內外科單位護理人員執行病人身體約束行為之探究

Nurses’ Use of Physical Restraints on Patients in Medical and Surgical Units

本研究目的在瞭解醫院內外科單位護理人員對執行病人身體約束的原因、看法與行為及相關因素。為橫斷式研究，經立意取樣，以台灣北部四所醫院內外科普通病房及加護病房共168名護理人員為研究對象，運用結構式問卷收集基本屬性、被約束者特質、約束使用情形、約束看法、約束知識等資料，先以SPSS 17.0電腦套裝軟體進行描述分析，再運用卡方檢定、獨立t檢定、皮爾森積差相關、單因子變異數分析等進行統計檢定。研究結果發現，超過90%的內外科單位護理人員曾在兩年內有約束病人的經驗，護理人員採取約束的最主要原因是預防或避免病人傷害。手腕與手套式約束是最常使用的約束方式，多數約束行為發生於白班，不同的約束病人時間在需要約束病人的看法上，具有明顯的差異性。本研究結果期作為制定病人安全教育訓練的參考，亦可提供相關領域學者設計內外科單位約束防治處置之初探。

This study examined the reasons of nurses’ using physical restraints on patients in medical and surgical units and the factors influencing such use. A cross-sectional design was employed. Purposive sampling was used to determine potential subjects. One hundred and sixty-eight registered nurses from the medical-surgical wards and intensive care units of four teaching hospitals in the metropolitan Taipei area participated in the study. Data was collected by well-trained research assistants, and the research tools included the nurse and patient demographic data, a survey of restraint use, perceptions regarding restraints, and knowledge of restraints. Descriptive statistics, the chi-square test, the independent t-test, the Pearson correlation test, and the one-way ANOVA were used to analyze all the obtained data. The data indicated that over 90% of nurses have used restraints on patients within the past two years. To prevent or minimize harm was the main reason for using physical restraints. Wrist and glove restraints were the preferred choices of nurses, and restraints were the most frequently used during the daytime, with less usage at night. The lengths of time for which nurses restrained their patients and nurses’ perceptions of the need for restraints showed significant differences. Findings can not only be viewed as data to assist in shaping educational training programs for patient safety, but can also serve as references for nursing professionals in providing “restraint-free” interventions in medical and surgical care settings in the future.