Predictors of physical restraint use in Canadian intensive care units

• DOI: 10.1186/cc13789
• Publication Date: 2014-03-25T03:27:37Z
• Authors: Elena Luk; Barbara Sneyers; Louise Rose; Marc M Perreault; David R Williamson; Sangeeta Mehta; Deborah J Cook; Stephanie C Lapinsky; Lisa Burry
• Keywords: Rate ratio; Defined daily dose; Bolus (digestion)

Physical restraint (PR) use in the intensive care unit (ICU) has been associated with higher rates of self-extubation and prolonged ICU length stay. Our objectives were to describe patterns predictors PR use. We conducted a secondary analysis prospective observational study analgosedation, antipsychotic, neuromuscular blocker, practices 51 Canadian ICUs. Data collected prospectively for all mechanically ventilated adults admitted during two-week period. tested patient, treatment, hospital characteristics that number days use, using logistic Poisson regression respectively. was used on 374 out 711 (53%) patients, mean 4.1 (standard deviation (SD) 4.0) days. Treatment daily benzodiazepine dose (odds ratio (OR) 1.05, 95% confidence interval (CI) 1.00 1.11), opioid (OR 1.04, CI 1.01 1.06), antipsychotic drugs 3.09, 1.74 5.48), agitation (Sedation-Agitation Scale (SAS) >4) 3.73, 1.50 9.29), sedation administration method (continuous bolus versus only) 5.48). Hospital indicated patients less likely be restrained ICUs from university-affiliated hospitals 0.32, 0.17 0.61). Mainly treatment more PR, including: (incidence rate (IRR) 1.07, 1.13), interruption (IRR 3.44, 1.48 8.10), 15.67, 6.62 37.12), SAS <3 2.62, 1.08 6.35), any adverse event including accidental device removal 8.27, 2.07 33.08). Patient (age, gender, Acute Physiology Chronic Health Evaluation II score, admission category, prior substance abuse, psychotropic medication, pre-existing psychiatric condition or dementia) not used. half these predominantly predicted as opposed patient hospital/ICU characteristics. Use sedative, analgesic, drugs, agitation, heavy sedation, occurrence an