降低加護病房病人身體約束傷害率

The Program of Reducing the Injury Rate of Physical Restraint in Intensive Care Units

身體約束在加護病房中是經常被運用的醫療輔助措施，但工作中常見約束方法不正確、缺乏合適之約束用物等狀況，造成病人末梢水腫變嚴重、約束部位受傷或已約束尚自拔管路等傷害。故本專案針對成人加護病房護理人員介入身體約束在職教育，提升技術之正確性，制定身體約束監護記錄單並汰舊換新約束帶。期望增進護理人員身體約束的認識及約束方法的正確性，進一步降低病人約束傷害率。經由專案改善後，身體約束傷害率由4.66%降為0.77%。此專案介入在職教育措施、身體約束技術示範及身體約束監護制度，的確有效提升身體約束技術正確性，增強護理同仁對身體約束病人之安全的警覺性，進而降低傷害發生。

Physical restraint is one kind of medical devices. It is frequently applied in intensive care units.Nevertheless, we found mistakes in methods of restraint, and a lack of restraint's tools. Also therewere restraint-related injuries to edema, skin abrasion and extubation. Therefore the program interventionconsisted of continuing education to promote the exact techniques, establish the nursingrecord of physical restrain, and eliminate the old tools. The goal of program was to improve theawareness and techniques for nurses to reduce the injury rate in intensive care units. The result ofimplementing this program indicated that the injury rate of physical restraint was reduced from 4.66%to 0.77%. Intervening continuing education, demonstrating the techniques of physical restraintand nursing record of physical restraint had effectively promoted the correct use of the techniquesof physical restraint. And it enhanced nurses alertness and reduced the injury rate of physicalrestraint.