Hemşirelerin COVID-19 Hastalarında Fiziksel Tespit Uygulamalarına İlişkin Bilgi, Tutum ve Uygulamaları

Abstract

Giriş: COVID-19 enfeksiyonu, akut bakım ortamlarında fiziksel tespit ihtiyacını artırmaktadır. Amaç: Bu araştırma, hemşirelerin COVID-19 hastalarında fiziksel tespit kullanımına ilişkin bilgi, tutum ve uygulamalarını incelemeyi amaçlamaktadır. Yöntem: Bu tanımlayıcı çalışma, 285 yoğun bakım hemşiresi ile çevrimiçi anket yöntemi kullanılarak yürütülmüştür. Verilerin toplanmasında “Hemşire Bilgi Formu” ve “Hemşirelerin Fiziksel Tespit Kullanma Bilgi, Tutum ve Uygulama Düzeyleri Ölçeği” kullanılmıştır. Bulgular: Hemşirelerin toplam ölçek puan ortalaması 76.11±9.21, bilgi puanı ortalaması 8.07±1.60, tutum puanı ortalaması 32.67±7.08, uygulama puanı ortalaması 35.36±3.66 idi. Hemşirelerin fiziksel tespit kullanım oranlarının pandemi öncesine göre anlamlı olarak arttığı saptandı (p<0,05). Hemşirelerin %59,3'ü fiziksel tespiti için hastaya semi-fowler pozisyonu verdiğini ve hemşirelerin tamamı alternatif bir yöntem kullanmadığını belirtmişlerdir. Sonuç: Hemşirelerin fiziksel tespit ile ilgili bilgi düzeyleri yüksek, COVID-19 hastalarına yönelik tutum ve uygulamaları olumludur. Hemşirelerin fiziksel kısıtlamaya alternatifler konusunda eğitime ihtiyaçları vardır. Gelecekteki çalışmalar, fiziksel tespite alternatifler belirlemeye, geliştirmeye ve bunların hastalarda tespit oranları üzerindeki etkilerini değerlendirmeye odaklanmalıdır.

Keywords

• Fiziksel tespit
• COVID-19
• yoğun bakım
• hemşire
• hasta güvenliği

Nurses' Knowledge, Attitudes and Practices regarding the Use of Physical Restraint on Patients with COVID-19

Abstract

Background: COVID-19 infection increases the need for physical restraint in acute care settings. Objective: This study aims to examine nurses' knowledge, attitudes and practices regarding the use of physical restraint in patients with COVID-19. Methods: This descriptive study was conducted using online self-report questionnaires distributed to 285 intensive care nurses. In the data collection, “Nurses Information Form” and “Level of Knowledge, Attitude and Practices for Using Physical Restraint Scale for Nurses” were used. Results: The mean score of the total scale of the nurses was 76.11±9.21, the mean knowledge score was 8.07±1.60, the mean attitude score was 32.67±7.08, the mean practice score was 35.36±3.66. It was found that physical restraint usage rates of nurses increased significantly compared to the pre-pandemic period (p<0.05). 59.3% of the nurses stated that they gave the semi-fowler position who would undergo physical restraint, and all of them did not use an alternative method. Discussion: The knowledge of nurses about physical restraint is high, their attitudes and practices are positive toward patients with COVID-19. The nurses need training on alternatives to physical restraint. Future studies should focus on determining and developing alternatives to physical restraint and evaluating their effects on the rates of restraint in the patients.

