Understanding nurses' perspectives of physical restraints during mechanical ventilation in intensive care: A qualitative study.
critical care
intensive care
mechanical ventilation
nurse education
nurse experience
physical restraints
qualitative
treatment interference
workplace culture
Journal
Journal of clinical nursing
ISSN: 1365-2702
Titre abrégé: J Clin Nurs
Pays: England
ID NLM: 9207302
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
revised:
14
02
2021
received:
17
11
2020
accepted:
17
02
2021
pubmed:
23
2
2021
medline:
29
7
2021
entrez:
22
2
2021
Statut:
ppublish
Résumé
This study explored the experiences of nurses using physical restraints on mechanically ventilated patients in intensive care. Physical restraints are frequently used to prevent treatment interference and maintain patient safety in intensive care units worldwide. However, physical restraints are found to be ineffective in preventing treatment interference and cause negative outcomes for patients. The practices surrounding physical restraints are inconsistent due to a lack of education, training and protocols. This research was conducted as a qualitative study with a naturalistic inquiry framework adhering to the Consolidated Criteria for Reporting Qualitative Research guidelines. Twelve in-depth, semi-structured conversations were conducted with registered nurses who have experience working in intensive care and have cared for patients who were physically restrained and mechanically ventilated. These conversations were audio-recorded and transcribed. Thematic analysis was used to analyse the data. Three major themes emerged from the data. The themes were as follows: the ICU culture and its impacts on physical restraint practices; the consequences of physical restraints through a nursing lens; and understanding the ways of learning. The insights into the ICU culture, the nurses' understanding of the consequences of physical restraints and the ways in which nurses learn physical restraint practices have provided a greater depth of knowledge and understanding of the realities of current practice in ICU. This new information demonstrates nurses' understanding of the potential harm caused by physical restraints and the way in which current practices are guided more-so by workplace norms and expectations rather than on critical thinking and decision-making. These insights provide valuable information to intensive care clinicians, educators and policymakers to guide future practice and improve patient outcomes by highlighting the importance of education on physical restraint practices and informing the development of policies and guidelines.
Sections du résumé
AIMS AND OBJECTIVES
OBJECTIVE
This study explored the experiences of nurses using physical restraints on mechanically ventilated patients in intensive care.
BACKGROUND
BACKGROUND
Physical restraints are frequently used to prevent treatment interference and maintain patient safety in intensive care units worldwide. However, physical restraints are found to be ineffective in preventing treatment interference and cause negative outcomes for patients. The practices surrounding physical restraints are inconsistent due to a lack of education, training and protocols.
DESIGN
METHODS
This research was conducted as a qualitative study with a naturalistic inquiry framework adhering to the Consolidated Criteria for Reporting Qualitative Research guidelines.
METHODS
METHODS
Twelve in-depth, semi-structured conversations were conducted with registered nurses who have experience working in intensive care and have cared for patients who were physically restrained and mechanically ventilated. These conversations were audio-recorded and transcribed. Thematic analysis was used to analyse the data.
RESULTS
RESULTS
Three major themes emerged from the data. The themes were as follows: the ICU culture and its impacts on physical restraint practices; the consequences of physical restraints through a nursing lens; and understanding the ways of learning.
CONCLUSION
CONCLUSIONS
The insights into the ICU culture, the nurses' understanding of the consequences of physical restraints and the ways in which nurses learn physical restraint practices have provided a greater depth of knowledge and understanding of the realities of current practice in ICU. This new information demonstrates nurses' understanding of the potential harm caused by physical restraints and the way in which current practices are guided more-so by workplace norms and expectations rather than on critical thinking and decision-making.
RELEVANCE TO CLINICAL PRACTICE
CONCLUSIONS
These insights provide valuable information to intensive care clinicians, educators and policymakers to guide future practice and improve patient outcomes by highlighting the importance of education on physical restraint practices and informing the development of policies and guidelines.
Types de publication
Journal Article
Langues
eng
Pagination
1706-1718Informations de copyright
© 2021 John Wiley & Sons Ltd.
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