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Published on: July 4, 2018
Prevalence and Influencing Factors of Physical Restraints in Intensive Care Units: A Retrospective Cohort Study
Nianqi Cui1,2, Hui Zhang3, Sijie Gan4
1Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine (SAHZU), Hangzhou, Zhejiang, People's Republic of China.
Insights
Physical restraints are frequently used in intensive care units (ICUs). Factors like surgical ICU admission and pain increase use, while male sex and light sedation decrease it, aiding in identifying high-risk patients.
Area of Science:
- Critical Care Medicine
- Patient Safety
- Clinical Research
Background:
- Physical restraints are commonly employed in intensive care units (ICUs).
- Their routine use is associated with adverse patient outcomes.
- Identifying factors influencing restraint use is crucial for critically ill patients.
Purpose of the Study:
- To investigate the prevalence of physical restraint use in critically ill patients.
- To identify independent impact factors associated with physical restraint utilization.
- To inform strategies for reducing physical restraint use in ICUs.
Main Methods:
- A retrospective cohort study was conducted in multiple ICUs at a tertiary hospital in China.
- Data from 3776 critically ill patients were analyzed using electronic medical records.
- Logistic regression analysis was employed to determine independent impact factors.
Main Results:
- The prevalence of physical restraint use was 48.8% among the studied cohort.
- Independent risk factors for restraint use included surgical ICU admission, pain, tracheal tube, and abdominal drainage tube placement.
- Independent protective factors included male sex, light sedation, muscle strength, and ICU length of stay.
Conclusions:
- Physical restraint use is high in critically ill patients.
- Specific clinical factors are significantly associated with restraint use.
- Targeting pain management, sedation, and device removal may reduce physical restraint utilization.
Purpose:
Physical restraints are used routinely in intensive care units (ICUs) and have negative effects. It is critical to identify the impact factors of physical restraints on critically ill patients. The present study investigated the prevalence of physical restraints and impact factors associated with their use in a large cohort of critically ill patients over one year.
Patients And Methods:
A retrospective cohort study was performed in multiple ICUs at a tertiary hospital in China in 2019 using observational data from electronic medical records. The data consisted of demographics and clinical variables. Logistic regression was used to assess the independent impact factors for the use of physical restraint.
Results:
The analysis consisted of 3776 critically ill patients with a prevalence of physical restraint use of 48.8%. The logistic regression analysis indicated that physical restraint use was associated with independent risk factors, including surgical ICU admission, pain, tracheal tube placement, and abdominal drainage tube placement. Physical restraint use was associated with independent protective factors, including male sex, light sedation, muscle strength, and ICU length of stay.
Conclusion:
The prevalence of physical restraint use in critically ill patients was high. Tracheal tubes, surgical ICU, pain, abdominal drainage tubes, light sedation, and muscle strength were independent variables associated with the use of physical restraint. These results will assist health professionals in identifying high-risk physical restraint patients based on their impact factors. Early removal of the tracheal tube and abdominal drainage tube, pain relief, light sedation, and improvements in muscle strength may help reduce the use of physical restraints.
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