Keywords

• Physical restraint
• COVID-19
• intensive care
• nurse
• patient safety

References

1. Acar, T., Demirel, E. A., Afsar, N., Akcali, A., Demir, G. A., Alagoz, A. N., Mengi, T. A., Arsava, E. M., Ayta, S., Bebek, N., Bilgic, B., Boz, C., Cakar, A., Celebisoy, N., Cevik, M. U., Delen, F., Tekce, H. D., Ekmekci, H., Elmali, A. D., Erdinc, O. O., Erdogan, F. F., Eren, F., Ergün, U., Parman,Y. G., Gümüs, H., Algin, D. İ., Karabudak, R., Karadas, Ö., Yildiz, Ö. K., Koc, E. R., Adapınar, D. Ö., Ozdemir, A. Ö., Oztürk, Ş., Kocaman, A. S., Şahin, Ş., Topcuoglu, E. S., Şener, Ö., Tezer, F. İ., Toğrol, R. E., Tokçaer, A. B., Topçuoğlu, M. A., Tuncer, N., Uca, A. U., Uluç, K., Yaka, E., & Yön, M. İ. (2020). Nörolojik bakış açısından COVID-19. Turk J Neurol., 26(2), 56-106. https://doi.org/10.4274/tnd.2020.73669
2. Alhazzani, W., Moller, M., Arabi, Y., Loeb, M., Gong, M., Fan, E., Oczkowski, S., Levy, M. M., Derde, L., Dzierba, A., Du, B., Aboodi, M., Wunsch, H., Cecconi, M., Koh, Y., Chertow, D. S., Maitland, K., Alshamsi, F., Belley‑Cote, E., Greco, M., Laundy, M., Morgan, J. S., Kesecioglu, J., McGeer, A., Mermel, L., Mammen, M. J., Alexander, P. E., Arrington, A., Centofanti, J. E., Citerio, G., Baw, B., Memish, Z. A., Hammond, N., Hayden, F. G., Evans, L., & Rhodes, A (2020). Surviving sepsis campaign: Guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Intensive Care Med., 46, 854-887. https://doi.org/10.1007/s00134-020-06022-5
3. American Nurses Association. Reduction of Patient Restraint and Seclusion in Health Care Settings, (ANA) (2012). ANA Position Statement Silver Spring. Accessed: https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/reduction-of-patient-restraint-and-seclusion-in-health-care-settings/ Accessed date: 13 May 2021.
4. Azab, S., & Negm, L. A. (2013). Use of physical restraint in intensive care units (ICUs) at Ain Shams University Hospitals, Cairo. Journal of American Science, 9(4), 230-240.
5. Balcı, H., & Arslan, S. (2018). Nurses' information, attıtude and practices towards use of physical restraint in intensive care units. Journal of Caring Sciences, 7(2), 75. https://doi.org/10.15171/jcs.2018.012
6. Camporota, L., Sanderson, B., Chiumello, D., Terzi, N., Argaud, L., Rimmelé, T., Metuor, R., Verstraete, A., Cour, M., Bohé, J., Piriou, V., Beuret, P., & Guérin, C. (2022). Prone position in COVID-19 and-COVID-19 acute respiratory distress syndrome: An international multicenter observational comparative study. Critical Care Medicine. 50(4), 633-643. https://doi.org/10.1097/CCM.0000000000005354
7. De Berardis, D., Ventriglio, A., Fornaro, M., Vellante, F., Martinotti, G., Fraticelli, S., & Di Giannantonio, M., (2020). Overcoming the use of mechanical restraints in psychiatry: A new challenge in the everyday clinical practice at the time of COVID-19. Journal of Clinical Medicine. 9(11), 3774. https://doi.org/10.3390/jcm9113774
8. Ertugrul, B., & Ozden, D. (2020). Nurses' knowledge and attitudes regarding physical restraint in Turkish intensive care units. Nursing in Critical Care. 26(4), 253-261. https://doi.org/10.1111/nicc.12541

