老年护理认证护士专家在三轮中评估每个指标的有效性。在最初的 50 名小组成员中，有 12 名来自高层管理，13 名来自中层管理，一直参与到第三轮。MaIN-PR 包含高层管理的 35 项指标和中层管理的 28 项指标，并分为以下六个指标：计划、激励、培训、指挥、组织和控制。据我们所知，目前的 MaIN-PR 是第一套最小化身体约束的护理管理指标，包括急性护理环境中老年护理的观点。这些指标可以为高层和中层护理管理提供指导，从而支持护士在最小化身体约束方面的判断，提高老年患者护理质量。
