Kari Johnson1, Valerie Curry2, Alison Steubing3, Shelly Diana4, Andrea McCray5, Amanda McFarren6, Alisa Domb7. 1. HonorHealth John C Lincoln Medical Center, 250 East Dunlap Avenue, Phoenix, AZ 85020, United States. Electronic address: Kari.Johnson@honorhealth.com. 2. Trauma Intensive Care Unit, HonorHealth John C Lincoln Medical Center, 250 East Dunlap Avenue, Phoenix, AZ 85020, United States. Electronic address: Valerie.Curry@honorhealth.com. 3. Trauma Intensive Care Unit, HonorHealth John C Lincoln Medical Center, 250 East Dunlap Avenue, Phoenix, AZ 85020, United States. Electronic address: Alison.Steubing@honorhealth.com. 4. Trauma Intensive Care Unit, HonorHealth John C Lincoln Medical Center, 250 East Dunlap Avenue, Phoenix, AZ 85020, United States. Electronic address: Shelly.Diana@honorhealth.com. 5. Trauma Intensive Care Unit, HonorHealth John C Lincoln Medical Center, 250 East Dunlap Avenue, Phoenix, AZ 85020, United States. Electronic address: Andrea.McCray@honorhealth.com. 6. Trauma Intensive Care Unit, HonorHealth John C Lincoln Medical Center, 250 East Dunlap Avenue, Phoenix, AZ 85020, United States. Electronic address: Amanda.McFarren@honorhealth.com. 7. HonorHealth Deer Valley Medical Center, Phoenix, AZ 85027, United States. Electronic address: Alisa.Domb@honorhealth.com.
Abstract
AIMS: To evaluate an education intervention to decrease restraint use in patients in a Trauma Intensive Care Unit (TICU) and to evaluate nurses' perceptions regarding restraints. OBJECTIVES: To measure restraint use pre/post-intervention and to measure nurses' perceptions of restraint use. METHODS: Pre/post-intervention design to collate incidences of delirium and restraints pre/post-intervention. Data reporting nurses' views and preferences were collected pre-intervention. MEASURES: Patients were assessed by nursing on admission and every shift with the Confusion Assessment Method for TICU. Restraint use was measured in a 24-hour period. Nurses' perception of restraints was measured using Perceptions of Restraint Use Questionnaire (PRUQ). RESULTS: A statistically significant difference was demonstrated in restraint use before and after the educational intervention. Mean and standard deviation for restraints per 1000 patient days pre-intervention was 314.1 (35.4), post-intervention 237.8 (56.4) (p=0.008). Mean PRUQ overall, 3.57 (range 1-5) indicated that nurses had positive attitudes towards restraints in certain circumstances. The primary reasons for using restraints were: "protecting patients from falling out of bed", 37 (72.5%), and "protecting patients from falling out of chair", 34 (66.7%). CONCLUSION: This study demonstrates that a low risk educational intervention aimed at use of an alternative device use can reduce restraint use.
AIMS: To evaluate an education intervention to decrease restraint use in patients in a Trauma Intensive Care Unit (TICU) and to evaluate nurses' perceptions regarding restraints. OBJECTIVES: To measure restraint use pre/post-intervention and to measure nurses' perceptions of restraint use. METHODS: Pre/post-intervention design to collate incidences of delirium and restraints pre/post-intervention. Data reporting nurses' views and preferences were collected pre-intervention. MEASURES: Patients were assessed by nursing on admission and every shift with the Confusion Assessment Method for TICU. Restraint use was measured in a 24-hour period. Nurses' perception of restraints was measured using Perceptions of Restraint Use Questionnaire (PRUQ). RESULTS: A statistically significant difference was demonstrated in restraint use before and after the educational intervention. Mean and standard deviation for restraints per 1000 patient days pre-intervention was 314.1 (35.4), post-intervention 237.8 (56.4) (p=0.008). Mean PRUQ overall, 3.57 (range 1-5) indicated that nurses had positive attitudes towards restraints in certain circumstances. The primary reasons for using restraints were: "protecting patients from falling out of bed", 37 (72.5%), and "protecting patients from falling out of chair", 34 (66.7%). CONCLUSION: This study demonstrates that a low risk educational intervention aimed at use of an alternative device use can reduce restraint use.