Authors

María Acevedo-Nuevo1, Mª Teresa González-Gil2, Concepción Martín-Arribas3, Montserrat Solís-Muñoz4

Position

1Máster en Cuidados Críticos. Unidad de Cuidados Intensivos Médica-Hospital Universitario Puerta de Hierro Majadahonda. Grupo de Investigación en Enfermería y Cuidados de Salud, Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA). Grupo de Trabajo Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería de Intensivos y Unidades Coronarias. Madrid2Doctora. Departamento de Enfermería, Universidad Autónoma de Madrid, Madrid. Grupo de Investigación en Enfermería y Cuidados de Salud. Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHISA). Madrid 3Doctora. Subdirección General de Investigación en Terapia Celular y Medicina Regenerativa. Instituto de Salud Carlos III. Madrid4Doctora. Investigación en Cuidados, Hospital Universitario Puerta de Hierro Majadahonda. Grupo de Trabajo Analgesia, Sedación, Contenciones y Delirio de la Sociedad Española de Enfermería de Intensivos y Unidades Coronarias. Madrid

Contact address

María Acevedo-Nuevo. Organización Nacional de Trasplantes. C/ Sinesio Delgado, 6-8, Pabellón 3. 28029 Madrid. Email: m.acevedo.nuevo@gmail.com

Contact email: m.acevedo.nuevo@gmail.com

Abstract

Objectives: primary objective: to design strategies and algorithms for decision that will minimize the use of mechanical restraints (MRs) and the risks derived in Critical Care Units (CCUs). Secondary Objectives: a) To learn about the experience of professionals when managing critical patients with MRs, and based on their current setting in terms of the use of MRs; b) To explore the meaning given by professionals to the terms “risk” and “safety”; c) To analyze the prevalence of the use of MRs in critical patients, those factors associated with their use, and any related adverse events; d) To understand the attitude of CCU professionals regarding the use of MRs.
Method: a multicenter study in two sequential stages: Stage I for the generation of a wide and comprehensive knowledge about the use of MRs in critical patients through different methodologies: interpretative phenomenological qualitative research, clinical audit (review of clinical practice) and cross-sectional study to explore the attitudes by professionals. In Stage II, through the Delphi method, and based on the knowledge generated, there will be a development of strategies, recommendations and decision algorithms that will minimize the risks derived of an inadequate use of MRs in critical patients.
Conclusions: in order to achieve the objective of minimizing the use of MRs in CCUs and, in those cases necessary, using them according to recommendations, it is considered necessary to generate wide and specific knowledge, adapted to the reality of critical patients.

Keywords:

physical restraint; critical care; qualitative research; mechanical containment; mixed method; nurses; physicians; Nursing assistants

Versión en Español

Título:

Contención mecánica en cuidados críticos: mapeo situacional, conceptualización profesional y recomendaciones para la práctica