Buenas prácticas para restricción física en unidades de cuidados intensivos: revisión integrativa

Santos, Gabriela Freitas dos; Oliveira, Ester Góes; Souza, Regina Cláudia Silva

Gabriela Freitas dos Santos

Hospital Sírio Libanês. São Paulo, São Paulo, Brazil.

https://orcid.org/0000-0003-2764-8520

Ester Góes Oliveira Corresponding author: Ester Góes Oliveira. E-mail: ego990@hotmail.com

Hospital Sírio Libanês. São Paulo, São Paulo, Brazil.

https://orcid.org/0000-0002-5068-6480

Regina Cláudia Silva Souza

Hospital Sírio Libanês. São Paulo, São Paulo, Brazil.

https://orcid.org/0000-0001-6433-7700

Corresponding author: Ester Góes Oliveira. E-mail: ego990@hotmail.com

EDITOR IN CHIEF: Dulce Barbosa

ASSOCIATE EDITOR: Antonio José de Almeida Filho

	Search strategy	Observations
PubMed	(("Restraint, Physical"[Mesh]) AND "Intensive Care Units"[Mesh]) AND ("Nursing"[Mesh] OR "Critical Care Nursing"[Mesh] OR "Advanced Practice Nursing"[Mesh] OR "Nursing, Team"[Mesh] OR "Nursing Care"[Mesh] OR "Nursing Assessment"[Mesh] OR "Patient Care Planning"[Mesh] OR "Nurses"[Mesh])
CINAHL	SU intensive care AND SU restraint AND physical	Limiters - Exclude records from MEDLINE; Special Interest: Advanced Nursing Practice, Evidence-Based Practice, Nursing Administration, Nursing Language/Classification, Patient Safety Expanders - Apply equivalent subjects Search Modes - Boolean/Phrase
Scopus	(TITLE (physical AND restraint) AND KEY (evidence OR standard* OR protocol* OR guidelines) OR KEY ("Patient Safety") OR KEY ("Nursing" OR "Critical Care Nursing" OR "Advanced Practice Nursing" OR "Nursing, Team" OR "Nursing Care" OR "Nursing Assessment" OR "Patient Care Planning" OR "Nurses") AND KEY (intensive AND care AND unit) AND NOT TITLE-ABS-KEY (psychiatr))
Virtual Health Library (VHL)	(tW:("containment")) AND (tw:( unit$)) AND (tw:(intensive care)) (tw:("immobilization")) AND (tw:(unit$)) AND (tw:(intensive care)) (tw:("physicalrestriction")) AND (tw:(unit$)) AND (tw:(intensive care)) AND (tw:(intensive care))	Filters: BDENF LILACS IBECS

