Physical restraints in critically ill children: Multicenter point prevalence study in Japan

2020 Fiscal Year Final Research Report

• Project/Area Number: 19K24249
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Multi-year Fund
• Review Section: 0908:Society medicine, nursing, and related fields
• Research Institution: Osama Woman's and Children's Hospital
• Principal Investigator: Ryo Ikebe 地方独立行政法人大阪府立病院機構大阪母子医療センター(研究所), その他部局等, 看護部・ICU・主任 (90844308)
• Project Period (FY): 2019-08-30 – 2021-03-31
• Keywords: 身体拘束 / 小児集中治療 / 多施設前向き横断調査

Outline of Final Research Achievements

Objectives: We investigate the prevalence of, and elucidate the factors associated with, the use of physical restraints among critically ill or injured children in pediatric intensive care units. Design: This was a multicenter, longitudinal point prevalence study.Setting: We included 26 PICUs in Japan. Patients: Included children were aged 1 month to 10 years. We screened all admitted patients in the PICUs on three study dates.
Main Results: A total of 398 children were screened in the participating pediatric intensive care units on the three data collection dates. The prevalence of children with physical restraints was 53% (211/398). The adjusted odds of using physical restraint in patients aged 1-2 years was 2.3 (95% Cl, 1.3-4.0) compared with children <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.

Free Research Field

小児集中治療

Academic Significance and Societal Importance of the Research Achievements

重症小児に対する身体拘束の実施率は高く、施設間での差が見られた。今回の研究結果から、患者の年齢、ユニットの規模、身体拘束の実践方針が、身体拘束の 実施率と関連している可能性が示唆された。
このことから、重症小児に対する身体拘束の実施基準作成や、施設間格差を是正する取り組みを行うことで、より快適、かつ質の高い重症小児に対する治療・療養環境の提供が可能となる。