身體約束替代措施的臨床運用

Alternative Methods to Physical Restraints in Clinical Settings

由於現今醫療人權逐漸受到重視，使用身體約束牽涉到病患的自主性及尊嚴，危險或不適當的約束看似維護安全但卻又潛藏危機。因此，國外近年來廣泛探討此議題且加以政策法令之明確規範，使得約束比率有逐年下降趨勢。而國內目前研究顯示約束比率趨高，臨床上護理人員對替代約束知識的瞭解欠缺，甚至質疑其效用。故本文將針對病患常被約束的理由及問題行為、約束的影響以及介紹約束替代措施，以提供護理人員在執行約束之前，能更廣泛思考與多重選擇，同時在維護病患的尊嚴及權利下，能正確使用約束並減少因約束所帶來的意外傷害及醫療糾紛。

Recent emphasis on human rights has led to concern about the use of physical restraints in the clinical setting and whether such use might violate patients' right, autonomy, and dignity. The use of physical restraints has the potential for causing injury, especially when improperly used. Therefore, literature reports of research related to physical restraints have increased. As a result, some foreign countries have instituted procedures and policies regulating the use of restraints. The prevalence of physical restraint use has decreased; some institutions have even eliminated the use of physical restraints. By contrast, according to domestic studies, the prevalence of restraint use remains high in Taiwan. Clinical nureses' knowledge about alternative methods of restraint is insufficient; they even doubt the effectiveness and the feasibility of using alternative methods in the clinical setting. Hence, this report focused on the reasons for restraining patients, the effects of physical restraints, and alternative methods to use. Findings provide nurses with current information on problems associated with physical restraints, identify multiple choices to use before applying physical restraints, and describe how to apply restraints properly in order to prevent accidents and injury. Such education is necessary to preserve the safety and dignity of the patients and to prevent malpractice suits related to improper use and application of physical restraints.