AUTHOR	YEAR	PROFESSIONAL TRAINING	COUNTRY	DESIGN	LEVEL OF EVIDENCE
Van de Kooi AW et al.⁽⁷7 Van der Kooi AW, Peelen LM, Raijmakers RJ, Vroegop RL, Bakker DF, Tekatli H, et al. Use of physical restraints in Dutch intensive care units: a prospective multicenter study. Am J Crit Care [Internet]. 2015[cited 2020 Sep 30];24(6):488-95. Available from: http://ajcc.aacnjournals.org/cgi/doi/10.4037/ajcc2015348 http://ajcc.aacnjournals.org/cgi/doi/10.... ⁾	2015	Doctor	The Netherlands	Cross-sectional study	6
Benbenbishty J et al.⁽⁸8 Benbenbishty J, Adam S, Endacott R. Physical restraint use in intensive care units across Europe: the PRICE study. Intensive Crit Care Nurs [Internet]. 2010 [cited 2020 Sep 30];26(5):241-5. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0964339710000686 https://linkinghub.elsevier.com/retrieve... ⁾	2010	Nurse and doctor	9 countries in Europe	Cross-sectional study	6
Lin Y-L et al.⁽⁹9 Lin YL, Liao CC, Yu WP, Chu TL, Ho LH. A multidisciplinary program reduces over 24 hours of physical restraint in neurological intensive care unit. J Nurs Res. 2018;26(4):288-96. https://doi.org/10.1097/jnr.0000000000000251 https://doi.org/10.1097/jnr.000000000000... ⁾	2018	Nurse and doctor	Taiwan	Before-and-after study	3
Hall DK et al.⁽¹⁰10 Hall DK, Zimbro KS, Maduro RS, Petrovitch D, Ver Schneider P, Morgan M. Impact of a restraint management bundle on restraint use in an intensive care unit. J Nurs Care Qual [Internet]. 2018 [cited 2020 Sep 30];33(2):143-8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28658189 http://www.ncbi.nlm.nih.gov/pubmed/28658... ⁾	2018	Nurse	USA	Before-and-after study	3
Lynn LL et al.⁽¹¹11 Lynn LL, Brookes JM. Changing perceptions of physical restraint use in the ICU. Nurs Crit Care. 2017;12(6):41-4. https://doi.org/10.1097/01.CCN.0000521939.91085.6f https://doi.org/10.1097/01.CCN.000052193... ⁾	2017	Nurse	USA	Before-and-after study	3
Luk E et al.⁽¹²12 Luk E, Burry L, Rezaie S, Mehta S, Rose L. Critical care nurses' decisions regarding physical restraints in two Canadian ICUs: a prospective observational study. Can J Crit care Nurs [Internet]. 2015 [cited 2020 Sep 30];26(4):16-22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26837121 http://www.ncbi.nlm.nih.gov/pubmed/26837... ⁾	2015	Nurse, pharmacist and physician	Canada	Cross-sectional study	6
Kandeel NA et al.⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000 http://doi.wiley.com/10.1111/nhs.12000... ⁾	2013	Nurse	Egypt	Observational study	4
Choi E et al.⁽¹⁴14 Choi E, Song M. Physical restraint use in a Korean ICU. J Clin Nurs [Internet]. 2003[cited 2020 Sep 30];12(5):651-9. Available from: http://doi.wiley.com/10.1046/j.1365-2702.2003.00789.x http://doi.wiley.com/10.1046/j.1365-2702... ⁾	2003	Nurse	South Korea	Cross-sectional study	6
Johnson K et al.⁽¹⁵15 Johnson K, Curry V, Steubing A, Diana S, McCray A, McFarren A, et al. A non-pharmacologic approach to decrease restraint use. Intensive Crit Care Nurs [Internet]. 2016 [cited 2020 Sep 30];34:12-9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26652790 http://www.ncbi.nlm.nih.gov/pubmed/26652... ⁾	2016	Nurse	USA	Before-and-after study	3
Turgay AS et al.⁽¹⁶16 Turgay AS, Sari D, Genc RE. Physical restraint use in Turkish intensive care units. Clin Nurse Spec [Internet]. 2009 [cited 2020 Sep 30];23(2):68-72. https://doi.org/10.1097/NUR.0b013e318199125c https://doi.org/10.1097/NUR.0b013e318199... ⁾	2009	Nurse	Turkey	Cross-sectional study	6
Perren A et al.⁽¹⁷17 Perren A, Corbella D, Iapichino E, Di Bernardo V, Leonardi A, Di Nicolantonio R, et al. Physical restraint in the ICU: does it prevent device removal? Minerva Anestesiol [Internet]. 2015 [2020 Sep 30];81(10):1086-95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25338282 http://www.ncbi.nlm.nih.gov/pubmed/25338... ⁾	2015	Doctor and psychologist	Switzerland	Prospective observational study	4
De Jonghe B et al.⁽¹⁸18 De Jonghe B, Constantin JM, Chanques G, Capdevila X, Lefrant JY, Outin H, et al. Physical restraint in mechanically ventilated ICU patients: a survey of French practice. Intensive Care Med [Internet]. 2013[cited 2020 Sep 30];39(1):31-7. Available from: http://link.springer.com/10.1007/s00134-012-2715-9 http://link.springer.com/10.1007/s00134-... ⁾	2013	Doctor	France	Cross-sectional study	6
Vance DL⁽¹⁹19 Vance DL. Effect of a treatment interference protocol on clinical decision making for restraint use in the intensive care unit: a pilot study. AACN Clin Issues [Internet]. 2003 Feb; 14(1):82-91. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12574706 http://www.ncbi.nlm.nih.gov/pubmed/12574... ⁾	2003	Nurse	USA	Before-and-after study	3
Yönt GH et al.⁽²⁰20 Yönt GH, Korhan EA, Dizer B, Gümüs F, Koyuncu R. Examination of ethical dilemmas experienced by adult intensive care unit nurses in physical restraint practices. Holist NursPract. 2014;28(2):85-90. https://doi.org/10.1097/HNP.0000000000000013 https://doi.org/10.1097/HNP.000000000000... ⁾	2014	Nurse	Turkey	Cross-sectional study	6
Gu T et al.⁽²¹21 Gu T, Wang X, Deng N, Weng W. Investigating influencing factors of physical restraint use in China intensive care units: a prospective, cross-sectional, observational study. Aust Crit Care [Internet]. 2019 [cited 2020 Sep 30];32(3):193-8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1036731417303971 https://linkinghub.elsevier.com/retrieve... ⁾	2019	Nurse	China	Cross-sectional study	6
Martin B et al.⁽²²22 Martin B, Mathisen L. Use of physical restraints in adult critical care: a bicultural study. Am J Crit Care [Internet]. 2005 [cited 2020 Sep 30];14(2):133-42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15728955 http://www.ncbi.nlm.nih.gov/pubmed/15728... ⁾	2005	Nurse	USA and Norway	Cross-sectional study	6
Guenette M et al.⁽²³23 Guenette M, Burry L, Cheung A, Farquharson T, Traille M, Mantas I, et al. Psychotropic drug use in physically restrained, critically ill adults receiving mechanical ventilation. Am J Crit Care. 2017;26(5):380-7. https://doi.org/10.4037/ajcc2017677 https://doi.org/10.4037/ajcc2017677... ⁾	2017	Pharmacist, nurse and doctor	Canada	Cross-sectional study	6
Suliman M⁽²⁴24 Suliman M. Prevalence of physical restraint among ventilated intensive care unit patients. J Clin Nurs. 2018;27(19-20):3490-6. https://doi.org/10.1111/jocn.14588 https://doi.org/10.1111/jocn.14588... ⁾	2018	Nurse	Jordan	Cross-sectional study	6
Hevener S et al.⁽²⁵25 Hevener S, Rickabaugh B, Marsh T. Using a decision wheel to reduce use of restraints in a medical-surgical intensive care unit. Am J Crit Care [Internet]. 2016 [cited 2020 Sep 30];25(6):479-86. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27802948 http://www.ncbi.nlm.nih.gov/pubmed/27802... ⁾	2016	Nurse	USA	Quasi-experimental study	3

