Prevalence of use of physical restraints in pediatric intensive care units and correlated variables: A Spanish multicenter study.

Autor: Bosch Alcaraz A; Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona (UB), Barcelona, Spain; Mental Health, Psychosocial and Complex Nursing Care Research Group-NURSEARCH, University of Barcelona, Barcelona, Spain. Electronic address: alejandrobosch@ub.edu., Belda Hofheinz S; Pediatric Intensive Care Unit 12 de Octubre Hospital, Madrid, Spain., Corrionero Alegre J; Pediatric Intensive Care Unit, Vall Hebron Hospital, Barcelona, Spain., Miguel García Piñero J; Pediatric Intensive Care Unit Nursing Supervisor, Málaga Regional University Hospital, Spain., Gil Domínguez S; Pediatric Intensive Care Unit 12 de Octubre Hospital, Madrid, Spain., Fernández Lorenzo R; Pediatric Intensive Care Unit, Sant Joan de Déu Hospital, Barcelona, Spain., Mata Ferro M; Pediatric Intensive Care Unit, Sant Joan de Déu Hospital, Barcelona, Spain., Martín Gómez A; Pediatric Intensive Care Unit, Sant Joan de Déu Hospital, Barcelona, Spain., Serradell Orea M; Pediatric Intensive Care Unit, Sant Joan de Déu Hospital, Barcelona, Spain., Luna Castaño P; Alfonso X el Sabio University, Madrid, Spain; Member of the Health Care and Services Research Unit (Investén-ISCIII), Spain., Ángeles Saz Roy M; Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona (UB), Barcelona, Spain; Mental Health, Psychosocial and Complex Nursing Care Research Group-NURSEARCH, University of Barcelona, Barcelona, Spain. Electronic address: masazroy@ub.edu., Zuriguel Pérez E; Department of Knowledge Management and Evaluation, Vall d'Hebron Hospital, Barcelona, Spain; Multidisciplinary Nursing Research Group. Vall d'Hebron Research Institute (VHIR), Barcelona, Spain., Martínez Oliva M; Pediatric Intensive Care Unit, Vall Hebron Hospital, Barcelona, Spain., González Rivas S; Pediatric Intensive Care Unit, Vall Hebron Hospital, Barcelona, Spain., Añaños Montoto N; Pediatric Intensive Care Unit, Vall Hebron Hospital, Barcelona, Spain., José Espildora González M; Pediatric Intensive Care Unit Nursing Supervisor, Málaga Regional University Hospital, Spain., Martín-Peñasco Osorio E; Pediatric Intensive Care Unit Nursing Supervisor, Málaga Regional University Hospital, Spain., Carracedo Muñoz E; Pediatric Intensive Care Unit 12 de Octubre Hospital, Madrid, Spain., López Fernández E; Pediatric Intensive Care Unit 12 de Octubre Hospital, Madrid, Spain., Lozano Almendral G; Pediatric Intensive Care Unit, La Paz Hospital, Madrid, Spain., Victoria Ureste Parra M; Pediatric Intensive Care Unit, La Paz Hospital, Madrid, Spain., Gomez Merino A; Pediatric Intensive Care Unit, La Paz Hospital, Madrid, Spain., García Martínez A; Pediatric Intensive Care Unit, La Paz Hospital, Madrid, Spain., Morales Cervera D; Pediatric Intensive Care Unit, La Paz Hospital, Madrid, Spain., Frade Pardo L; Pediatric Intensive Care Unit, La Paz Hospital, Madrid, Spain., Díaz Lerma A; Intensive Care Unit, Clinic Hospital, Barcelona, Spain., Piqueras Rodríguez P; Pediatric Intensive Care Unit, La Paz Hospital, Madrid, Spain; Health Research Institute, La Paz Hospital - IdiPAZ, Madrid, Spain.
Jazyk: angličtina
Zdroj: Intensive & critical care nursing [Intensive Crit Care Nurs] 2024 Dec; Vol. 85, pp. 103788. Date of Electronic Publication: 2024 Aug 07.
DOI: 10.1016/j.iccn.2024.103788
Abstrakt: Objective: To calculate the prevalence of physical restraint (PR) use in Spanish PICUs and (2) to analyze the correlation between the prevalence of PR use and the sociodemographic, clinical variables of the patients and the PICU structural and organizational variables.
Methods: We conducted a multicenter prevalence study from January 2022 to January 2023 in Spanish PICUs. The method of data collection was by direct observation, review of the patient's medical history, and asking the professionals involved in the patient's care. Three weekly 24-hour prevalence observations (morning, afternoon, and night) were conducted for 6 months.
Results: A total of 336 patients were included in the study, obtaining an overall crude prevalence of PR use of 16 % (95 %CI: 15 %-17.7 %). Pediatric patients with respiratory pathology received the highest number of hours of PR, with significant differences observed when comparing respiratory cases with post-surgical cases. Statistical significance was also observed when comparing the mean scores of hours of PR according to admission diagnosis (p = 0.01), with respiratory patients being the ones who were restrained the longest (24 h [20-24]) and infectious patients the least (15 h [14-20]). Patients who receive PR upon admission remain in this situation for more hours (24 h [15-24] and in the PICUs that specifically recorded PR application, fewer hours of PR occurred (20 h [4-24]).
Conclusions: The use of PR is still present in the PICUs analyzed, with a crude prevalence of 16%. Factors such as the reason for admission, the use of respiratory support, and the reason for application of PR were linked to the hours of use of PR.
Implications for Clinical Practice: Knowing the prevalence of PR use will make professionals aware that it is still necessary to implement policies that avoid its use to prevent the side effects they have in pediatric patients.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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