USE OF PHYSICAL RESTRAINTS IN INTENSIVE CARE UNIT: A SYSTEMATIC REVIEW STUDY

Background and purpose: Use of physical restraints is a common clinical practice in different conditions and hospital wards including Intensive Care Units (ICU). Given the importance of the use of physical restraints in the ICUs, the present systematic review was conducted in order to determine the prevalence of physical restraint use in the ICUs.

Materials and methods: Related papers on restraint use in the ICUs published from 2000 to 2016 were included in this study by searching the national and international scientific databases. Based on Farsi and English keywords searching, and applying inclusion and exclusion criteria, final 22 papers from 17 countries were selected for the meta-analysis. The data were analyzed by using Stata Software Version 12.0. The index of heterogeneity among different studies was determined using Cochran (Q) and I2 tests.

Results: The present systematic review study includes 22 related articles. The prevalence of physical restrains use varied from 7% in the study by Elliott with a sample size of 569 patients in general ICUs in Australia to 87% in Curry’s study with a sample of 26 patients in a surgical ICU in the United States. According to the results of the meta-analysis, the prevalence of physical restrains use was estimated to be 46.7% (CI 95%: 34.7-58.6) in the ICUs.

Conclusion: As there is a widespread use of physical restraints in the ICU, it is necessary that hospital managers plan appro- priately to reduce the use of physical restraints and whereby its complications and to increase adequately the knowledge, attitudes of ICU nurses towards physical restraint of patients and its affecting factors so that they adhere to the guidelines of this method of care properly.