Indications
Prevent devices from being lost or misplaced⁽⁷7 Van der Kooi AW, Peelen LM, Raijmakers RJ, Vroegop RL, Bakker DF, Tekatli H, et al. Use of physical restraints in Dutch intensive care units: a prospective multicenter study. Am J Crit Care [Internet]. 2015[cited 2020 Sep 30];24(6):488-95. Available from: http://ajcc.aacnjournals.org/cgi/doi/10.4037/ajcc2015348
http://ajcc.aacnjournals.org/cgi/doi/10....

8 Benbenbishty J, Adam S, Endacott R. Physical restraint use in intensive care units across Europe: the PRICE study. Intensive Crit Care Nurs [Internet]. 2010 [cited 2020 Sep 30];26(5):241-5. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0964339710000686
https://linkinghub.elsevier.com/retrieve... ^-⁹9 Lin YL, Liao CC, Yu WP, Chu TL, Ho LH. A multidisciplinary program reduces over 24 hours of physical restraint in neurological intensive care unit. J Nurs Res. 2018;26(4):288-96. https://doi.org/10.1097/jnr.0000000000000251
https://doi.org/10.1097/jnr.000000000000... ^,¹²12 Luk E, Burry L, Rezaie S, Mehta S, Rose L. Critical care nurses' decisions regarding physical restraints in two Canadian ICUs: a prospective observational study. Can J Crit care Nurs [Internet]. 2015 [cited 2020 Sep 30];26(4):16-22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26837121
http://www.ncbi.nlm.nih.gov/pubmed/26837...

13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ^-¹⁴14 Choi E, Song M. Physical restraint use in a Korean ICU. J Clin Nurs [Internet]. 2003[cited 2020 Sep 30];12(5):651-9. Available from: http://doi.wiley.com/10.1046/j.1365-2702.2003.00789.x
http://doi.wiley.com/10.1046/j.1365-2702... ^,¹⁶16 Turgay AS, Sari D, Genc RE. Physical restraint use in Turkish intensive care units. Clin Nurse Spec [Internet]. 2009 [cited 2020 Sep 30];23(2):68-72. https://doi.org/10.1097/NUR.0b013e318199125c
https://doi.org/10.1097/NUR.0b013e318199... ^-¹⁷17 Perren A, Corbella D, Iapichino E, Di Bernardo V, Leonardi A, Di Nicolantonio R, et al. Physical restraint in the ICU: does it prevent device removal? Minerva Anestesiol [Internet]. 2015 [2020 Sep 30];81(10):1086-95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25338282
http://www.ncbi.nlm.nih.gov/pubmed/25338... ^,¹⁹19 Vance DL. Effect of a treatment interference protocol on clinical decision making for restraint use in the intensive care unit: a pilot study. AACN Clin Issues [Internet]. 2003 Feb; 14(1):82-91. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12574706
http://www.ncbi.nlm.nih.gov/pubmed/12574...

20 Yönt GH, Korhan EA, Dizer B, Gümüs F, Koyuncu R. Examination of ethical dilemmas experienced by adult intensive care unit nurses in physical restraint practices. Holist NursPract. 2014;28(2):85-90. https://doi.org/10.1097/HNP.0000000000000013
https://doi.org/10.1097/HNP.000000000000...

