Application effect of reduced restraint nursing for patients with tracheal intubation in the ICU:a Meta-analysis

ZHU Xuanjing; CHEN Qiaoling; ZHAO Huiling; HUANG Zhuofan; LIN Yang

doi:10.12104/j.issn.1674-4748.2024.20.004

Abstract：Objective:To evaluate the effect of reduced restraint strategy in patients with tracheal intubation in intensive care unit(ICU).Methods:Randomized controlled trials of reduced restraint care for tracheal intubation patients in ICU were searched in 8 databases including CNKI,VIP database,Wanfang database,SinoMed,PubMed,Embase,Web of Science and the Cochrane Library.The search period is limited to the date of completion of each library until December 20,2023.Two researchers independently conducted literature screening,data extraction and quality evaluation,and Meta-analysis was performed using RevMan 5.3 software.Results:A total of 9 articles were included,with a total of 1 370 patients.The results of Meta-analysis showed that the physical restraint rate of patients with reduced restraint care[RR=0.64,95％CI(0.58,0.72),P＜0.000 01],the physical restraint time[MD=-11.50,95％CI(-12.66,-10.34),P＜0.000 01],skin abnormalities[RR=0.29,95％CI(0.20,0.43),P＜0.000 01],rate of unplanned extubation[RR=0.26,95％CI(0.16,0.43),P＜0.000 01],satisfaction[RR=1.25,95％CI(1.18,1.32),P＜0.000 01],anxiety[SMD=-0.77,95％CI(-0.97,-0.57),P＜0.000 01],depression[SMD=-0.72,95％CI(-0.95,-0.50),P＜0.000 01],compared with the usual care group,the difference was statistically significant.Conclusions:Current evidence shows that compared with conventional restraint nursing,reduced restraint nursing can effectively shorten the physical restraint time of tracheal intubation patients in ICU,reduce the rate of physical restraint and unplanned extubation,improve the nursing satisfaction of patients and their families,and reduce the occurrence of skin abnormalities and negative emotions of patients.