중환자실 간호사의 신체보호대 적용간호 경험
Nursing Experience with Application of Physical Restraints in Intensive Care Units
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Purpose: To explore types of nursing care performed by intensive care unit (ICU) nurses during application of physical restraints to patients. Methods: Data were collected from October to November 2023 through face-to-face interviews with nine ICU nurses. The qualitative thematic analysis method by Braun and Clarke was employed. Results: Three types of nursing care were derived depending on the time point: 'nursing care when applying physical restraints', 'nursing care when releasing the physical restraints', and 'nursing care when reapplying physical restraints'. When applying physical restraints, nurses prioritized preventing physical damage caused by such restraints. However, emotional and psychological nursing care appeared to be limited in practice. Upon releasing physical restraints, the nursing approach involved a gradual process with continuous monitoring of patient's consciousness through scales, verbal communication, and non-verbal communication. When reapplying physical restraints, nurses increased their observation frequency to prevent safety incidents from recurring and applied restraints more rigorously. Conclusion: These findings suggest that ICU nurses should receive comprehensive education on the purpose of applying physical restraints, nursing care that considers potential side effects, and the use of verbal and nonverbal observations to assess patient consciousness.
Abstract
Purpose: To explore types of nursing care performed by intensive care unit (ICU) nurses during application of physical restraints to patients. Methods: Data were collected from October to November 2023 through face-to-face interviews with nine ICU nurses. The qualitative thematic analysis method by Braun and Clarke was employed. Results: Three types of nursing care were derived depending on the time point: 'nursing care when applying physical restraints', 'nursing care when releasing the physical restraints', and 'nursing care when reapplying physical restraints'. When applying physical restraints, nurses prioritized preventing physical damage caused by such restraints. However, emotional and psychological nursing care appeared to be limited in practice. Upon releasing physical restraints, the nursing approach involved a gradual process with continuous monitoring of patient's consciousness through scales, verbal communication, and non-verbal communication. When reapplying physical restraints, nurses increased their observation frequency to prevent safety incidents from recurring and applied restraints more rigorously. Conclusion: These findings suggest that ICU nurses should receive comprehensive education on the purpose of applying physical restraints, nursing care that considers potential side effects, and the use of verbal and nonverbal observations to assess patient consciousness.
참고문헌 (30)
- Abraham, J., "Interventions for preventing and reducing the use of physical restraints of older people in general hospital settings", The Cochrane Database of Systematic Reviews, 8(8), pp.CD012476~ (2022)[DOI]
- Azizpour, M., "Use of physical restraints in intensive care unit : A systematic review study", Acta Medica Mediterranea, 33(1), pp.129~136 (2017)[DOI]
- Benner, P., "Expertise in nursing practice: Caring, clinical judgment, and ethics" (2009), Springer Publishing Company
- Bleijlevens, M. H. C., "Physical restraints : Consensus of a research definition using a modified delphi technique", Journal of the American Geriatrics Society, 64(11), pp.2307~2310 (2016)[DOI]
- Braun, V., "Using thematic analysis in psychology", Qualitative Analysis in Psychology, 3(2), pp.77~101 (2006)
- Chen, T. J., "Diagnostic accuracy of the CAM-ICU and ICDSC in detecting intensive care unit delirium : A bivariate meta-analysis", International Journal of Nursing Studies, 113, pp.103782~ (2021)[DOI]
- Choi, S. J., "Prevalence and related risk factors of delirium in intensive care units as detected by the CAMICU", Journal of Korean Clinical Nursing Research, 20(3), pp.406~416 (2014)[DOI]
- Dall'Ora, C., "Burnout in nursing : A theoretical review", Human Resources for Health, 18(1), pp.41~ (2020)[DOI]
- De Jonghe, B., "Physical restraint in mechanically ventilated ICU patients : A survey of French practice", Intensive Care Medicine, 39, pp.31~37 (2013)[DOI]
- Douglas, L., "Patient experience of physical restraint in the acute setting : A systematic review of the qualitative research evidence", Issues in Mental Health Nursing, 43(5), pp.473~481 (2022)[DOI]
- Farina-Lopez, E., "Physical restraint use with elderly patients : Perceptions of nurses and nursing assistants in Spanish acute care hospitals", Nursing Research, 67(1), pp.55~59 (2018)[DOI]
- Golubovic, J., "Music interventions and delirium in adults : A systematic literature review and meta-analysis", Brain Sciences, 12(5), pp.568~ (2022)[DOI]
- Guba, E., "Fourth generation evaluation" (1989), Sage Publications
- Ha, S. M., "Development and evaluation of educational programs on nurses and nurse's aide to reduce physical restraint use in a longterm care hospital", doctor, pp.2018
- Hevener, S., "Using a decision wheel to reduce use of restraints in a medical-surgical intensive care unit", American Journal of Critical Care, 25(6), pp.479~486 (2016)[DOI]
- Hong, J. H., "Delirium in the intensive care unit", Journal of Neurocritical Care, 8(2), pp.46~52 (2015)[DOI]
- Jang, J. I., "The experiences of patients in intensive care units", Journal of Korea Society for Wellness, 15(3), pp.135~144 (2020)[DOI]
- Kang, Y. S., "Investigation of delirium occurrence and intervention status in intensive care unit at a hospital and perception of delirium by medical staff", Journal of Korean Critical Care Nursing, 16(1), pp.71~86 (2023)[DOI]
- Kim, H. N., "Factors affecting the nursing practice on physical restraints use of nurses", master, pp.2023
- Kim, N. S., "A study on perceptions about physical restraint use of nurse in small and medium sized hospitals", Journal of Digital Convergence, 15(12), pp.581~590 (2017)[DOI]
- Kim, "Perception and attitude of using restraints among long-term care hospital nurses and family members", master, pp.2013
- Ko, Y. J., "Physical restraints use and associated factors among elderly patients in long-term care hospitals", Journal of the Korea Academia-Industrial Cooperation Society, 20(9), pp.167~174 (2019)[DOI]
- "Guidelines for safe management of critical care unit" (2017)[URL]
- Lee, K. S., "Exploration on the nurses trust building toward the patient's: Using the focus group research method", Journal of Multimedia Services Convergent with Art, Humanities, and Sociology, 7(7), pp.279~296 (2017)[DOI]
- Park, M., "Factors influencing nurses' implementation of evidence-based restraint use in long-term care hospitals", Journal of Korean Gerontological Nursing, 18(3), pp.172~181 (2016)[DOI]
- Perez, D., "Physical restraints in intensive care-An integrative review", Australian Critical Care, 32(2), pp.165~174 (2019)[DOI]
- Rollo, E., "Physical restraint precipitates delirium in stroke patients", Journal of the Neurological Sciences, 421, pp.117290~ (2021)[DOI]
- "2012 Guideline for physical restraining in adult intensive care units" (2012)[URL]
- Wong, W. K., "Nurses' attitudes towards the use of physical restraint in psychiatric care : A systematic review of qualitative and quantitative studies", Journal of Psychiatric and Mental Health Nursing, 29(5), pp.659~675 (2022)[DOI]
- Yun, M., "Occupational stress in Korean hospital nurses : Secondary data analysis of the development of a Korean nurses' occupational stress scale", Journal of Korean Academy of Nursing Administration, 28(4), pp.393~405 (2022)[DOI]