21 Gu T, Wang X, Deng N, Weng W. Investigating influencing factors of physical restraint use in China intensive care units: a prospective, cross-sectional, observational study. Aust Crit Care [Internet]. 2019 [cited 2020 Sep 30];32(3):193-8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1036731417303971
https://linkinghub.elsevier.com/retrieve... ^-²²22 Martin B, Mathisen L. Use of physical restraints in adult critical care: a bicultural study. Am J Crit Care [Internet]. 2005 [cited 2020 Sep 30];14(2):133-42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15728955
http://www.ncbi.nlm.nih.gov/pubmed/15728... ^,²⁵25 Hevener S, Rickabaugh B, Marsh T. Using a decision wheel to reduce use of restraints in a medical-surgical intensive care unit. Am J Crit Care [Internet]. 2016 [cited 2020 Sep 30];25(6):479-86. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27802948
http://www.ncbi.nlm.nih.gov/pubmed/27802... ⁾ (adverse events), ensure continuity of treatment⁽¹¹11 Lynn LL, Brookes JM. Changing perceptions of physical restraint use in the ICU. Nurs Crit Care. 2017;12(6):41-4. https://doi.org/10.1097/01.CCN.0000521939.91085.6f
https://doi.org/10.1097/01.CCN.000052193... ^,¹⁹19 Vance DL. Effect of a treatment interference protocol on clinical decision making for restraint use in the intensive care unit: a pilot study. AACN Clin Issues [Internet]. 2003 Feb; 14(1):82-91. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12574706
http://www.ncbi.nlm.nih.gov/pubmed/12574... ^,²³23 Guenette M, Burry L, Cheung A, Farquharson T, Traille M, Mantas I, et al. Psychotropic drug use in physically restrained, critically ill adults receiving mechanical ventilation. Am J Crit Care. 2017;26(5):380-7. https://doi.org/10.4037/ajcc2017677
https://doi.org/10.4037/ajcc2017677... ^,²⁵25 Hevener S, Rickabaugh B, Marsh T. Using a decision wheel to reduce use of restraints in a medical-surgical intensive care unit. Am J Crit Care [Internet]. 2016 [cited 2020 Sep 30];25(6):479-86. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27802948
http://www.ncbi.nlm.nih.gov/pubmed/27802... ⁾, altered level of consciousness (agitation, restlessness, disorientation, confusion, aggressiveness, comatose, drowsiness⁽⁷7 Van der Kooi AW, Peelen LM, Raijmakers RJ, Vroegop RL, Bakker DF, Tekatli H, et al. Use of physical restraints in Dutch intensive care units: a prospective multicenter study. Am J Crit Care [Internet]. 2015[cited 2020 Sep 30];24(6):488-95. Available from: http://ajcc.aacnjournals.org/cgi/doi/10.4037/ajcc2015348
http://ajcc.aacnjournals.org/cgi/doi/10....

8 Benbenbishty J, Adam S, Endacott R. Physical restraint use in intensive care units across Europe: the PRICE study. Intensive Crit Care Nurs [Internet]. 2010 [cited 2020 Sep 30];26(5):241-5. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0964339710000686
https://linkinghub.elsevier.com/retrieve... ^-⁹9 Lin YL, Liao CC, Yu WP, Chu TL, Ho LH. A multidisciplinary program reduces over 24 hours of physical restraint in neurological intensive care unit. J Nurs Res. 2018;26(4):288-96. https://doi.org/10.1097/jnr.0000000000000251
https://doi.org/10.1097/jnr.000000000000... ^,¹²12 Luk E, Burry L, Rezaie S, Mehta S, Rose L. Critical care nurses' decisions regarding physical restraints in two Canadian ICUs: a prospective observational study. Can J Crit care Nurs [Internet]. 2015 [cited 2020 Sep 30];26(4):16-22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26837121
http://www.ncbi.nlm.nih.gov/pubmed/26837... ^,¹⁴14 Choi E, Song M. Physical restraint use in a Korean ICU. J Clin Nurs [Internet]. 2003[cited 2020 Sep 30];12(5):651-9. Available from: http://doi.wiley.com/10.1046/j.1365-2702.2003.00789.x
http://doi.wiley.com/10.1046/j.1365-2702... ^,¹⁶16 Turgay AS, Sari D, Genc RE. Physical restraint use in Turkish intensive care units. Clin Nurse Spec [Internet]. 2009 [cited 2020 Sep 30];23(2):68-72. https://doi.org/10.1097/NUR.0b013e318199125c
https://doi.org/10.1097/NUR.0b013e318199...

