Study on continuous improvement of clinical application of evidence-based practice program of physical restraint in ICU patients / 中国实用护理杂志

ABSTRACT

Objective:To understand the current status of the evidence-based practice program of physical restraint in ICU patients and analyze its influencing factors, formulate and implement an action plan for continuous application of the program, so as to improve the knowledge level and evidence-based nursing ability of nurses, promote the improvement of patient outcomes, and strengthen the organization′s evidence-based cultural atmosphere.Methods:This study selected the program application departments of China Japan Friendship Hospital Surgical ICU as the research object, including all nurses, patients, nursing process, department standard system, etc. To understand the status and influencing factors of the project through observation and interview methods. The "Optimized Version of Evidence-based Practice Program of Physical Restraint in ICU Patients" was formulated and implemented, and a before-and-after comparative study method was used to comprehensively evaluate the implementation effect from the level of patients, nurses and organization.Results:The implementation rate of the 7 review standards of the program application department showed a downward trend; the patient restraint rate and restraint duration increased compared with the previous period; after the implementation of the optimized version program, the implementation of each item had been improved; the physical restraint rate decreased from 34.91% (37/106) before optimization to 28.57% (8/28) ( χ 2 value was 0.40, P>0.05), and the time of physical restraint decreased from 60.93 hours before optimization to 48.09 hours after optimization ( Z value was -0.19, P>0.05). Conclusions:The continuous application of the evidence-based practice project of physical restraint in ICU patients was not very optimistic. The continuity of implementation was affected by many factors. The continuous quality improvement of this evidence-based practice project can promote the improvement of the standard of physical restraint of patients, improve the quality of life of patients, promote the improvement of nurses' knowledge level and the improvement of evidence-based nursing ability; at the same time, it created a better organization′s evidence-based cultural atmosphere.