Prevalence, risk factors, and outcomes associated with physical restraint use in mechanically ventilated adults

Rose, Louise; Burry, Lisa; Mallick, Ranjeeta; Luk, Elena; Cook, Deborah J.; Fergusson, Dean; Dodek, Peter; Burns, Karen E. A.; Granton, John; Ferguson, Niall D.; Devlin, John W.; Steinberg, Marilyn; Keenan, Sean; Reynolds, Stephen J.; Tanios, Maged; Fowler, Robert; Jacka, Michael J.; Olafson, Kendiss; Skrobik, Yoanna; Mehta, Sangeeta

doi:10.1016/j.jcrc.2015.09.011

Cited by 93 publications

(68 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The few descriptive studies exploring physical restraint use and outcomes of the critically ill paradoxically report higher rates of the events that their use is intended to prevent. These events include more unplanned extubations and frequent reintubations (245,247,267,268); greater unintentional device removal (268); longer ICU LOS (245); increased agitation; higher benzodiazepine, opioid, and antipsychotic medication use (244,268); and increased risk for delirium or disorientation (257,259,268,270,271).…”

Section: Physical Restraintsmentioning

confidence: 99%

“…Certain modifiable and nonmodifiable factors appear to increase critically ill adults' risk for physical restraint use. These factors include the following: older age (250,264); non-coma level of arousal; neurologic or psychiatric conditions including delirium (257,258,261,268); sedative type/ strategy (169,242,261,272); mechanical ventilation use (242,261,263); use of invasive devices (246,250); nurse-to-patient ratio and perceived workload (242,268,271); and time of day (249). Interestingly, patients participating in an early mobility program (273) who received early pharmacologic treatment of delirium (272) and patients who had a history of alcohol use were less restrained (268).…”

Section: Physical Restraintsmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

Devlin

Skrobik

Gélinas

et al. 2018

Critical Care Medicine

Self Cite

2,584

2,938

View full text Add to dashboard Cite

We found substantial agreement among a large, interdisciplinary cohort of international experts regarding evidence supporting recommendations, and the remaining literature gaps in the assessment, prevention, and treatment of Pain, Agitation/sedation, Delirium, Immobility (mobilization/rehabilitation), and Sleep (disruption) in critically ill adults. Highlighting this evidence and the research needs will improve Pain, Agitation/sedation, Delirium, Immobility (mobilization/rehabilitation), and Sleep (disruption) management and provide the foundation for improved outcomes and science in this vulnerable population.

show abstract

Section: Physical Restraintsmentioning

confidence: 99%

Section: Physical Restraintsmentioning

confidence: 99%

Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

Devlin

Skrobik

Gélinas

et al. 2018

Critical Care Medicine

Self Cite

2,584

2,938

View full text Add to dashboard Cite

show abstract

“…1 International studies in different countries show that the use of PR in different countries varies from 0 to 100%. [6][7][8] Depending on geographical location, being 87% in a USA surgical ICU, 9 76% in a Canadian General ICU, 10 and 50% in France. 11 Prevalence was generally lower in Norway ICU, being 14.36%, 12 11% in Germany General ICU, 13 and 7% in Australia.…”

Section: Introductionmentioning

confidence: 99%

The challenges of using physical restraint in intensive care units in Iran: A qualitative study

Salehi

Joolaee

Hajibabaee

et al. 2020

Journal of the Intensive Care Society

View full text Add to dashboard Cite

Background Physical restraint is widely used in intensive care units to ensure patient safety, manage agitated patients, and prevent the removal of medical equipment connected to them. However, physical restraint use is a major healthcare challenge worldwide. Aim This study aimed to explore nurses' experiences of the challenges of physical restraint use in intensive care units. Methods This qualitative study was conducted in 2018–2019. Twenty critical care nurses were purposively recruited from the intensive care units of four hospitals in Tehran, Iran. Data were collected via in-depth semi-structured interviews, concurrently analyzed via Graneheim and Lundman's conventional content analysis approach, and managed via MAXQDA software (v. 10.0). Findings Three main themes were identified (i) organizational barriers to effective physical restraint use (lack of quality educations for nurses about physical restraint use, lack of standard guidelines for physical restraint use, lack of standard physical restraint equipment), (ii) ignoring patients' wholeness (their health and rights), and (iii) distress over physical restraint use (emotional and mental distress, moral conflict, and inability to find an appropriate alternative for physical restraint). Conclusion Critical care nurses face different organizational, ethical, and emotional challenges in using physical restraint. Healthcare managers and authorities can reduce these challenges by developing standard evidence-based guidelines, equipping hospital wards with standard equipment, implementing in-service educational programs, supervising nurses' practice, and empowering them for finding and using alternatives to physical restraint. Nurses can also reduce these challenges through careful patient assessment, using appropriate alternatives to physical restraint, and consulting with their expert colleagues.

show abstract

“…The use of restraints is also known to have a negative psychological impact on patients, provoking feelings of fear or anger, as well as feelings of embarrassment and the experience of loss of dignity (2,16). Furthermore, the evidence on the benefits of restraints is not convincing, e.g., restraints do not always seem to be effective in reducing falls, or in preventing patients from removing their medical devices (4,17,18). A majority of the patients admitted to hospitals nowadays are elderly.…”

Section: Introduction Rationalementioning

confidence: 99%

Physical and Pharmacological Restraints in Hospital Care: Protocol for a Systematic Review

et al. 2020

View full text Add to dashboard Cite

show abstract

Prevalence, risk factors, and outcomes associated with physical restraint use in mechanically ventilated adults

Cited by 93 publications

References 22 publications

Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU

The challenges of using physical restraint in intensive care units in Iran: A qualitative study

Physical and Pharmacological Restraints in Hospital Care: Protocol for a Systematic Review

Contact Info

Product

Resources

About