• Title, Summary, Keyword: restraints

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Development and Application of the Sleeve-type Restraints for Intensive Care Unit Patients (중환자실 환자를 위한 소매형 억제대의 개발 및 적용)

  • Ko, Hyun-Young;Kang, Jiyeon
    • Korean Journal of Adult Nursing
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    • v.25 no.6
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    • pp.665-678
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    • 2013
  • Purpose: The purpose of this study was to develop sleeve-type restraints and to compare the sleeve-type and conventional wrist restraints. Methods: Forty four pairs of intensive care unit (ICU) patients and their families participated in the experiment. The nurses applied sleeve-type restraints to the patients in the experimental group, and wrist restraints to the control group. The trained research assistant measured ROMs, skin temperature, edema, and skin lesions of both upper extremities (UEs) before, 24, 48, and 72 hours after the restraints applied. The emotional response of family was measured 72 hours after the restraints applied. Thirty one ICU nurses evaluated the efficiency of both types of restraints. Results: Compared to the control group, changes of ROMs, edema, and skin abrasions on both U/Es of the experimental group indicated a significant difference in physical side effects. The emotional response scores of the experimental group were significantly lower than those of the control group. The mean efficiency scores for the sleeve-type restraints were significantly higher than those for the wrist restraints. Conclusion: The results indicate that the sleeve-type restraints are better than wrist restraints with respect to physical side effects, emotional responses of family members, and application efficiency.

Perception, Attitude, and Knowledge about Physical Restraints among Nursing Personnel in Long Term Care Facilities (노인시설 간호제공자의 신체적 억제대에 대한 인식, 태도 및 지식에 대한 연구)

  • Kim, Shin-Mi;Lee, Yun-Jung;Kim, Duck-Hee;Kim, Sook-Young;Ahn, Hye-Young;Yu, Su-Jeong
    • The Journal of Korean Academic Society of Nursing Education
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    • v.15 no.1
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    • pp.62-71
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    • 2009
  • Purpose: The present study was performed to identify the perception, attitude, and knowledge regarding the use of physical restraints among nursing personnel working at long-term care facilities. Method: 289 nurses, nurse aids and private caregivers working at 13 wards from 7 facilities participated in the survey. Perception, attitude and knowledge regarding the use of physical restraints were evaluated using the Perceptions of Restraints Use Questionnaire developed by Evans and Strumpf(1993) and Physical Restraint Questionnaire suggested by Janelli, et al(2006). Results: Wrist restraints were used the most frequently. The perception score regarding the use of physical restraints was 3.35, which is a moderate value. Study respondents considered 'safety measure' and 'safe use of a medical device' as the most important aspects when applying physical restraints to elderly. The respondents reported physical restraints were therapeutic at least to some degree but knowledge level about physical restraints of the respondents was rather low. Conclusion: Perception and attitude toward physical restraints were identified. The lack in knowledge about physical restraints needs to be addressed for more efficient use of them.

A Study on the Application of Physical Restraints in Intensive Care Units (일 대학병원 중환자실의 억제대 사용실태)

  • Kim, Mi-Yeon;Park, Jeong-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.17 no.2
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    • pp.177-186
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    • 2010
  • Purpose: The purpose of this descriptive study was to investigate the application of physical restraints in ICUs of a university hospital. Method: Data were collected from August 1 to October 1 2009, using a recording tool from Electric Nursing Records and an observation tool for physical restraints and related factors. Frequency, percentage, and paired t-test with the SPSS/WIN 16.0 program were used to analyze the data. Results: The application rate for physical restraints in 5 ICUs was 34.3%, the highest application rate was 48.4% in the neurosurgical ICU. The mean frequency for physical restraint application per patient was 1.14, and the mean hours of restraint application per incident was 113.01 hours. The most common complications of physical restraints were bruising and edema. Conclusion: Many ICU nurses use physical restraints when caring for patients who are at high risk for falls, including patients have high levels of acuity, decreased level of consciousness or increased irritability. When physical restraints are applied, patients show resistance against the use resulting in side effects of bruising and edema. Therefore, nurses should observe changes in restrain sites, perform nursing interventions to prevent complications, and minimize the use of physical restraints.

