Physical restraint in critical care units from the experience of doctors and nursing assistants: In search of an interdisciplinary interpretation.

Autor: Acevedo-Nuevo M; Organización Nacional de Trasplantes, Madrid, España; Grupo de Trabajo Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería de Intensivos y Unidades Coronarias, Madrid, España; Grupo de Investigación en Enfermería y Cuidados de Salud, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Majadahonda, Madrid, España. Electronic address: m.acevedo.nuevo@gmail.com., González-Gil MT; Grupo de Investigación en Enfermería y Cuidados de Salud, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Majadahonda, Madrid, España; Universidad Autónoma de Madrid, Madrid, España., Solís-Muñoz M; Grupo de Investigación en Enfermería y Cuidados de Salud, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA), Majadahonda, Madrid, España; Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España., Arias-Rivera S; Grupo de Trabajo Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería de Intensivos y Unidades Coronarias, Madrid, España; Hospital Universitario de Getafe, Getafe, Madrid, España; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, España., Toraño-Olivera MJ; Hospital General Universitario Gregorio Marañón, Madrid, España., Carrasco Rodríguez-Rey LF; Hospital Universitario 12 de Octubre, Madrid, España., Velasco-Sanz TR; Hospital Clínico San Carlos, Madrid, España; Universidad Complutense de Madrid, Madrid, España., Martín Rivera BE; Hospital Universitario Ramón y Cajal, Madrid, España., Carmona-Monge FJ; Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España., Rodríguez-Huerta MD; Hospital Universitario La Princesa, Madrid, España., Lospitao-Gómez S; Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España., Martínez Álvarez A; Hospital Universitario de Móstoles, Móstoles, Madrid, España., García-González S; Hospital Universitario de Móstoles, Móstoles, Madrid, España., Láiz-Díez N; Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España.
Jazyk: English; Spanish; Castilian
Zdroj: Enfermeria intensiva [Enferm Intensiva (Engl Ed)] 2020 Jan - Mar; Vol. 31 (1), pp. 19-34. Date of Electronic Publication: 2019 Jun 26.
DOI: 10.1016/j.enfi.2019.01.004
Abstrakt: Objectives: The study aim was to explore the experience of doctors and nursing assistants in the management of physical restraint (PR) in critical care units.
Method: A multicentre phenomenological study that included 14 critical care units (CCU) in Madrid (Spain). The CCU were stratified according to their use of physical restraint: "frequently used" versus "seldom used". Three focus groups were formed: the first comprised nursing assistants from CCUs that frequently used physical restraint, the second comprised nursing assistants from CCUs that seldom used physical constraint, and the final group comprised doctors from both CCU subtypes. Sampling method: purposive.
Data Analysis: thematic content analysis. Data saturation was achieved.
Results: Four principle themes emerged: 1) concept of safety and risk (patient safety versus the safety of the professional), 2) types of restraint, 3) professional responsibilities (prescription, recording, and professional roles) and 4) "zero restraint" paradigm. The conceptualisation regarding the use of physical contentions shows differences in some of the principal themes, depending on the type of CCU, in terms of policies, use and management of physical constraint (frequently used versus seldom used).
Conclusions: The real reduction in the use of physical restraint in CCU must be based on one crucial point: acceptance of the complexity of the phenomenon. The use of physical restraint observed in the different CCU is influenced by individual, group and organisational factors. These factors will determine how doctors and nursing assistants interpret safety and risk, the centre of care (patient or professional-centred care), the concept of restraint, professional responsibilities and interventions, interactions of the team and the leadership.
(Copyright © 2019 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: