Physical Restraints in Critically Ill Children: A Multicenter Longitudinal Point Prevalence Study

Area of Science:

• Pediatric critical care medicine
• Patient safety and quality improvement
• Clinical research methodology

Background:

• Physical restraints are used in pediatric intensive care units (PICUs) for critically ill or injured children.
• Understanding the prevalence and associated factors of physical restraint use is crucial for improving patient care and safety.

Purpose of the Study:

• To investigate the prevalence of physical restraint use in critically ill or injured children admitted to PICUs.
• To identify factors associated with the use of physical restraints in this vulnerable population.

Main Methods:

• A multicenter, longitudinal point prevalence study was conducted across 26 PICUs in Japan.
• Data were collected on three dates in 2019, screening 398 children aged 1 month to 10 years.
• Prevalence, demographic characteristics, and details of physical restraint use were recorded.

Main Results:

• The prevalence of physical restraint use was 53%, with wrist restraint bands being the most common type.
• Children aged 1-2 years had higher odds of restraint use (adjusted odds ratio 2.3).
• Units without a practice policy or those with over 10 beds showed increased likelihood of restraint use.

Conclusions:

• Physical restraint use is prevalent and varies significantly among PICUs.
• Patient age, unit size, and the presence of a practice policy are associated with physical restraint frequency.
• Findings highlight the need for standardized protocols to optimize physical restraint management in pediatric critical care.