Protocol for Physical Restraints of Patients in Nursing Homes (노인요양시설의 신체적 억제대 프로토콜 개발)

  • Lim, Mi Hye;Ko, Il Sun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.20 no.4
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    • pp.345-358
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    • 2013
  • Purpose: The purpose of this study was to develop a protocol that would help prevent accidents, apply physical restraints properly, and reduce the use of physical restraints in nursing homes. Method: A review of the literature and analysis of existing statutes and regulations were used to develop the preliminary protocol. To test the validity of this preliminary protocol, ten experts were selected from academia and clinical practice to review the protocol. The initial protocol was finalized after it had been reviewed by experts and tested for clinical validity in five different nursing homes. Result: The protocol consists of objectives, definitions and accident probability assessment, principle of using physical restraints, monitoring and documentation of physical restraints. Conclusion: The findings of this study can be used as guidelines to focus on preventing accidents arising out of use of physical restraints, assessing the probability of accidents, and reducing the use of physical restraints through preventive interventions. This will be helpful to prevent ethical, physical, or psychological problems arising from use of physical restraints and to protect the rights of elderly people in nursing homes.

A Study on the Use of Physical Restraints in ICUs (일 종합병원 중환자실의 억제대 적용 실태조사)

  • Cho, Yongae;Kim, Jungsook;Kim, Nari;Choi, Heejung;Cho, Junggu;Lee, Heejung;Kim, Ryungin;Sung, Younghee
    • Korean Journal of Adult Nursing
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    • v.18 no.4
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    • pp.543-552
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    • 2006
  • Purpose: The purpose of this descriptive study was to investigate the pattern of physical restraints used in ICUs and to identify influencing factors of application and removal of restraints. Method: The subjects of this study were 90 restrained patients out of 215 patients over 6 years old who were admitted to 6 ICUs in SMC during a 2 weeks period. The data was collected through a questionnaire of characteristics, guidelines and nursing care of restraint uses. The data were analyzed by non-parametric statistic with the use of the SAS program. Results: The restraints were applied to 31.4% of subjects. Mean time of physical restraint was $36.76{\pm}55.7$ hours. There were significant difference with mean time and frequency according to duty shift. GCS, restless behavior and discomfort factors, medical devices, and life sustaining devices had significant relation with application of restraints. In addition, the mean time of restraints used were related significantly with GCS, restless behavior, and discomfort factors. Conclusion: The used of restraints were dependent on mainly the nurses' decision. Thus ICU nurses have to develop the guidelines to applying restraints and removal of restraints in regard to patients rights and ethics. Continuous monitoring and evaluation of application of the restraints is essential in professional nursing.

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Effects of on Education Program for Nurses on the Use of Restraints (억제대 사용에 대한 간호사 교육프로그램의 효과)

  • Yeo Jeong-Min;Park Myong-Hwa
    • Journal of Korean Academy of Nursing
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    • v.36 no.3
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    • pp.532-541
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    • 2006
  • Purpose: This study was conducted to verify the effects of an education program of restraints use on nurses' knowledge, attitude and nursing performance related to restraints use. Method: A quasi experimental study with a pre and post non-equivalent design was used. The subjects were nurses who met the selection criteria and worked in intensive care units of two university hospitals located at K-city, Gyeongbuk. Twenty nurses in A hospital were designated as the experimental group and 20 nurses in B hospital as the control group. Result: The first hypothesis which assumed that the experimental group would have higher scores of knowledge than the control group was supported(F=62.66, p=0.000). The second hypothesis which assumed that the experimental group would have lower scores of attitude toward using restraints than the control group was supported(F=23.77, p=0.000). The third hypothesis which assumed that the experimental group would have higher scores of nursing performance than the control group was supported(F=3.28, p=0.032). Conclusion: An education program for nurses' on the use of restraints needs to be introduced to decrease inappropriate use of restraints.

Effects of an Educational Program for the Reduction of Physical Restraint Use by Caregivers in Geriatric Hospitals (노인전문병원 간호제공자의 신체적 억제대 사용 감소를 위한 교육 프로그램의 효과)

  • Choi, Keum-Bong;Kim, Jin-Sun
    • Journal of Korean Academy of Nursing
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    • v.39 no.6
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    • pp.769-780
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    • 2009
  • Purpose: The purposes of this study were to develop an educational program to reduce the use of physical restraints for caregivers in geriatric hospitals and to evaluate the effects of the program on cargivers' knowledge, attitude and nursing practice related to the use of physical restraints. Methods: A quasi experimental study with a non-equivalent control group pretest-posttest design was used. Participants were recruited from two geriatric hospitals. Eighteen caregivers were assigned to the experimental group and 20 to the control group. The data were collected prior to the intervention and at 6 weeks after the intervention through the use of self-administered questionnaires. Descriptive statistics, $\chi^2$ test, Fisher's exact probability test, and Mann-Whitney U test were used to analyze the data. Results: After the intervention, knowledge about physical restraints increased significantly in experimental group compared to the control group. However, there were no statistically significant differences between the groups for attitude and nursing practice involving physical restraints. Conclusion: Findings indicate that it is necessary to apply knowledge acquired through educational programs to nursing practice to reduce the use of physical restraints. User friendly guidelines for physical restraints, administrative support of institutions, and multidisciplinary approaches are required to achieve this goal.