17 Perren A, Corbella D, Iapichino E, Di Bernardo V, Leonardi A, Di Nicolantonio R, et al. Physical restraint in the ICU: does it prevent device removal? Minerva Anestesiol [Internet]. 2015 [2020 Sep 30];81(10):1086-95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25338282
http://www.ncbi.nlm.nih.gov/pubmed/25338... ^-¹⁸18 De Jonghe B, Constantin JM, Chanques G, Capdevila X, Lefrant JY, Outin H, et al. Physical restraint in mechanically ventilated ICU patients: a survey of French practice. Intensive Care Med [Internet]. 2013[cited 2020 Sep 30];39(1):31-7. Available from: http://link.springer.com/10.1007/s00134-012-2715-9
http://link.springer.com/10.1007/s00134-... ^,²²22 Martin B, Mathisen L. Use of physical restraints in adult critical care: a bicultural study. Am J Crit Care [Internet]. 2005 [cited 2020 Sep 30];14(2):133-42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15728955
http://www.ncbi.nlm.nih.gov/pubmed/15728... ^-²³23 Guenette M, Burry L, Cheung A, Farquharson T, Traille M, Mantas I, et al. Psychotropic drug use in physically restrained, critically ill adults receiving mechanical ventilation. Am J Crit Care. 2017;26(5):380-7. https://doi.org/10.4037/ajcc2017677
https://doi.org/10.4037/ajcc2017677... ⁾, keep the team safe⁽⁷7 Van der Kooi AW, Peelen LM, Raijmakers RJ, Vroegop RL, Bakker DF, Tekatli H, et al. Use of physical restraints in Dutch intensive care units: a prospective multicenter study. Am J Crit Care [Internet]. 2015[cited 2020 Sep 30];24(6):488-95. Available from: http://ajcc.aacnjournals.org/cgi/doi/10.4037/ajcc2015348
http://ajcc.aacnjournals.org/cgi/doi/10.... ⁾, maintain the safety of other patients, maintain patient safety⁽⁷7 Van der Kooi AW, Peelen LM, Raijmakers RJ, Vroegop RL, Bakker DF, Tekatli H, et al. Use of physical restraints in Dutch intensive care units: a prospective multicenter study. Am J Crit Care [Internet]. 2015[cited 2020 Sep 30];24(6):488-95. Available from: http://ajcc.aacnjournals.org/cgi/doi/10.4037/ajcc2015348
http://ajcc.aacnjournals.org/cgi/doi/10.... ^-⁸8 Benbenbishty J, Adam S, Endacott R. Physical restraint use in intensive care units across Europe: the PRICE study. Intensive Crit Care Nurs [Internet]. 2010 [cited 2020 Sep 30];26(5):241-5. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0964339710000686
https://linkinghub.elsevier.com/retrieve... ^,¹⁰10 Hall DK, Zimbro KS, Maduro RS, Petrovitch D, Ver Schneider P, Morgan M. Impact of a restraint management bundle on restraint use in an intensive care unit. J Nurs Care Qual [Internet]. 2018 [cited 2020 Sep 30];33(2):143-8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28658189
http://www.ncbi.nlm.nih.gov/pubmed/28658...

11 Lynn LL, Brookes JM. Changing perceptions of physical restraint use in the ICU. Nurs Crit Care. 2017;12(6):41-4. https://doi.org/10.1097/01.CCN.0000521939.91085.6f
https://doi.org/10.1097/01.CCN.000052193...

12 Luk E, Burry L, Rezaie S, Mehta S, Rose L. Critical care nurses' decisions regarding physical restraints in two Canadian ICUs: a prospective observational study. Can J Crit care Nurs [Internet]. 2015 [cited 2020 Sep 30];26(4):16-22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26837121
http://www.ncbi.nlm.nih.gov/pubmed/26837... ^-¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000...

14 Choi E, Song M. Physical restraint use in a Korean ICU. J Clin Nurs [Internet]. 2003[cited 2020 Sep 30];12(5):651-9. Available from: http://doi.wiley.com/10.1046/j.1365-2702.2003.00789.x
http://doi.wiley.com/10.1046/j.1365-2702...

15 Johnson K, Curry V, Steubing A, Diana S, McCray A, McFarren A, et al. A non-pharmacologic approach to decrease restraint use. Intensive Crit Care Nurs [Internet]. 2016 [cited 2020 Sep 30];34:12-9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26652790
http://www.ncbi.nlm.nih.gov/pubmed/26652...

16 Turgay AS, Sari D, Genc RE. Physical restraint use in Turkish intensive care units. Clin Nurse Spec [Internet]. 2009 [cited 2020 Sep 30];23(2):68-72. https://doi.org/10.1097/NUR.0b013e318199125c
https://doi.org/10.1097/NUR.0b013e318199...

17 Perren A, Corbella D, Iapichino E, Di Bernardo V, Leonardi A, Di Nicolantonio R, et al. Physical restraint in the ICU: does it prevent device removal? Minerva Anestesiol [Internet]. 2015 [2020 Sep 30];81(10):1086-95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25338282
http://www.ncbi.nlm.nih.gov/pubmed/25338...

18 De Jonghe B, Constantin JM, Chanques G, Capdevila X, Lefrant JY, Outin H, et al. Physical restraint in mechanically ventilated ICU patients: a survey of French practice. Intensive Care Med [Internet]. 2013[cited 2020 Sep 30];39(1):31-7. Available from: http://link.springer.com/10.1007/s00134-012-2715-9
http://link.springer.com/10.1007/s00134-...

