A Study to Evaluate the Effectiveness of Protocol on Physical Restraints Practices in Terms of Outcomes among Nurses and Patients in Intensive Care Units
*Corresponding author: Dr. Seema Sachdeva, Tutor in Nursing, College of Nursing, AIIMS, Delhi, Email ID: firstname.lastname@example.org
To assess the nurse's outcome in terms of knowledge and practices on physical restraints before implementation of protocol; To assess the nurses outcome in terms of knowledge and practices on physical restraints after implementation of protocol; To assess the patient outcome in terms of complications related to physical restraints before implementation of protocol; To assess the patient outcome in terms of complications related to physical restraints after implementation of protocol.
Quasi experimental with non equivalent pre test post test control group design was used to conduct the study in a selected hospital of NCR, Delhi. The sample size was 60 for nurses and 145 for patients divided in control and experimental group. The sampling technique was total enumeration sampling for nurses and simple random sampling for patients. The tools used were ‘Nurse Outcome Measurement Sheet’ (Knowledge questionnaire and skill checklist on physical restraints practices) and ‘Patient Outcome Measurement Sheet’ (complications related to physical restraints). Protocol and tools were developed and validated before actual intervention. The study was conducted over 7 month's period (May 2014 to December 2014). The pre test included knowledge and skill of nurses and observation for complications related to physical restraints among patients in both groups. The intervention i.e protocol on physical restraints practices was administered to experimental group through structured teaching program using lecture cum discussion and demonstration method. The post test was done on nurses and patients in both groups after a gap of 1 month.
Majority of nursing subjects were in age group of 21–30 years, GNM nursing as qualification, professional experience of 1–3 years and average nurse patient ratio of 1: 3 per shift. The knowledge and skill both increased significantly for physical restraints practices at the level p<0.05, in experimental group than control group after the intervention. There was a significant association of nurses outcome with demographic variables like education and experience at the level p<0.05. For patient's demographics, the majority of patients were in age group of 31–40 years (67%), had head injury with GCS of 9–12 (73%) and respiratory system disorders (59%) and had hypertension and diabetes mellitus as co morbid illness. Regarding duration, the average ICU stay of patients was 6.7 days, for physical restraints the average duration was 24–72 hrs (77%). For patients’ outcomes in terms of complications related to physical restraints, the incidence was found more in control group than experimental group after administration of protocol. A significant association was found between hours of restraining (24–72 hrs) and skin bruising, edema and paleness at the level p<0.05.
Nurse outcome, Patient Outcome, Physical Restraints.