Your browser doesn't support javascript.
Why are physical restraints still in use? A qualitative descriptive study from Chinese critical care clinicians' perspectives.
Cui, Nianqi; Qiu, Ruolin; Zhang, Yuping; Chen, Dandan; Zhang, Hui; Rao, Hongyu; Jin, Jingfen.
  • Cui N; Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine (SAHZU), Hangzhou, Zhejiang, China.
  • Qiu R; Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
  • Zhang Y; Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine (SAHZU), Hangzhou, Zhejiang, China.
  • Chen D; Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
  • Zhang H; Faculty of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
  • Rao H; Faculty of Nursing, Yunnan University of Business Management, Kunming, Yunnan, China.
  • Jin J; Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine (SAHZU), Hangzhou, Zhejiang, China zrjzkhl@zju.edu.cn.
BMJ Open ; 11(11): e055073, 2021 11 03.
Article in English | MEDLINE | ID: covidwho-1501724
ABSTRACT

OBJECTIVES:

To understand why critical care clinicians still implement physical restraints, to prevent unplanned extubation and to explore the driving factors influencing the decision-making of physical restraints use.

DESIGN:

A qualitative descriptive design was used. The data were collected through one-to-one, semistructured interviews and analysed through the framework of thematic analysis. PARTICIPANTS AND

SETTING:

The study was conducted from December 2019 to May 2020 at one general intensive care unit (ICU) and one emergency ICU in a general tertiary hospital with 3200 beds in Hangzhou, China. The sampling strategy was combined maximum variation sampling and criterion sampling.

RESULTS:

A total of 14 clinicians participated in the study. The reason why critical care clinicians implemented physical restraints to prevent unplanned extubation was that the tense healthcare climate was caused by family members' rejection of mismatched expectations. As unplanned extubation was highly likely to create medical disputes, hospitals placed excessive emphasis on unplanned extubation, which resulted in a lack of analysis of the cause of unplanned extubation and strict measures for dealing with unplanned extubation. The shortage of nursing human resources, unsuitable ward environments, intensivists' attitudes, timely extubation for intensivists, nurse experiences and the patient's possibility of unplanned extubation all contributed to the decision-making resulting in the use of physical restraints.

CONCLUSIONS:

Although nurses played a crucial role in the decision-making process of using physical restraints, changing the healthcare climate and the hospital management mode for unplanned extubation are fundamental measures to reduce physical restraints use.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Restraint, Physical / Critical Care Type of study: Prognostic study / Qualitative research Limits: Humans Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2021-055073

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Restraint, Physical / Critical Care Type of study: Prognostic study / Qualitative research Limits: Humans Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2021-055073