19 Vance DL. Effect of a treatment interference protocol on clinical decision making for restraint use in the intensive care unit: a pilot study. AACN Clin Issues [Internet]. 2003 Feb; 14(1):82-91. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12574706
http://www.ncbi.nlm.nih.gov/pubmed/12574... ^-²⁰20 Yönt GH, Korhan EA, Dizer B, Gümüs F, Koyuncu R. Examination of ethical dilemmas experienced by adult intensive care unit nurses in physical restraint practices. Holist NursPract. 2014;28(2):85-90. https://doi.org/10.1097/HNP.0000000000000013
https://doi.org/10.1097/HNP.000000000000... ⁾, delirium⁽⁷7 Van der Kooi AW, Peelen LM, Raijmakers RJ, Vroegop RL, Bakker DF, Tekatli H, et al. Use of physical restraints in Dutch intensive care units: a prospective multicenter study. Am J Crit Care [Internet]. 2015[cited 2020 Sep 30];24(6):488-95. Available from: http://ajcc.aacnjournals.org/cgi/doi/10.4037/ajcc2015348
http://ajcc.aacnjournals.org/cgi/doi/10.... ^-⁸8 Benbenbishty J, Adam S, Endacott R. Physical restraint use in intensive care units across Europe: the PRICE study. Intensive Crit Care Nurs [Internet]. 2010 [cited 2020 Sep 30];26(5):241-5. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0964339710000686
https://linkinghub.elsevier.com/retrieve... ^,¹²12 Luk E, Burry L, Rezaie S, Mehta S, Rose L. Critical care nurses' decisions regarding physical restraints in two Canadian ICUs: a prospective observational study. Can J Crit care Nurs [Internet]. 2015 [cited 2020 Sep 30];26(4):16-22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26837121
http://www.ncbi.nlm.nih.gov/pubmed/26837... ^,¹⁷17 Perren A, Corbella D, Iapichino E, Di Bernardo V, Leonardi A, Di Nicolantonio R, et al. Physical restraint in the ICU: does it prevent device removal? Minerva Anestesiol [Internet]. 2015 [2020 Sep 30];81(10):1086-95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25338282
http://www.ncbi.nlm.nih.gov/pubmed/25338... ^,²¹21 Gu T, Wang X, Deng N, Weng W. Investigating influencing factors of physical restraint use in China intensive care units: a prospective, cross-sectional, observational study. Aust Crit Care [Internet]. 2019 [cited 2020 Sep 30];32(3):193-8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1036731417303971
https://linkinghub.elsevier.com/retrieve... ⁾, patients with impaired verbal communication⁽⁹9 Lin YL, Liao CC, Yu WP, Chu TL, Ho LH. A multidisciplinary program reduces over 24 hours of physical restraint in neurological intensive care unit. J Nurs Res. 2018;26(4):288-96. https://doi.org/10.1097/jnr.0000000000000251
https://doi.org/10.1097/jnr.000000000000... ⁾, age above 75 years⁽²¹21 Gu T, Wang X, Deng N, Weng W. Investigating influencing factors of physical restraint use in China intensive care units: a prospective, cross-sectional, observational study. Aust Crit Care [Internet]. 2019 [cited 2020 Sep 30];32(3):193-8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1036731417303971
https://linkinghub.elsevier.com/retrieve... ⁾, prevent wound contamination⁽¹¹11 Lynn LL, Brookes JM. Changing perceptions of physical restraint use in the ICU. Nurs Crit Care. 2017;12(6):41-4. https://doi.org/10.1097/01.CCN.0000521939.91085.6f
https://doi.org/10.1097/01.CCN.000052193... ⁾, insufficient nursing staff⁽⁸8 Benbenbishty J, Adam S, Endacott R. Physical restraint use in intensive care units across Europe: the PRICE study. Intensive Crit Care Nurs [Internet]. 2010 [cited 2020 Sep 30];26(5):241-5. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0964339710000686
https://linkinghub.elsevier.com/retrieve... ^,¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ⁾, misunderstanding/resistance about the need for care or therapeutic devices⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ⁾, request from more than one staff member, patient, family, or other physicians⁽¹⁴14 Choi E, Song M. Physical restraint use in a Korean ICU. J Clin Nurs [Internet]. 2003[cited 2020 Sep 30];12(5):651-9. Available from: http://doi.wiley.com/10.1046/j.1365-2702.2003.00789.x
http://doi.wiley.com/10.1046/j.1365-2702... ^,¹⁶16 Turgay AS, Sari D, Genc RE. Physical restraint use in Turkish intensive care units. Clin Nurse Spec [Internet]. 2009 [cited 2020 Sep 30];23(2):68-72. https://doi.org/10.1097/NUR.0b013e318199125c
https://doi.org/10.1097/NUR.0b013e318199... ⁾, patient in an isolated room⁽¹²12 Luk E, Burry L, Rezaie S, Mehta S, Rose L. Critical care nurses' decisions regarding physical restraints in two Canadian ICUs: a prospective observational study. Can J Crit care Nurs [Internet]. 2015 [cited 2020 Sep 30];26(4):16-22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26837121
http://www.ncbi.nlm.nih.gov/pubmed/26837... ⁾, post-anesthesia recovery⁽⁹9 Lin YL, Liao CC, Yu WP, Chu TL, Ho LH. A multidisciplinary program reduces over 24 hours of physical restraint in neurological intensive care unit. J Nurs Res. 2018;26(4):288-96. https://doi.org/10.1097/jnr.0000000000000251
https://doi.org/10.1097/jnr.000000000000... ⁾, sedation weaning and insufficient sedation⁽¹⁷17 Perren A, Corbella D, Iapichino E, Di Bernardo V, Leonardi A, Di Nicolantonio R, et al. Physical restraint in the ICU: does it prevent device removal? Minerva Anestesiol [Internet]. 2015 [2020 Sep 30];81(10):1086-95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25338282
http://www.ncbi.nlm.nih.gov/pubmed/25338... ^-¹⁸18 De Jonghe B, Constantin JM, Chanques G, Capdevila X, Lefrant JY, Outin H, et al. Physical restraint in mechanically ventilated ICU patients: a survey of French practice. Intensive Care Med [Internet]. 2013[cited 2020 Sep 30];39(1):31-7. Available from: http://link.springer.com/10.1007/s00134-012-2715-9
http://link.springer.com/10.1007/s00134-... ⁾, presence of an unstable fracture⁽⁷7 Van der Kooi AW, Peelen LM, Raijmakers RJ, Vroegop RL, Bakker DF, Tekatli H, et al. Use of physical restraints in Dutch intensive care units: a prospective multicenter study. Am J Crit Care [Internet]. 2015[cited 2020 Sep 30];24(6):488-95. Available from: http://ajcc.aacnjournals.org/cgi/doi/10.4037/ajcc2015348
http://ajcc.aacnjournals.org/cgi/doi/10.... ⁾ and proper patient positioning⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ^,²⁰20 Yönt GH, Korhan EA, Dizer B, Gümüs F, Koyuncu R. Examination of ethical dilemmas experienced by adult intensive care unit nurses in physical restraint practices. Holist NursPract. 2014;28(2):85-90. https://doi.org/10.1097/HNP.0000000000000013
https://doi.org/10.1097/HNP.000000000000... ⁾.

