Physical restraint use in a Korean ICU.

Area of Science:

• Critical Care Medicine
• Nursing Research
• Patient Safety

Background:

• Physical restraints are utilized in intensive care units (ICUs) to manage patient behavior.
• Understanding the patterns and decision-making factors for restraint use is crucial for improving patient care and safety.

Purpose of the Study:

• To investigate the patterns of physical restraint use in a Korean ICU.
• To identify factors that discriminate the application and removal of restraints in ICU patients.

Main Methods:

• A descriptive study analyzing 94 incidents of restraint application and removal in 23 patients over a 6-week period.
• Data collection included nurse questionnaires, restraint documentation, ICU flowsheets, and patient chart reviews.
• Key variables analyzed were patient restlessness scores and the presence of a nasogastric tube.

Main Results:

• Bilateral wrist restraints were most common; mean application per patient was 3.62, with a mean duration of 22.64 hours.
• Restraint use showed no significant difference across day, evening, or night shifts.
• Restless behavior score and nasogastric tube presence were significant discriminators (70.2% accuracy); nurses made over 90% of application decisions.

Conclusions:

• Patient restless behavior is the primary factor influencing restraint application and removal.
• Nurses primarily use restraints to prevent removal of medical devices.
• Developing tools for accurate patient restlessness evaluation may reduce restraint duration in ICUs.