Perceptions of Family Care-givers toward Use of Physical Restraints: An Application of Q-methodology (중환자 가족의 신체억제대 사용에 대한 인식: Q방법론적 접근)

  • Yeun, Eun Ja;An, Jeong Hwa;Kim, Jung A;Jeon, Mi Soon
    • Korean Journal of Adult Nursing
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    • v.25 no.3
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    • pp.344-355
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    • 2013
  • Purpose: The purpose of this study was to identify on the perceptions of family care-givers toward use of physical restraints according to their values, beliefs, and perceptions using Q methodology. Methods: Thirty-three family care-givers classified 41 selected Q-statements into 9 points standard. The obtained data were analyzed by using a pc QUANL program. Results: Principal component analysis identified 4types of the perceptions of family care-givers toward the use of physical restraints. Type I is 'Rational accepted', which means that they perceived the restraints are essential therapeutic devices and had cooperative attitude to use of medical staffs' restraints. Type II is 'Sardonic sensibility', which means that they have a negative and a cynical attitude to use of physical restraints. Type III is 'Ambivalent', which means that they have conflicts between rationality and emotion, and type IV is 'Practical claim of a right', which means they insist that patients and their family members must be provided with a detailed explanation regarding the application of physical restraints. Conclusion: The findings of this study suggest that perceptions toward the use of physical restraints among family care-givers should be understood for patients' safety and dignity in medical circumstance. Based on the results, this study will be useful in developing the customized nursing intervention for supporting family care-givers' subjectivity considering the Korean context.

BIOMECHANICS OF THE SHOULDER JOINT

  • Lee Yong Geol
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • pp.9-13
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    • 1995
  • 1. The static restraints are improtant in maintaining balance between shoulder mobility and stability. But the shoulder musculature plays the vital role in moving the joint and providing stability. 2. Study of the dynamic restraints continues and study of the combined effect of the static and dynamic restraints is demanded.

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Study on the ICU Nurses' Intention to Use Restraints and Related Factors (중환자실 간호사의 억제대 사용의도와 관련 요인에 관한 연구)

  • 박명화;이병숙
    • Health Policy and Management
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    • v.8 no.2
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    • pp.191-215
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    • 1998
  • This descriptive correlational study was done to identify ICU nurses' intention to use restraints and related factors using Ajzen and Madden(1986)'s Theory of Planned Behavior. Self-reported questionnaires were used to measure intention and related factors. The subjects of this study were 287 ICU nurses in 21 general hospitals with at least 200 beds at Taegu, Pusan and Kyungbuk area in Korea. The results of this study were : 1. There were significant differences in intention according to age and marnital status, attitude according to educastion(with indirect measure), subjective norm according to career in ICU(with both measures), perceived behavioral control according to age and career in ICU(with direct measure), and knowledge according to education and position. 2. There were significant correlations among intention and all factors. Intention was correlated with attitude(r=.2119), subjective norm(r=.1112), and perceived behavioral control(r=.3448) with direct measure. Attitude was correlated with subjective norm(r=.2530), perceived behavioral control(r=.3005), and knowledge(r=.1388) with direct measure. Subjective norm was correlated with perceived behavioral control(r=.1321) with direct measure. Intention was correlated with attitude(r=.1496) and perceived behavioral control(r=.2922) with indirect measure. Attitude was correlated with subjectivenorm(r=.2829) and knowledge(r=-.1390) with indirect measure. Also, subjective norm was correlated with perceived behavioral control(r=.2363) with indirect measure. 3. ICU nurses' intention to use restraints was explained 16.7% by perceived behavioral control, attitude with direct measure, control belief, and age. By this study, it was foundr that ICU nurses reported high level of intention to use restraints. The most important predictor of intention to use restraints was perceived behavioral control toward using restrains, which reflected the easiness and difficulty in the use of restraints.

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