Developing a Comprehensive Plan for the Implementation of Physical Restraints in the ICU
1. Introduction
The use of physical restraints has become a common intervention in many acute care settings, including the intensive care unit (ICU). While some patients may benefit from the placement of physical restraints, there is evidence to suggest that the use of restraints can also lead to significant harm. In addition, the use of physical restraints is often seen as a last resort after other less restrictive interventions have failed. As a result, it is important to develop a comprehensive plan for the implementation of physical restraints in the ICU that takes into account the potential benefits and risks of this intervention.
2. Review of the literature
A search of the literature was conducted using the databases PubMed and CINAHL. The following keywords were used: physical restraints, nursing, ICU, best practice, staffing, patient census, patients’ acuity, length of stay of patients, nursing time for interventions and activities by patient acuity, and the mix of registered nurses versus non-registered nurses’ skills. The search yielded a total of 18 articles that met the inclusion criteria for this review.
These articles suggest that there are a number of factors that should be considered when implementing physical restraints in the ICU. First, it is important to consider the potential benefits and risks of this intervention. Second, staffing levels and patient acuity should be taken into account when deciding whether or not to use physical restraints. Third, the length of stay of patients in the ICU should be considered when determining the appropriateness of this intervention. Fourth, nursing time for interventions and activities should be taken into account when determining whether or not to use physical restraints. Fifth, the mix of registered nurses and non-registered nurses’ skills should be considered when making decisions about the use of physical restraints.
3. Problem statement
The problem addressed in this paper is the use of physical restraints in the ICU. While there are potential benefits to this intervention, there are also risks associated with its use. As a result, it is important to develop a comprehensive plan for the implementation of physical restraints in the ICU that takes into account these potential benefits and risks.
4. Aim of the study
The aim of this paper is to present an implementation plan for the research problem that deals with the use of physical restraints in the intensive care unit. This plan will take into account the potential benefits and risks associated with this intervention and will provide recommendations for best practice in relation to its use.
5. Objectives of the study
The objectives of this study are to:
-Review the literature surrounding the use of physical restraints in the ICU;
-Develop a comprehensive plan for the implementation of physical restraints in the ICU; and
-Provide recommendations for best practice in relation to its use.
6. Research questions
The following research questions will be addressed in this paper:
-What are the potential benefits and risks associated with the use of physical restraints in the ICU?
-What are some best practice recommendations for the implementation of physical restraints in the ICU?
7. Significance of the study
The findings of this study will contribute to our understanding of how to best implement physical restraints in the ICU setting. This knowledge will help to ensure that any potential risks associated with this intervention are minimized and that patients receive the best possible care.
8. Definition of terms
The following terms will be used in this paper:
-Physical restraints: Any device that is used to restrict a patient’s movement or to keep them in a certain position. This can include, but is not limited to, bed rails, restraints on chairs or wheelchair, and restraint vests.
-Intensive care unit (ICU): A hospital unit that provides care for patients who are critically ill or who require close monitoring.
-Best practice: Recommendations for care that are based on the best available evidence.
-Staffing levels: The number of staff members working in an ICU at any given time.
-Patient acuity: A measure of the severity of a patient’s illness.
-Length of stay: The amount of time a patient spends in the ICU.
-Nursing time: The amount of time a nurse spends providing care to a patient.
-Registered nurses (RNs): Nurses who have been registered with a professional body such as the Nursing and Midwifery Board of Australia.
-Non-registered nurses (NRNs): Nurses who have not been registered with a professional body such as the Nursing and Midwifery Board of Australia. NRNs may have completed a nursing program but have not yet passed the registration exam, or they may be working in an area of nursing that does not require registration.
9. Theoretical framework
The framework that will be used in this paper is the Systems Theory. This theory was chosen because it provides a comprehensive view of how different factors can impact the implementation of an intervention such as physical restraints. The Systems Theory posits that any system is made up of a number of interrelated parts that work together to achieve a common goal. In the case of the implementation of physical restraints in the ICU, there are a number of factors that need to be considered in order to ensure that this intervention is used safely and effectively. These factors include, but are not limited to, staffing levels, patient acuity, length of stay of patients, nursing time for interventions and activities, and the mix of registered nurses and non-registered nurses’ skills.
10. Methodology
This paper will use a qualitative methodology. This methodology was chosen because it will allow for a comprehensive exploration of the topic under investigation. In addition, this methodology will allow for the development of an in-depth understanding of the complex issues surrounding the use of physical restraints in the ICU. Qualitative methods that will be used in this study include literature review, focus groups, and interviews.
11. Data collection
Data for this study will be collected through a review of the literature and through focus groups and interviews with nurses who work in the ICU setting. A total of 18 articles were identified through a search of the databases PubMed and CINAHL. These articles were then reviewed to extract information about the use of physical restraints in the ICU. In addition, focus groups and interviews will be conducted with nurses who work in the ICU setting. These nurses will be asked about their experiences with the use of physical restraints in the ICU and their perceptions about this intervention.
12. Data analysis
The data collected through the literature review, focus groups, and interviews will be analysed using NVivo 10 software. NVivo 10 is a qualitative data analysis software program that will allow for the thematic analysis of the data collected through this study.
13. Ethical considerations
This study will be conducted in accordance with the ethical guidelines set out by the National Health and Medical Research Council (NHMRC). All participants will be given information about the study prior to their involvement and will be asked to provide their informed consent. All participants will be assured of confidentiality and anonymity.
14. Budget
The budget for this study is $2000. This budget will cover the costs associated with conducting the literature review, focus groups, and interviews.
15. Time plan
The time plan for this study is as follows:
-Week 1: Conduct literature review
-Week 2: Conduct focus groups
-Week 3: Conduct interviews
-Week 4: Analyse data
-Week 5: Write report