摘要
目的:构建ICU分级化身体约束护理质量标准并开展培训,为规范ICU护士分级化身体约束护理提供参考。方法:于2023年7月—12月,在福建省4个地市的4家三级甲等医院ICU采用整群抽样方法选取346名ICU护士,按照阶梯设计整群随机对照试验方法将4家医院ICU护士分为4个群组并培训。对照组护士进行常规身体约束护理质量标准的培训,干预组护士进行ICU分级化身体约束护理质量标准的培训。评价两组护士的“ICU分级化身体约束测评卷”得分和实施身体约束质量查检不合格项目数,以及患者的身体约束率、身体约束时长、身体约束等级、身体约束相关并发症发生率和非计划性拔管率。结果:干预组测评卷得分高于对照组,身体约束查检不合格项目数少于对照组,身体约束率和三、四级身体约束时长均低于对照组,不同干预阶段身体约束等级存在差异(P<0.05)。两组患者身体约束相关并发症发生率差异无统计学意义(P>0.05),均未发生非计划性拔管事件。结论:ICU分级化身体约束护理质量标准的建立、培训和应用有助于ICU护士树立精准评估身体约束等级,精益身体约束质量的管理观念。
Objective:To establish a graded physical restraint nursing quality standard for ICU and conduct training to ICU nurses,to provide references for standardizing graded physical restraint nursing practices.Methods:From July to December 2023,a Stepped Wedge Cluster Randomized Trial was conducted among 346 ICU nurses across 4 tertiary grade A hospitals in 4 cities in Fujian province.Using a cluster sampling approach,ICU nurses in 4 hospitals were sequentially randomized into 4 groups according to the stepped wedge design.Nurses in the control group received training based on the conventional physical restraint nursing quality standard,while those in the intervention group were trained according to the graded physical restraint nursing quality standard for the ICU.Evaluations included scores on the ICU Graded Physical Restraint Nursing Assessment Questionnaire,as well as the number of non-compliant items in physical restraint quality checks,physical restraint rate,duration of graded physical restraint,distribution of restraint levels,incidence of restraintrelated complications,and unplanned extubation rate.Results:After training,the intervention group showed improved assessment scores and a reduction in non-compliant items during physical restraint quality checks.The physical restraint rate and the duration of grade III and IV physical restraints were lower in the intervention group compared to the control group.Differences in physical restraint levels were also observed across intervention phases(P<0.05).There was no statistically significant difference in the incidence of physical restraint-related complications between the two groups(P>O.O5),and no unplanned extubation events occurred in either group.Conclusion:The establishment,training and application of the ICU graded physical restraint nursing quality standard helpes ICU nurses to develop an awareness of the need to accurately assess the level of physical restraint and to manage the quality of lean physical restraint.
作者
陈巧玲
伍永佳
程欢
陈钗英
别园园
朱宣静
CHEN Qiaoling;WU Yongjia;CHENG Huan;CHEN Chaiying;BIE Yuanyuan;ZHU Xuanjing(Shengli Clinical Medical College,Fujian Medical University,Fuzhou,350001,China)
出处
《中国护理管理》
北大核心
2026年第3期444-449,共6页
Chinese Nursing Management
基金
福建省科技创新联合基金项目引领项目(2023Y9326)。
