Restricciones físicas en UCI: su utilización y percepción de pacientes y familiares

Amatriain, A.I. Pérez de Ciriza; Olmedo, A. Nicolás; Viguria, R. Goñi; Regaira-Martínez, E.; Coscojuela, M.A. Margall; Erro, M.C. Asiaín

doi:10.1016/j.enfi.2011.12.004

Cited by 16 publications

(6 citation statements)

References 35 publications

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“…36 Regarding alternatives, the family presence was pointed out by nurses as a barrier to physical restraint use. 5,21 In the units included, family visiting policies are flexible but they are not allowed to stay 24 h a day. As cited in other studies, relatives were usually informed after restraint application, fact that caused a first disapproval from the family.…”

Section: Discussionmentioning

confidence: 99%

“…As cited in other studies, relatives were usually informed after restraint application, fact that caused a first disapproval from the family. 21 However, once they were informed, they approve the measure, or even request their use due to the perception of patient's loneliness. Therefore, it could be interesting to find out the impact of open visiting policies and family members' involvement in the care of critically ill patients on physical restraint implementation.…”

Section: Discussionmentioning

confidence: 99%

“…20 In Spain, research concerning physical restraint use in the ICU context is scarce. 21 The National Health Standards follow the international position statement recommendations regarding physical restraint use in the ICU. Likewise, among the quality indicators created and published jointly by the Spanish medical and nursing societies, there is one that encourages minimising their use to as near to zero as possible.…”

Section: Introductionmentioning

confidence: 99%

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Eliciting critical care nurses’ beliefs regarding physical restraint use

et al. 2018

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Nurses' behavioural and control beliefs were related. Nurses should be trained in alternatives to physical restraint use. The impact of analgo-sedation protocols, relatives' involvement, leadership support and intensive care unit restraint policies on physical restraint practices need to be revised. Further research is required to explore why nurses do not act with moral courage to change this harmful practice.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Eliciting critical care nurses’ beliefs regarding physical restraint use

et al. 2018

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“…We found that PR use in Canadian ICUs is frequent despite provincial legislation and national accreditation standards requiring restraint minimization to maintain patient safety and provide quality health care [16,31]. Internationally, use of PR in ICUs is highly variable with recent survey data and observational studies reporting prevalence rates between 15% and 100% [9,12,28,32-34]. The highest prevalence rates (for example, 90% or 100%) were found in single ICU settings [9,32].…”

Section: Discussionmentioning

confidence: 99%

Predictors of physical restraint use in Canadian intensive care units

et al. 2014

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IntroductionPhysical restraint (PR) use in the intensive care unit (ICU) has been associated with higher rates of self-extubation and prolonged ICU length of stay. Our objectives were to describe patterns and predictors of PR use.MethodsWe conducted a secondary analysis of a prospective observational study of analgosedation, antipsychotic, neuromuscular blocker, and PR practices in 51 Canadian ICUs. Data were collected prospectively for all mechanically ventilated adults admitted during a two-week period. We tested for patient, treatment, and hospital characteristics that were associated with PR use and number of days of use, using logistic and Poisson regression respectively.ResultsPR was used on 374 out of 711 (53%) patients, for a mean number of 4.1 (standard deviation (SD) 4.0) days. Treatment characteristics associated with PR were higher daily benzodiazepine dose (odds ratio (OR) 1.05, 95% confidence interval (CI) 1.00 to 1.11), higher daily opioid dose (OR 1.04, 95% CI 1.01 to 1.06), antipsychotic drugs (OR 3.09, 95% CI 1.74 to 5.48), agitation (Sedation-Agitation Scale (SAS) >4) (OR 3.73, 95% CI 1.50 to 9.29), and sedation administration method (continuous and bolus versus bolus only) (OR 3.09, 95% CI 1.74 to 5.48). Hospital characteristics associated with PR indicated patients were less likely to be restrained in ICUs from university-affiliated hospitals (OR 0.32, 95% CI 0.17 to 0.61). Mainly treatment characteristics were associated with more days of PR, including: higher daily benzodiazepine dose (incidence rate ratio (IRR) 1.07, 95% CI 1.01 to 1.13), daily sedation interruption (IRR 3.44, 95% CI 1.48 to 8.10), antipsychotic drugs (IRR 15.67, 95% CI 6.62 to 37.12), SAS <3 (IRR 2.62, 95% CI 1.08 to 6.35), and any adverse event including accidental device removal (IRR 8.27, 95% CI 2.07 to 33.08). Patient characteristics (age, gender, Acute Physiology and Chronic Health Evaluation II score, admission category, prior substance abuse, prior psychotropic medication, pre-existing psychiatric condition or dementia) were not associated with PR use or number of days used.ConclusionsPR was used in half of the patients in these 51 ICUs. Treatment characteristics predominantly predicted PR use, as opposed to patient or hospital/ICU characteristics. Use of sedative, analgesic, and antipsychotic drugs, agitation, heavy sedation, and occurrence of an adverse event predicted PR use or number of days used.

