Application of assessment of orientation in judging patients for removing physical constraints in Neurosurgical Intensive Care Units / 中华护理杂志

ABSTRACT

Objective To explore an assessment tool for releasing physical restraints of patients in neurosurgical intensive care unit (NICU).Methods Totally 70 patients in NICU with physical restraints whose Glasgow Coma Scale (GCS)scores were 13 to 15 were assessed by Johns Hopkins Adapted Cognitive Exam (ACE).After assessment,patients were divided into the normal orientation group and the abnormal orientation group according to the results.Then we removed physical constraints of patients in the normal orientation group.We analyzed occurrence of unplanned extubation and overall cognitive function of two groups.Results There was no unplanned extubation after removal of physical restraints in the normal orientation group,whereas there were five cases of unplanned extubation in the abnormal orientation group (P＜0.05).With regards to overall cognitive function,scores of other subtests and total scores in the normal orientation group were significantly higher than those in the abnormal orientation group (P＜0.05).Conclusion ACE can be used as assessment tool for orientation among patients in NICU,and normal orientation can serve as an indication of removal of physical restraints in patients with GCS scores of 13 to 15 in NICU.