Prevalence of and factors associated with physical restraint use in the intensive care unit: a multicenter prospective observational study in Japan.
Intern Emerg Med
; 17(1): 37-42, 2022 Jan.
Article
in En
| MEDLINE
| ID: mdl-33852145
ABSTRACT
Physical restraint is widely used in the intensive care unit (ICU) to ensure patient safety despite its ethical implications. We performed a prospective observational study in six ICUs in Japan to determine the prevalence of and factors associated with physical restraint use in the ICU, a phenomenon that has not yet been reported on in Japan. Data were collected on 10 random days between November 2018 and February 2019. We evaluated physical restraint use in ICU patients aged ≥ 20 years during the data collection days. Among the 787 observations, the prevalence of physical restraint use was 32.9%; however, it was 41.5% in patients receiving invasive mechanical ventilation (IMV). The average age of patients was 68.5 years, and the average Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) II score was 19.4. Among the included patients, 52.1% received IMV, and 17.2% were diagnosed with delirium. Logistic regression analysis revealed that the independent factors [odds ratio (95% confidence interval)] associated with physical restraint use were age [1.02 (1.00-1.05)], APACHE II score [1.05 (1.01-1.09)], IMV [2.15 (1.16-4.01)], central venous catheter indwelling [2.66 (1.46-4.85)], sedative medication [2.98 (1.72-5.17)], agitation [7.83 (2.96-20.8)], and delirium [4.16 (2.37-7.29)]. Approximately one-third of the ICU patients required physical restraint in Japan. In addition, physical restraint use was influenced by disease severity, mental condition, and the medical apparatus used. Based on these findings, further investigations are imperative to develop strategies to reduce physical restraint use.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Restraint, Physical
/
Delirium
Type of study:
Clinical_trials
/
Diagnostic_studies
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Aspects:
Ethics
Limits:
Aged
/
Humans
Country/Region as subject:
Asia
Language:
En
Journal:
Intern Emerg Med
Journal subject:
MEDICINA DE EMERGENCIA
/
MEDICINA INTERNA
Year:
2022
Document type:
Article
Affiliation country:
Japón