Prevalence of use of physical restraints in pediatric intensive care units and correlated variables: A Spanish multicenter study.

作者信息

Bosch Alcaraz Alejandro, Belda Hofheinz Sylvia, Corrionero Alegre Jesús, Miguel García Piñero José, Gil Domínguez Sonia, Fernández Lorenzo Rocío, Mata Ferro María, Martín Gómez Ainhoa, Serradell Orea Marta, Luna Castaño Patricia, Ángeles Saz Roy M, Zuriguel Pérez Esperanza, Martínez Oliva Marta, González Rivas Susana, Añaños Montoto Nerea, José Espildora González María, Martín-Peñasco Osorio Elena, Carracedo Muñoz Eva, López Fernández Eduardo, Lozano Almendral Gema, Victoria Ureste Parra Maria, Gomez Merino Alicia, García Martínez Alexandra, Morales Cervera David, Frade Pardo Laura, Díaz Lerma Ainhoa, Piqueras Rodríguez Pedro

机构信息

Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona (UB), Barcelona, Spain; Mental Health, Psychosocial and Complex Nursing Care Research Group-NURSEARCH, University of Barcelona, Barcelona, Spain.

Pediatric Intensive Care Unit 12 de Octubre Hospital, Madrid, Spain.

出版信息

Intensive Crit Care Nurs. 2024 Dec;85:103788. doi: 10.1016/j.iccn.2024.103788. Epub 2024 Aug 7.

OBJECTIVE

To calculate the prevalence of physical restraint (PR) use in Spanish PICUs and (2) to analyze the correlation between the prevalence of PR use and the sociodemographic, clinical variables of the patients and the PICU structural and organizational variables.

METHODS

We conducted a multicenter prevalence study from January 2022 to January 2023 in Spanish PICUs. The method of data collection was by direct observation, review of the patient's medical history, and asking the professionals involved in the patient's care. Three weekly 24-hour prevalence observations (morning, afternoon, and night) were conducted for 6 months.

RESULTS

A total of 336 patients were included in the study, obtaining an overall crude prevalence of PR use of 16 % (95 %CI: 15 %-17.7 %). Pediatric patients with respiratory pathology received the highest number of hours of PR, with significant differences observed when comparing respiratory cases with post-surgical cases. Statistical significance was also observed when comparing the mean scores of hours of PR according to admission diagnosis (p = 0.01), with respiratory patients being the ones who were restrained the longest (24 h [20-24]) and infectious patients the least (15 h [14-20]). Patients who receive PR upon admission remain in this situation for more hours (24 h [15-24] and in the PICUs that specifically recorded PR application, fewer hours of PR occurred (20 h [4-24]).

CONCLUSIONS

The use of PR is still present in the PICUs analyzed, with a crude prevalence of 16%. Factors such as the reason for admission, the use of respiratory support, and the reason for application of PR were linked to the hours of use of PR.

IMPLICATIONS FOR CLINICAL PRACTICE

Knowing the prevalence of PR use will make professionals aware that it is still necessary to implement policies that avoid its use to prevent the side effects they have in pediatric patients.