Survey of End-of-Life Care in Intensive Care Units in Ain Shams University Hospitals, Cairo, Egypt

Nurses' knowledge and practices of physical restraints in intensive care units: An observational study

“…However, evidence showed that nurses require physician orders to apply PR and this order should be renewed by the physician at varying frequencies based on the type of restraint; for example, every 24 hr and the date and time must be included (Maccioli et al., 2003). Furthermore, one‐third of nurses believed that the nursing staff should be responsible for deciding on the initiation of PR (Azab & Negm, 2013). This might be related to the fact that nurses perceive themselves as being responsible for restraining their patients since they spend more time than physicians at the bedside (Cho et al., 2006; Eşer et al., 2007).…”

“…Physical restraints are widely used, particularly in the care of critically ill patients, to ensure their safety and to protect them from fall, injury and/or unintended harm (Birgili & İzan, 2019; Kandeel & Attia, 2013; Pellfolk, Gustafson, Bucht, & Karlsson, 2010; Wang, Zhu, Zeng, & Xiong, 2019). However, applying PR is often considered unsafe and unacceptable (Luk, Burry, Rezaie, Mehta, & Rose, 2015; Martin & Mathisen, 2005); therefore, accreditation standards, guidelines and legislation recommend minimization of PR use (Azab & Negm, 2013; Luk et al., 2015; Möhler & Meyer, 2014; Taha & Ali, 2013). However, in some situations, it can become a necessity for the safety of the patient and caregivers.…”

“…Nurses in intensive care units (ICUs), who try to manage the patient and the technology used for care, are the key decision‐makers regarding the application of PR (Lane & Harrington, 2011; Luk et al., 2015; Minnick, Mion, Johnson, Catrambone, & Leipzig, 2007; Pellfolk et al., 2010). Many factors influence their decisions which can be grouped into three categories: patient factors, nurse factors and environmental factors (Azab & Negm, 2013; Lane & Harrington, 2011; Pellfolk et al., 2010). Factors related to patients include patient's age, medical diagnosis and the presence of invasive devices (Al‐Khaled, Zahran, & El‐Soussi, 2011; Lane & Harrington, 2011; Martin & Mathisen, 2005; Pellfolk et al., 2010).…”

“…Factors related to patients include patient's age, medical diagnosis and the presence of invasive devices (Al‐Khaled, Zahran, & El‐Soussi, 2011; Lane & Harrington, 2011; Martin & Mathisen, 2005; Pellfolk et al., 2010). Factors related to nurses include nurse's age, years of experience, nurse's attitude, knowledge and qualifications (Al‐Khaled et al., 2011; Azab & Negm, 2013; Martin & Mathisen, 2005; Pellfolk et al., 2010). Environmental factors in ICU include those which would increase patient agitation, anxiety and deliria such as noise from alarms of equipment, other patients or the healthcare personnel, lighting and presence of multiple caregivers (Bray et al., 2004).…”

“…Möhler and Meyer (2014) emphasized that understanding nurses' knowledge about PR use is essential to address the problem related to that. A satisfactory level of nurses' knowledge of PR is found to be associated with their practice of PR and related complications or events (Azab & Negm, 2013; Heeren et al., 2014; Taha & Ali, 2013).…”