중환자실 환자의 물리적 억제대 적용 여부에 따른 신체손상, 정서반응, 우발적 치료기구 자가 제거 발생 비교
Comparison of Physical Injury, Emotional Response and Unplanned Self-Removal of Medical Devices According to Use of Physical Restraint in Intensive Care Unit Patients
1
조회
0
다운로드
9
인용
0
참고문헌
키워드
초록
Purpose: This study was done to compare the physical injury, emotional response and unplanned self-removal of medical devices in patients with physical restraints and patients not restrained. Methods: Eighty patients admitted to the intensive care unit (ICU) of a university hospital in Seoul participated in this study. Forty patients made up each group and the group not restrained was matched with the restraint group for age and history of smoking and alcohol consumption. Data on occurrence of physical injury, intensity of anxiety, stage of agitation and unplanned self-removal of medical devices were collected by observation and medical chart review using a structured instrument. Statistical processing of collected data was done with the SPSS WIN 17.0program. Results: The physically restrained group experienced more physical injuries and recorded significantly higher levels of anxiety and agitation than the unrestrained group. However, there were no significant differences between the groups in occurrence of unplanned self-removal of medical devices. Conclusion:Results indicate a need for critical care nurses to carefully monitor physical injuries and emotional responses of physically restrained patients and to develop nursing interventions to prevent adverse effects associated with restraint use. There is also a need to develop patient safety guidelines when using physical restraints.
Abstract
Purpose: This study was done to compare the physical injury, emotional response and unplanned self-removal of medical devices in patients with physical restraints and patients not restrained. Methods: Eighty patients admitted to the intensive care unit (ICU) of a university hospital in Seoul participated in this study. Forty patients made up each group and the group not restrained was matched with the restraint group for age and history of smoking and alcohol consumption. Data on occurrence of physical injury, intensity of anxiety, stage of agitation and unplanned self-removal of medical devices were collected by observation and medical chart review using a structured instrument. Statistical processing of collected data was done with the SPSS WIN 17.0program. Results: The physically restrained group experienced more physical injuries and recorded significantly higher levels of anxiety and agitation than the unrestrained group. However, there were no significant differences between the groups in occurrence of unplanned self-removal of medical devices. Conclusion:Results indicate a need for critical care nurses to carefully monitor physical injuries and emotional responses of physically restrained patients and to develop nursing interventions to prevent adverse effects associated with restraint use. There is also a need to develop patient safety guidelines when using physical restraints.
참고문헌 (30)
- 김기숙, "병원 간호현장에서의 억제대 사용실태에 관한 연구", 대한간호학회지, 30(1), pp.60~71 (2000)
- 김보영, "일 대학병원 중환자실 환자를 위한 억제대 개발 및 효과 측정", 임상간호연구지, 9, pp.17~30 (2006)
- 김순자, "기본간호학(제7판)" (2005), 수문사
- 문정숙, "중환자실 환자의 부종및 피부손상을 감소시킬 수 있는 억제대 개발 및 적용효과", 석사, pp.2009
- 서선희, "중환자실 환자를 위한 억제대 개발과 그 사용효과", 성인간호학회지, 8(2), pp.361~374 (1996)
- 이용규, "중환자실에서의 신체 억제대 사용에 관한 조사연구", 임상간호연구, 8(2), pp.117~130 (2003), 병원간호사회
- 조용애, "일 종합병원 중환자실의 억제대 적용 실태조사", 성인간호학회지, 18(4), pp.543~552 (2006), 성인간호학회
- Abrahamsen, C., "JCAHO and HCFA issue new restraint guidelines", Nursing Management, 32(12), pp.69~72 (2001)
- Bray, K., "British association of critical care nurses position statement on the use of restraint in adult critical care units", Nursing in Critical Care, 9(5), pp.199~212 (2004)
- Chang, L. Y., "Influence of physical restraint on unplanned extubation of adult intensive care patients: A case-control study", American Journal of Critical Care, 17(5), pp.408~415 (2008)
- Choi, E., "Physical restraint use in a Korean ICU", Journal of Clinical Nursing, 12(5), pp.651~659 (2003)
- Demir, A., "Nurses' use of physical restraints in four Turkish hospitals", Journal of Nursing Scholarship, 39(1), pp.38~45 (2007)
- Ely, E. W., "Monitoring sedation status over time in ICU patients: Reliability and validity of the richmond agitation-sedation scale (RASS)", The Journal of the American Medical Association, 289(22), pp.2983~2991 (2003)
- Evans, D., "Patient injury and physical restraint devices: A systematic review", Journal of Advanced Nursing, 41(3), pp.274~282 (2003)
- Happ, M. B., "Preventing treatment interference: The nurse’s role in maintaining technologic devices", Heart and Lung, 29(1), pp.60~69 (2000)
- HofsØ, K., "Part 2. Chemical and physical restraints in the management of mechanically ventilated patients in the ICU: A patient perspective", Intensive and Critical Care Nursing, 23(6), pp.316~322 (2007)
- Joint Commission on Accreditation of Healthcare Organizations, "Comprehensive accreditation manual forhospitals: Restraint and seclusion standards", Joint Commission on Accreditation of Healthcare Organizations, ~ (2001)
- Lauver, D., "A theory of care‐seeking behavior", Journal of Nursing Scholarship, 24(4), pp.281~288 (1992)
- Maccioli, G. A., "Clinical practice guidelines for the maintenance of patient physical safety in the intensive care unit: Use of restraining therapiesamerican college of critical care medicine task force 2001-2002", Critical Care Medicine, 31(11), pp.2665~2676 (2003)
- Maklebust, J., "Pressure ulcers: Guidelines for prevention and nursing management (2nd ed.)" (1996), Springhouse Corp
- Martin, B., "Use of physical restraints in adult critical care: A bicultural study", American Journal of Critical Care, 14(2), pp.133~142 (2005)
- Millar, K., "Assessment of preoperative anxiety: Comparison of measures in patients awaiting surgery for breast cancer", British Journal of Anaesthesia, 74(2), pp.180~183 (1995)
- Minnick, A., "Elderly patients' reports of physical restraint experiences in intensive care units", American Journal of Critical Care, 10(3), pp.168~171 (2001)
- Minnick, A. F., "Prevalence and variation of physical restraint use in acute care settings in the US", Journal of Nursing Scholarship, 39(1), pp.30~37 (2007)
- Ofoegbu, B. N., "The use of physical restraints on paediatric intensive care units", Pediatric Anesthesia, 15(5), pp.407~411 (2005)
- Sequeira, H., "Control and restraint in the UK: Service user perspectives", The British Journal of Forensic Practice, 4(1), pp.9~18 (2002)
- Thomas, L. A., "Clinical management of stressors perceived by patients on mechanical ventilation", AACN Clinical Issues, 14(1), pp.73~81 (2003)
- Whitman, G. R., "Practice patterns related to mechanical restraintuse across a multi-institutional health care system", OutcomesManagement for Nursing Practice, 5(3), pp.102~109 (2001)
- Yeh, S. H., "The effects of continuing education in restraint reduction on novice nurses in intensive care units", Journal of Nursing Research, 12(3), pp.246~256 (2004)
- Zun, L. S., "A prospective study of the complication rate of use of patient restraint in the emergency department", The Journal of Emergency Medicine, 24(2), pp.119~124 (2003)