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“…De acuerdo con Pérez la restricción a la movilidad es aceptada y percibida por los pacientes como una medida que favorece la recuperación de la salud, mientras que por otros, como una medida innecesaria y que denota falta de confianza en el paciente, argumentando también una falta de información respecto a la medida y sensaciones de angustia derivada de la sujeción (55).…”

Section: Discussionunclassified

Experiencias del paciente en posoperatorio de cirugía cardiovascular en la UCI Clínica Medical Duarte, Cúcuta Colombia entre mayo y octubre del 2020

Bonilla¹,

Jaimes²,

Mosquera³

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Introducción: La cirugía cardiovascular como procedimiento quirúrgico que pretende mejorar la calidad de vida del paciente, requiere de cuidados postquirúrgicos para lograr una adecuada recuperación. Desde esta perspectiva, la experiencia de los pacientes a nivel físico, psicológico, emocional y espiritual requiere ser estudiada para favorecer la comprensión y el direccionamiento de los cuidados de enfermería al interior de la unidad de cuidado intensivo. Objetivo: describir el significado de la experiencia vivida por el paciente en postoperatorio de cirugía cardiovascular en la unidad de cuidados intensivos de la clínica Medical Duarte en el periodo comprendido entre mayo y octubre del 2020, en Cúcuta, Norte de Santander. Metodología: Se realizo un estudio fenomenológico con la participación de 10 pacientes quienes se encontraban en su postoperatorio mediato, 5 de los cuales se practicaron revascularizaciones cardiacas y los demás remplazos valvulares, Mediante la aplicación y el análisis de la entrevista, se generaron categorías clave, a partir de las nociones teóricas de Van-Manen, aplicando las características de rigor metodológico de la credibilidad, audibilidad y transferibilidad. Resultados: Del análisis de la investigación surge la categoría emergente “Consecuencias de la experiencia vivida”, que nos muestra como las acciones de automotivación ayudan al paciente a evolucionar satisfactoriamente en su proceso de recuperación convirtiéndose en un factor protector. Discusión: el paciente en la unidad de cuidados intensivos debe visualizarse de forma holística pero también individualmente, para lograr entender las vivencias existenciales que plantea Van Manen y fomentar los factores protectores que cada paciente tiene para lograr una recuperación satisfactoria en el postoperatorio.

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Restricciones físicas en UCI: su utilización y percepción de pacientes y familiares

Cited by 16 publications

References 35 publications

Eliciting critical care nurses’ beliefs regarding physical restraint use

Eliciting critical care nurses’ beliefs regarding physical restraint use

Predictors of physical restraint use in Canadian intensive care units

Experiencias del paciente en posoperatorio de cirugía cardiovascular en la UCI Clínica Medical Duarte, Cúcuta Colombia entre mayo y octubre del 2020

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