Affiliation 1 Department of Cardiac Surgery Intensive Care Unit, Shandong Provincial Hospital Affiliated to Shandong First Medical University (Shandong Provincial Hospital), Jinan 250021, Shandong, China. Corresponding author: Zheng Jing, Email: 517365118@qq.com.
刊名
Zhonghua wei zhong bing ji jiu yi xue
年份
2024
卷号
Vol.36 No.10
页码
1102-1107
ISSN
2095-4352
摘要
Objective: To construct a physical restraint reduction scheme based on eCASH concept of Shandong Provincial Hospital Affiliated to Shandong First Medical University from July to October 2022 were enrolled as subjects. According to the implementation time node of the physical restraint reduction scheme, 250 patients admitted from July to August were served as the control group, and 236 patients admitted from September to October were served as the observation group. The control group adopted the...更多
Objective: To construct a physical restraint reduction scheme based on eCASH concept of Shandong Provincial Hospital Affiliated to Shandong First Medical University from July to October 2022 were enrolled as subjects. According to the implementation time node of the physical restraint reduction scheme, 250 patients admitted from July to August were served as the control group, and 236 patients admitted from September to October were served as the observation group. The control group adopted the routine physical restraint nursing process, including selecting the appropriate restraint device according to the patient's condition and consciousness and following the doctor's advice, and checking on time to prevent adverse reactions. The observation group implemented the physical restraint reduction scheme based on eCASH concept, including preoperative visit, postoperative assessment of whether patients needed physical restraint according to the restraint decision wheel and the physical restraint flow, and adopted personalized nursing programs. The restraint rate, restraint duration, incidence of restraint-related complication , restraint device application standard rate, delirium rate and incidence of unplanned extubation event were compared between the two groups. Results: There was no significant difference in age, gender, cardiopulmonary bypass, endotracheal catheter retention duration and operation type between the two groups with comparability. The restraint rate in the observation group was significantly lower than that in the control group [16.95% vs. 84.40% , P < 0.01], and the restraint duration was significantly shorter than that in the control group [hours: 0 vs. 7.0 , P < 0.01], the incidence of restraint-related complication and delirium were significantly lower than those in the control group [restraint-related complication: 0.85% vs. 1.60% , delirium: 0% vs. 2.80% , both P < 0.05], and the restraint device application standard rate was significantly higher than that in the control group [100.00% vs. 90.52% , P < 0.05]. No unplanned extubation event occurred in both groups. Conclusions: The physical restraint reduction scheme based on eCASH concept in adult patients after cardiac surgery can effectively reduce the restraint rate and the incidence of restraint-related complication, shorten the restraint duration, reduce the incidence of delirium, improve the standardization of restraint device application, without increasing the incidence of unplanned extubation events.收起