9. Eskandari, F., Abdullah, K. L., Zainal, N. Z., & Wong, L. P. (2017). Use of physical restraint: Nurses’ knowledge, attitude, intention and practice and influencing factors. Journal of Clinical Nursing. 26(23-24), 4479-4488. https://doi.org/10.1111/jocn.13778
10. Estévez-Guerra, G. J., Fariña-López, E., Núñez-González, E., Gandoy-Crego, M., Calvo-Francés, F., & Capezuti, E. A. (2017). The use of physical restraints in long-term care in Spain: A multi-center cross-sectional study. BMC Geriatrics. 17(1), 1-7. https://doi.org/10.1186/s12877-017-0421-8
11. Font, R., Quintana, S., & Monistrol, O. (2021). Impact of family restrictions during COVID-19 pandemic on the use of physical restraint in an acute hospital: An observational study. Journal of Healthcare Quality Research. 36(5), 263-268. https://doi.org/10.1016/j.jhqr.2021.04.005
12. George, D., & Mallery, M. (2010) SPSS for Windows Step by Step: A Simple Guide and Reference, 17.0 update (10a ed). Boston:Pearson.
13. Ghelichkhani P, & Esmaeili M. Prone position in management of COVID-19 patients; A commentary. Archives of Academic Emergency Medicine. 2020;8(1):e48.
14. Göktaş, A., & Buldukoğlu, K. (2018). Psikiyatri kliniğinde çalışan hemşirelerin fiziksel tespit kullanımına ilişkin bilgi, tutum ve uygulamalarının belirlenmesi. Psikiyatri Hemşireliği Dergisi. 9(1), 1-10. https://doi.org/10.14744/phd.2017.38247
15. Gu, T., Wang, X., Deng, N., & Weng, W. (2019). Investigating influencing factors of physical restraint use in China intensive care units: a prospective, cross-sectional, observational study. Australian Critical Care. 32(3), 193-198. https://doi.org/10.1016/j.aucc.2018.05.002
16. Gül, Ü., & Kavak, F. (2019). Hemşirelerin fiziksel tespite yönelik bilgi düzeyi, tutum ve uygulamalarının değerlendirilmesi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 10(4), 657-662. https://doi.org/10.31067/0.2019.216
17. Gürdoğan, E. P., Uğur, E., Kınıcı, E., & Aksoy, B. (2016). Yoğun bakım hemşirelerinin fiziksel tespite ilişkin bilgi, tutum ve uygulamaları ve etkileyen faktörler. Yoğun Bakım Derg. 7, 83-88. https://doi.org/10.5152/dcbybd.2017.1260
18. Kassew, T., Dejen Tilahun, A., & Liyew, B. (2020). Nurses’ knowledge, attitude, and influencing factors regarding physical restraint use in the intensive care unit: A multicenter cross-sectional study. Critical Care Research and Practice. 1-10. Article ID 4235683. https://doi.org/10.1155/2020/4235683
19. Kaya, H., şsti, T., Acaroğlu, R., Erol, S., & Savcı, C. (2008). Nurses’ knowledge, attitudes and practices related to using physical restraints. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi. 2, 22-29.
20. Kısacık, Ö.G., Sönmez, M., & Çoşgun, T. (2020). Use of physical restraints in critical care units: Nurses’ knowledge, attitudes, and practices. Critical Care Nurse. 40(3), 37-47. https://doi.org/10.4037/ccn2020856
21. Köse, G., Taştan, S., Çatalbaş, A., Akkaya, H., Seyfi, M., & Avşar, Ö. (2020). Bir üniversite hastanesinde çalışan hemşirelerin fiziksel kısıtlama kullanımına ilişkin bilgi, tutum ve uygulamalarının belirlenmesi. Kocaeli Tıp Dergisi. 9(2), 39-48.
22. Kotfis, K., Roberson, S. W., Wilson, J. E., Pun, B. T., Ely, E. W., Jeżowska, I., Jezierska, M., & Dabrowski, W. (2020). COVID-19: What do we need to know about ICU delirium during the SARS-CoV-2 pandemic? Anaesthesiology Intensive Therapy. 52(2), 132-138. https://doi.org/10.5114/ait.2020.95164
23. O’Hanlon S., & Inouye S. K. (2020). Delirium: A missing piece in the COVID-19 pandemic puzzle. Age and Ageing. 49(4), 497–498. https://doi.org 10.1093/ageing/afaa094
24. Okuno, T., Itoshima, H., Shin, J. H., Morishita, T., Kunisawa, S., & Imanaka, Y. (2021). Physical restraint of dementia patients in acute care hospitals during the COVID-19 pandemic: A cohort analysis in Japan. Plos One. 16(11), e0260446. https://doi.org/10.1371/journal.pone.0260446
25. Özbilen, F., & Altunkan, A. A. (2020). COVID-19 ve uyanık pron pozisyon. Turkish Journal of Intensive Care. 18, 50-56. . https://doi.org 10.4274/tybd.galenos.2020.51422
26. Pan, Y., Jiang, Z., Yuan, C., Wang, L., Zhang, J., Zhou, J., Tao, M., Quan, M., & Wu, Q. (2018). Influence of physical restraint on delirium of adult patients in ICU: A nested case–control study. Journal of Clinical Nursing. 27(9-10), 1950-1957. https://doi.org/10.1111/jocn.14334
27. Rollas, K., & Şenoğlu, N. (2020). COVID-19 hastalarının yoğun bakım ünitesinde yönetimi. Tepecik Eğit ve Araşt Hast Dergisi. 30(Ek sayı), 142-155. https://doi.org 10.5222/terh.2020.77044
28. Rose, L., Burry, L., Mallick, R., Luk, E., Cook, D., Fergusson, D., Dodek, P., Burns, K., Granton, J., Ferguson, N., Devlin, J.W., Steinberg, M., Keenan, S., Reynolds, S., Tanios, M., Fowler, R.A., Jacka, M., Olafson, K., Skrobik, Y., & Mehta, S. (2016). Prevalence, risk factors, and outcomes associated with physical restraint use in mechanically ventilated adults. Journal of Critical Care. 31(1), 31-35. http://dx.doi.org/10.1016/j.jcrc.2015.09.011
29. San Turgay, A., Sarı, D., & Genç, R. E. (2009). Physical restraint use in Turkish intensive care units. Clinical Nurse Specialist. 23(2), 68-72. http://dx.doi.org/10.1097/NUR.0b013e318199125c
30. Söylemez, B. A., Küçükgüçlü, Ö., Özkaya, B., & Özgül, E. (2020). Prevalence of physical restraint: A cross-sectional observational study. Turkish Journal of Geriatrics. 23(3), 384-392. http://dx.doi.org/10.31086/tjgeri.2020.174
31. Suen, K. P. L. (1998). Knowledge, attitude and practice of nursing home staff towards physical restraints in Hong Kong nursing homes. Asian Journal of Nursing Studies. 5(2), 73-86. http://hdl.handle.net/10397/2498
32. Suliman, M., Aloush, S., & Al‐Awamreh, K. (2017). Knowledge, attitude and practice of intensive care unit nurses about physical restraint. Nursing in Critical Care. 22(5), 264-269. https://doi.org/10.1111/nicc.12303
33. Via-Clavero, G., Sanjuán-Naváis, M., Romero-García, M., de la Cueva-Ariza, L., Martínez-Estalella, G., Plata-Menchaca, E., & Delgado-Hito, P. (2019). Eliciting critical care nurses’ beliefs regarding physical restraint use. Nursing Ethics. 26(5), 1458-1472. https://doi.org/10.1177/0969733017752547
34. Wong, A. H., Roppolo, L. P., Chang, B. P., Yonkers, K. A., Wilson, M. P., Powsner, S., & Rozel, J. S. (2020). Management of agitation during the COVID-19 pandemic. Western Journal of Emergency Medicine. 21(4), 795. https://doi.org/10.5811/westjem.2020.5.47789