Complications
Skin injuries⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ^,¹⁶16 Turgay AS, Sari D, Genc RE. Physical restraint use in Turkish intensive care units. Clin Nurse Spec [Internet]. 2009 [cited 2020 Sep 30];23(2):68-72. https://doi.org/10.1097/NUR.0b013e318199125c
https://doi.org/10.1097/NUR.0b013e318199... ⁾, hyperemia⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ^,²⁴24 Suliman M. Prevalence of physical restraint among ventilated intensive care unit patients. J Clin Nurs. 2018;27(19-20):3490-6. https://doi.org/10.1111/jocn.14588
https://doi.org/10.1111/jocn.14588... ⁾, edema of the restricted limb⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ^,²⁴24 Suliman M. Prevalence of physical restraint among ventilated intensive care unit patients. J Clin Nurs. 2018;27(19-20):3490-6. https://doi.org/10.1111/jocn.14588
https://doi.org/10.1111/jocn.14588... ^-²⁵25 Hevener S, Rickabaugh B, Marsh T. Using a decision wheel to reduce use of restraints in a medical-surgical intensive care unit. Am J Crit Care [Internet]. 2016 [cited 2020 Sep 30];25(6):479-86. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27802948
http://www.ncbi.nlm.nih.gov/pubmed/27802... ⁾, psychomotor agitation⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ^,²²22 Martin B, Mathisen L. Use of physical restraints in adult critical care: a bicultural study. Am J Crit Care [Internet]. 2005 [cited 2020 Sep 30];14(2):133-42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15728955
http://www.ncbi.nlm.nih.gov/pubmed/15728... ^-²³23 Guenette M, Burry L, Cheung A, Farquharson T, Traille M, Mantas I, et al. Psychotropic drug use in physically restrained, critically ill adults receiving mechanical ventilation. Am J Crit Care. 2017;26(5):380-7. https://doi.org/10.4037/ajcc2017677
https://doi.org/10.4037/ajcc2017677... ⁾, pressure ulcer⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ⁾, bruises on the restricted limb⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ⁾, death⁽²⁴24 Suliman M. Prevalence of physical restraint among ventilated intensive care unit patients. J Clin Nurs. 2018;27(19-20):3490-6. https://doi.org/10.1111/jocn.14588
https://doi.org/10.1111/jocn.14588... ⁾, skin necrosis in the restricted limb⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ⁾, anxiety⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ⁾, crying ⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ⁾, patient discomfort, perceived loss of dignity⁽¹⁸18 De Jonghe B, Constantin JM, Chanques G, Capdevila X, Lefrant JY, Outin H, et al. Physical restraint in mechanically ventilated ICU patients: a survey of French practice. Intensive Care Med [Internet]. 2013[cited 2020 Sep 30];39(1):31-7. Available from: http://link.springer.com/10.1007/s00134-012-2715-9
http://link.springer.com/10.1007/s00134-... ⁾, post-traumatic stress disorder⁽¹⁸18 De Jonghe B, Constantin JM, Chanques G, Capdevila X, Lefrant JY, Outin H, et al. Physical restraint in mechanically ventilated ICU patients: a survey of French practice. Intensive Care Med [Internet]. 2013[cited 2020 Sep 30];39(1):31-7. Available from: http://link.springer.com/10.1007/s00134-012-2715-9
http://link.springer.com/10.1007/s00134-... ⁾ and device removal⁽²²22 Martin B, Mathisen L. Use of physical restraints in adult critical care: a bicultural study. Am J Crit Care [Internet]. 2005 [cited 2020 Sep 30];14(2):133-42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15728955
http://www.ncbi.nlm.nih.gov/pubmed/15728... ⁾.

