Multicenter Study

. 2021 Nov 1;49(11):1955-1962.

doi: 10.1097/CCM.0000000000005111.

Physical Restraints in Critically Ill Children: A Multicenter Longitudinal Point Prevalence Study

Ryo Ikebe¹, Atsushi Kawaguchi^{1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18}, Tatsuya Kawasaki⁵, Norimasa Miura⁶, Yujiro Matsuishi⁷, Muneyuki Takeuchi⁸, Takehiro Nittsu⁹, Naoki Fujiwara¹⁰, Shinya Shimoyama¹¹, Yuko Nakayama¹², Chisato Akita¹³, Ikkei Munekawa¹⁴, Yumi Kajinishi¹⁵, Emi Sasaki¹⁶, Katsuko Sakamoto¹⁷, Wakato Matsuoka¹⁸; PRINCE Study Group and Innovative Support for Pediatric Intensive Care Research and Education (INSPIRED)

Affiliations

¹ Department of Nursing, Osaka Women's and Children's Hospital, Osaka, Japan.
² Department of Pediatrics, CHU Sainte-Justine Research Center, University of Montreal, Montreal, QC, Canada.
³ Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
⁴ Department of Intensive Care Medicine, Tokyo Women's Medical University, Tokyo, Japan.
⁵ Department of Pediatric Critical Care, Shizuoka Children's Hospital, Shizuoka, Japan.
⁶ Department of Nursing, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
⁷ Department of Nursing, University of Tsukuba Hospital, Ibaraki, Japan.
⁸ Department of Intensive Care Medicine, Osaka Women's and Children's Hospital, Osaka, Japan.
⁹ Department of Critical Care Medicine, Saitama Children's Medical Center, Saitama, Japan.
¹⁰ Department of Pediatric Intensive Care, Okinawa Prefectural Nanbu Children's Medical Center, Okinawa, Japan.
¹¹ Department of Cardiology, Gunma Children's Medical Center, Gunma, Japan.
¹² Department of Critical Care Medicine, Toyama Prefectural Central Hospital, Toyama, Japan.
¹³ Department of Pediatrics, Kanazawa Medical University, Ishikawa, Japan.
¹⁴ Department of Nursing, Sakakibara Heart Institute, Tokyo, Japan.
¹⁵ Department of Nursing, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan.
¹⁶ Department of Nursing, Miyagi Children's Hospital, Miyagi, Japan.
¹⁷ Department of Nursing, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
¹⁸ Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan.

PMID: 34166295
DOI: 10.1097/CCM.0000000000005111

Multicenter Study

Physical Restraints in Critically Ill Children: A Multicenter Longitudinal Point Prevalence Study

Ryo Ikebe et al. Crit Care Med. 2021.

. 2021 Nov 1;49(11):1955-1962.

doi: 10.1097/CCM.0000000000005111.

Authors

Affiliations

¹ Department of Nursing, Osaka Women's and Children's Hospital, Osaka, Japan.
² Department of Pediatrics, CHU Sainte-Justine Research Center, University of Montreal, Montreal, QC, Canada.
³ Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.
⁴ Department of Intensive Care Medicine, Tokyo Women's Medical University, Tokyo, Japan.
⁵ Department of Pediatric Critical Care, Shizuoka Children's Hospital, Shizuoka, Japan.
⁶ Department of Nursing, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
⁷ Department of Nursing, University of Tsukuba Hospital, Ibaraki, Japan.
⁸ Department of Intensive Care Medicine, Osaka Women's and Children's Hospital, Osaka, Japan.
⁹ Department of Critical Care Medicine, Saitama Children's Medical Center, Saitama, Japan.
¹⁰ Department of Pediatric Intensive Care, Okinawa Prefectural Nanbu Children's Medical Center, Okinawa, Japan.
¹¹ Department of Cardiology, Gunma Children's Medical Center, Gunma, Japan.
¹² Department of Critical Care Medicine, Toyama Prefectural Central Hospital, Toyama, Japan.
¹³ Department of Pediatrics, Kanazawa Medical University, Ishikawa, Japan.
¹⁴ Department of Nursing, Sakakibara Heart Institute, Tokyo, Japan.
¹⁵ Department of Nursing, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan.
¹⁶ Department of Nursing, Miyagi Children's Hospital, Miyagi, Japan.
¹⁷ Department of Nursing, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
¹⁸ Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan.

PMID: 34166295
DOI: 10.1097/CCM.0000000000005111

Abstract

Objectives: We elucidate to investigate the prevalence of and factors associated with the use of physical restraints among critically ill or injured children in PICUs.

Design: This was a multicenter, longitudinal point prevalence study.

Setting: We included 26 PICUs in Japan.

Patients: Included children were 1 month to 10 years old. We screened all admitted patients in the PICUs on three study dates (in March, June, and September 2019).

Intervention: None.

Measurements and main results: We collected prevalence and demographic characteristics of critically ill or injured children with physical restraints, as well as details of physical restraints, including indications and treatments provided. A total of 398 children were screened in the participating PICUs on the three data collection dates. The prevalence of children with physical restraints was 53% (211/398). Wrist restraint bands were the most frequently used means (55%, 117/211) for potential contingent events. The adjusted odds of using physical restraint in patients 1-2 years old was 2.3 (95% CI, 1.3-4.0) compared with children less than 1 year old. When looking at the individual hospital effect, units without a prespecified practice policy for physical restraints management or those with more than 10 beds were more likely to use physical restraints.

Conclusions: The prevalence of physical restraints in critically ill or injured children was high, and significant variation was observed among PICUs. Our study findings suggested that patient age, unit size, and practice policy of physical restraint could be associated with more frequent use of physical restraints.

PubMed Disclaimer

Conflict of interest statement

The authors have disclosed that they do not have any potential conflicts of interest.

Comment in

International Comparisons of ICU Treatment: What Can We Learn Together?
Slonim AD, See H. Slonim AD, et al. Crit Care Med. 2021 Nov 1;49(11):1991-1993. doi: 10.1097/CCM.0000000000005159. Crit Care Med. 2021. PMID: 34643581 No abstract available.

References

1. Maccioli GA, Dorman T, Brown BR, et al.; American College of Critical Care Medicine, Society of Critical Care Medicine. Clinical practice guidelines for the maintenance of patient physical safety in the intensive care unit: Use of restraining therapies—American College of Critical Care Medicine Task Force 2001-2002. Crit Care Med. 2003; 31:2665–2676
1. Japanese Ministry of Health and Welfare: Constitution of Japan. Chapter 3: Rights and Duties of the People (No. 34). [Japanese]. Available at: https://elaws.e-gov.go.jp/search/elawsSearch/elaws_search/lsg0500/detail... . Accessed July 27, 2020
1. Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci. 2013; 15:79–85
1. Van Rompaey B, Elseviers MM, Schuurmans MJ, et al. Risk factors for delirium in intensive care patients: A prospective cohort study. Crit Care. 2009; 13:R77
1. Mehta S, Cook D, Devlin J, et al. Incidence, risk factors and outcomes of delirium in mechanically ventilated adults. Crit Care Med. 2015; 43:557–566

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Consumer Health Information
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Physical Restraints in Critically Ill Children: A Multicenter Longitudinal Point Prevalence Study

Affiliations

Physical Restraints in Critically Ill Children: A Multicenter Longitudinal Point Prevalence Study

Authors

Affiliations

Abstract

Conflict of interest statement

Comment in

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical