Using the evidence to decision frameworks to formulate the direction and strength of recommendations for adapted guidelines of physical restraints in critical care: A Delphi study

作者全名："Cui, Nianqi; Yang, Ruiqi; Zhang, Hui; Chen, Dandan; Wu, Jingjie; Zhang, Yuping; Ma, Yajun; Jin, Jingfen"

作者地址："[Cui, Nianqi; Zhang, Yuping; Ma, Yajun; Jin, Jingfen] Zhejiang Univ Sch Med SAHZU, Affiliated Hosp 2, Nursing Dept, Hangzhou, Zhejiang, Peoples R China; [Yang, Ruiqi] Chongqing Med Univ, Affiliated Hosp 2, Dept Crit Care Med, Chongqing, Peoples R China; [Zhang, Hui] Guizhou Prov Peoples Hosp, Dept Cardiol, Guiyang, Guizhou, Peoples R China; [Chen, Dandan; Wu, Jingjie] Zhejiang Univ, Sch Med, Fac Nursing, Hangzhou, Zhejiang, Peoples R China; [Jin, Jingfen] Key Lab Diag & Treatment Severe Trauma & Burn Zhej, Hangzhou, Zhejiang, Peoples R China; [Jin, Jingfen] Hosp SAHZU, Changxing Branch, Huzhou, Zhejiang, Peoples R China; [Jin, Jingfen] Zhejiang Univ Sch Med SAHZU, Affiliated Hosp 2, Key Lab Diag & Treatment Severe Trauma & Burn Zhej, 88 Jiefang Rd, Hangzhou 310009, Zhejiang, Peoples R China; [Jin, Jingfen] Hosp SAHZU, Changxing Branch, 66 Taihu Middle Rd, Huzhou 313100, Zhejiang, Peoples R China"

通信作者："Jin, JF (通讯作者)，Zhejiang Univ Sch Med SAHZU, Affiliated Hosp 2, Key Lab Diag & Treatment Severe Trauma & Burn Zhej, 88 Jiefang Rd, Hangzhou 310009, Zhejiang, Peoples R China.; Jin, JF (通讯作者)，Hosp SAHZU, Changxing Branch, 66 Taihu Middle Rd, Huzhou 313100, Zhejiang, Peoples R China."

来源：INTENSIVE AND CRITICAL CARE NURSING

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001007919000001

JCR分区：Q1

影响因子：4.9

年份：2023

卷号：76

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：Clinical practice guidelines; Delphi; Evidence to decision; GRADE; Intensive care units; Physical restraints; Recommendations

摘要："Background: It has been shown that the use of physical restraints has negative physiological and psychological impacts on critically ill patients. The development of clinical practice guidelines is necessary for minimizing the use of physical restraints.Objective: As part of a guideline adaptation project, this study aimed to formulate the direction and strength of recommendations for adapted guidelines of physical restraints in critical care.Methods: Literature retrieval of guidelines and systematic reviews was performed and guideline steering com-mittee discussions were conducted to develop an inquiry questionnaire. From February to April 2022, a two-round study, including 27 multidisciplinary experts, was conducted using the evidence to decision frame-works and Delphi methods.Results: The 27 experts were from 22 of the 33 provinces/municipalities/autonomous regions of mainland China. For the first and second questionnaires, the recovery rates were 85.7% and 100%, respectively. In the first and second rounds, the average authoritative coefficients were 0.93 and 0.94, respectively. Regarding Kendall W values, the values were 0.555 and 0.120, respectively. A consensus was reached on 15 recommendations, including one strong recommendation, seven conditional recommendations and seven good practice statements.Conclusion: In the two rounds of consultations, a consensus was reached on 15 recommendations for the adapted physical restraint guidelines in critical care through the evidence to decision frameworks and Delphi methods. Recommendations in the adapted physical restraint guidelines are related to institutional and educational in-terventions, risk assessment, the management of patients' unsafe behaviours, pain, mechanical ventilation, sleep, family engagement, mobility, sedation, and delirium.Implications for Clinical Practice: Based on our recommendations, we suggest nurses develop a physical restraint education bundle."

基金机构：Science Research Foundation of Chinese Nursing Association [ZHKY201913]; Zhejiang University Academic Award for Outstanding Doctoral Candidates [202059]

基金资助正文：Funding This work is supported by The Science Research Foundation of Chinese Nursing Association [Grant No: ZHKY201913] and Zhejiang University Academic Award for Outstanding Doctoral Candidates [grant numbers: 202059] .