住院患者规范化身体约束管理最佳证据总结

doi:10.16460/j.issn1008-9969.2019.04.031

摘要/Abstract

摘要： 目的检索并获取符合住院患者身体约束管理的最佳证据,为医务人员、管理者、患者及家属临床实践提供参考。方法用PIPOST确定科学问题,制定合适的检索策略和纳排标准,检索JBI、RNAO、CINAHL等数据库,由2名有资质的研究员对不同的文献类型采用对应的评价工具独立进行评价、证据提取与综合。结果纳入11篇有关身体约束的文献,其中1篇临床决策、3篇证据总结、3篇指南、3篇系统评价、1篇专家共识。从11篇文献中共提取了50条证据,综合成5个维度22条最佳证据,分别是组织政策、培训教育、约束评估、替代方案和实施监测。结论临床管理者应根据专科特色制定合适的约束制度,对员工定期培训,促进零约束的组织文化。对实施约束的患者进行人文关怀,充分尊重患者的人权与尊严。

关键词: 身体约束, 证据总结, 循证护理

Abstract: Objective To summarize the best evidence for physical restraint management in inpatients and to provide reference for medical staff, managers, patients and families. Methods We employed PIPOST to identify scientific problems, then formulated appropriate retrieval strategies and criteria. We searched the JBI, RNAO and CINAHL, etc. and 2 qualified researchers independently evaluated articles using different tools according different types of the articles. We used The Joanna Briggs Institute Levels of Evidence and Grades of Recommendation to assess the evidence classification and recommendation level. Two researchers synthesized the best evidence. Results Totally 11 articles were enrolled, including 1 clinical decision, 3 evidence summaries, 3 guidelines, 3 systematic reviews and 1 expert consensus. A total of 50 evidences were extracted which were integrated into 22 best evidences in 5 dimensions. There were organizational policy, training education, restraint evaluation, alternative methods and implementation monitoring. Conclusion Clinical managers should establish appropriate restraint system according to specialty characteristics, regular training for medical staff, and promote the free-restraint culture. Humanistic care is recommended for patients with physical restraints to fully respect the human rights and dignity of the patients.

Key words: physical restraints, evidence summary, evidence-based nursing

中图分类号:

R197.323.2

杨中善, 许妮娜, 詹昱新, 刘宁, 李昭慧, 乐格芬. 住院患者规范化身体约束管理最佳证据总结[J]. 护理学报, 2019, 26(4): 31-36.

YANG Zhong-shan, XU Ni-na, ZHAN Yu-xin, LIU Ning, LI Zhao-hui, LE Ge-fen. Summary of Best Evidence for Standardized Management of Physical Restraint in Inpatients[J]. Journal of Nursing, 2019, 26(4): 31-36.

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