Alternative Strategies
Administration of painkillers and sedation medication⁽¹²12 Luk E, Burry L, Rezaie S, Mehta S, Rose L. Critical care nurses' decisions regarding physical restraints in two Canadian ICUs: a prospective observational study. Can J Crit care Nurs [Internet]. 2015 [cited 2020 Sep 30];26(4):16-22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26837121
http://www.ncbi.nlm.nih.gov/pubmed/26837... ^-¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ^,²¹21 Gu T, Wang X, Deng N, Weng W. Investigating influencing factors of physical restraint use in China intensive care units: a prospective, cross-sectional, observational study. Aust Crit Care [Internet]. 2019 [cited 2020 Sep 30];32(3):193-8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1036731417303971
https://linkinghub.elsevier.com/retrieve... ⁾, extension of the permanence period of family members and caregivers with the patient⁽¹¹11 Lynn LL, Brookes JM. Changing perceptions of physical restraint use in the ICU. Nurs Crit Care. 2017;12(6):41-4. https://doi.org/10.1097/01.CCN.0000521939.91085.6f
https://doi.org/10.1097/01.CCN.000052193... ^,¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ^,¹⁵15 Johnson K, Curry V, Steubing A, Diana S, McCray A, McFarren A, et al. A non-pharmacologic approach to decrease restraint use. Intensive Crit Care Nurs [Internet]. 2016 [cited 2020 Sep 30];34:12-9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26652790
http://www.ncbi.nlm.nih.gov/pubmed/26652... ⁾, appropriate nurse-patient relationship⁽²¹21 Gu T, Wang X, Deng N, Weng W. Investigating influencing factors of physical restraint use in China intensive care units: a prospective, cross-sectional, observational study. Aust Crit Care [Internet]. 2019 [cited 2020 Sep 30];32(3):193-8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1036731417303971
https://linkinghub.elsevier.com/retrieve... ⁾, co-participation and co-responsibility of the multidisciplinary team in patient care⁽¹¹11 Lynn LL, Brookes JM. Changing perceptions of physical restraint use in the ICU. Nurs Crit Care. 2017;12(6):41-4. https://doi.org/10.1097/01.CCN.0000521939.91085.6f
https://doi.org/10.1097/01.CCN.000052193... ⁾, sleep hygiene promotion⁽¹⁵15 Johnson K, Curry V, Steubing A, Diana S, McCray A, McFarren A, et al. A non-pharmacologic approach to decrease restraint use. Intensive Crit Care Nurs [Internet]. 2016 [cited 2020 Sep 30];34:12-9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26652790
http://www.ncbi.nlm.nih.gov/pubmed/26652... ⁾, therapeutic distraction strategies such as television, games, exercises, music, magazines, and pencils to keep the hands busy⁽¹¹11 Lynn LL, Brookes JM. Changing perceptions of physical restraint use in the ICU. Nurs Crit Care. 2017;12(6):41-4. https://doi.org/10.1097/01.CCN.0000521939.91085.6f
https://doi.org/10.1097/01.CCN.000052193... ⁾.

Category	Care
Patient Assessment	Frequent evaluation of the restrained limb related to skin integrity, peripheral perfusion and presence of tourniquet, assessment of pain, delirium, sedation, agitation, cognitive and behavioral status of the patient, frequent evaluation of alternative strategies for the replacement of the physical restraint, reassessment of the indication for physical restraint every eight hours, assessment of mobility and sensibility of the restrained limb, and assessment of the patient's appropriate level of sedation.
Communication	Reorientation of the patient, often about the use of physical restraint, prescription of physical restraint for no more than 24 hours, orientation to the patient about the purpose and importance of the devices in the quality of care, detailed documentation of the physical restraint procedure, participation of the medical team in the indication of physical restraint, effective communication between patient, professional and family, and obtaining consent on the use of physical restraint with the patient, legal representative and family.
Patient Safety	Promotion of patient comfort with sedation, narcotic analgesia, positioning of the patient and use of mattresses or special beds, release of the restricted limb every two hours for 15 minutes, use of restraint made with fabrics less harmful to the skin, maintenance of patient safety, proper positioning of devices, use of strategies that promote patient calm and tranquility, pain management, administration of sedation medications when needed, use of restraints that allow limb movement but avoid fine motor functions, standardization of care and indications related to the use of physical restraint, use of pharmacological options before and after the use of physical restraint.

[1] Corresponding author: Ester Góes Oliveira. E-mail: ego990@hotmail.com

Brasil

Brasil

Buenas prácticas para restricción física en unidades de cuidados intensivos: revisión integrativa

RESUMEN

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