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Qual Improv Health Care > Volume 20(1); 2014 > Article
Quality Improvement in Health Care 2014;20(1): 42.
DOI: https://doi.org/10.14371/QIH.2014.20.1.42    Published online July 30, 2014.
신체적 억제대 지침 개발 및 사용 효과
정윤중1, 김혜현1, 김은한1, 김지연1, 차세정1, 김유진1, 강정은1, 정연화1, 정영선1, 김영환2, 경규혁3, 홍석경4
1서울아산병원 중환자 간호팀
2아주대학교병원 외상센터
3울산대학교병원 외상센터
4서울아산병원 외과학교실 외상 및 중환자외과
Development of physical restraints guidelines and use effect
Yooun-Joong Jung1, Hea-Hyun Kim1, Eun-Han Kim1, Ji-Yeoun Kim1, Se-Jung Cha1, You-Jin Kim1, Jung-Eun Kang1, Yeon-Hwa Chung1, Young-Sun Jung1, Young-Hwan Kim2, Kyu-Hyouck Kyoung3, Suk-Kyung Hong4
1Department of Nursing Team, Asan Medical Center
2Department of Emergency Medicine, Ajou University School of Medicine
3Trauma Center, Ulsan University Hospital
4Department of Surgery, Asan Medical Center
Abstract
Objective: The objective of this research was to develop a guideline for more effective use of physical restraint on patients in the intensive care unit and training the nurses on it and applying it on clinical practice to assess its effectiveness. Method: This research analyzed the before and after effect of the development of a guideline for physical restraint by dividing the category into nurse and patient. In the case of nurse, a comparison of knowledge and nursing service regarding the use of physical restraint from before the training on physical restraint guideline(Jan. 2011) and after the training on physical restraint guideline(Dec. 2011) was made. In the case of patient, a comparison of physical restraint usage rate and average usage time, the number of unplanned extubation cases were compared from before the use of physical restraint (Jan.~Apr. 2011) and after the use of physical restraint (Sep.~Dec. 2011) were made.
Result
After the training on the physical restraint guideline, the knowledge of the nurse and the nursing practice showed notable improvement by (p<0.000) and (p<0.048) respectively and in patient, physical restraint usage rate and average time of usage decreased by (p<0.001) and (p<0.001) respectively. And despite the decrease in the number of cases in which the physical restraint was used, the number of unplanned extubation cases remained the same.
Conclusion
Physical restraint guideline training and guideline usage can be stated to have brought out positive effect in both the nurse and patient. In order to maintain such positive effects, continuous training is necessary and continuous revaluation is necessary, regarding knowledge and nursing practices.
Key words Physical restraint;Guidelines;Intensive care unit;


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