Boas práticas para restrição física em unidades de terapia intensiva: revisão integrativa

Santos, Gabriela Freitas dos; Oliveira, Ester Góes; Souza, Regina Cláudia Silva

Gabriela Freitas dos Santos

Hospital Sírio Libanês. São Paulo, São Paulo, Brasil.

https://orcid.org/0000-0003-2764-8520

Ester Góes Oliveira Autor Correspondente: Ester Góes Oliveira. E-mail: ego990@hotmail.com

Hospital Sírio Libanês. São Paulo, São Paulo, Brasil.

https://orcid.org/0000-0002-5068-6480

Regina Cláudia Silva Souza

Hospital Sírio Libanês. São Paulo, São Paulo, Brasil.

https://orcid.org/0000-0001-6433-7700

Autor Correspondente: Ester Góes Oliveira. E-mail: ego990@hotmail.com

EDITOR CHEFE: Dulce Barbosa

EDITOR ASSOCIADO: Antonio José de Almeida Filho

	Estratégia de busca	Observações
PubMed	(("Restraint, Physical"[Mesh]) AND "Intensive Care Units"[Mesh]) AND ("Nursing"[Mesh] OR "Critical Care Nursing"[Mesh] OR "Advanced Practice Nursing"[Mesh] OR "Nursing, Team"[Mesh] OR "Nursing Care"[Mesh] OR "Nursing Assessment"[Mesh] OR "Patient Care Planning"[Mesh] OR "Nurses"[Mesh] )
CINAHL	SU intensive care AND SU restraint AND physical	Limitadores - Excluir registros do MEDLINE; Interesse especial: Advanced Nursing Practice, Evidence-Based Practice, Nursing Administration, Nursing Language/Classification, Patient Safety Expansores - Aplicar assuntos equivalentes Modos de busca - Booleano/Frase
Scopus	(TITLE (physical AND restraint) AND KEY (evidence OR standard* OR protocol* OR guidelines) OR KEY ("Patient Safety") OR KEY ("Nursing" OR "Critical Care Nursing" OR "Advanced Practice Nursing" OR "Nursing, Team" OR "Nursing Care" OR "Nursing Assessment" OR "Patient Care Planning" OR "Nurses") AND KEY (intensive AND care AND unit) AND NOT TITLE-ABS-KEY* (psychiatr*))
Biblioteca Virtual em Saúde (BVS)	(tW:("contencao")) AND (tw:(unidade$)) AND (tw:(terapia intensiva)) (tw:("imobilizacao")) AND(tw:(unidade$ )) AND (tw:(terapia intensiva))(tw:("restricaofisica")) AND (tw:(unidade$ )) AND (tw:(terapia intensiva))	Filtros: BDENF LILACS IBECS

AUTOR	ANO	FORMAÇÃO DOS PROFISSIONAIS	PAÍS	DELINEAMENTO	NÍVEL DE EVIDÊNCIA
Van de Kooi AW et al.⁽⁷7 Van der Kooi AW, Peelen LM, Raijmakers RJ, Vroegop RL, Bakker DF, Tekatli H, et al. Use of physical restraints in Dutch intensive care units: a prospective multicenter study. Am J Crit Care [Internet]. 2015[cited 2020 Sep 30];24(6):488-95. Available from: http://ajcc.aacnjournals.org/cgi/doi/10.4037/ajcc2015348 http://ajcc.aacnjournals.org/cgi/doi/10.... ⁾	2015	Médico	Holanda	Estudo transversal	6
Benbenbishty J et al.⁽⁸8 Benbenbishty J, Adam S, Endacott R. Physical restraint use in intensive care units across Europe: the PRICE study. Intensive Crit Care Nurs [Internet]. 2010 [cited 2020 Sep 30];26(5):241-5. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0964339710000686 https://linkinghub.elsevier.com/retrieve... ⁾	2010	Enfermeiro e médico	9 países da Europa	Estudo transversal	6
Lin Y-L et al.⁽⁹9 Lin YL, Liao CC, Yu WP, Chu TL, Ho LH. A multidisciplinary program reduces over 24 hours of physical restraint in neurological intensive care unit. J Nurs Res. 2018;26(4):288-96. https://doi.org/10.1097/jnr.0000000000000251 https://doi.org/10.1097/jnr.000000000000... ⁾	2018	Enfermeiro e médico	Taiwan	Estudo antes e depois	3
Hall DK et al.⁽¹⁰10 Hall DK, Zimbro KS, Maduro RS, Petrovitch D, Ver Schneider P, Morgan M. Impact of a restraint management bundle on restraint use in an intensive care unit. J Nurs Care Qual [Internet]. 2018 [cited 2020 Sep 30];33(2):143-8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28658189 http://www.ncbi.nlm.nih.gov/pubmed/28658... ⁾	2018	Enfermeiro	EUA	Estudo antes e depois	3
Lynn LL et al.⁽¹¹11 Lynn LL, Brookes JM. Changing perceptions of physical restraint use in the ICU. Nurs Crit Care. 2017;12(6):41-4. https://doi.org/10.1097/01.CCN.0000521939.91085.6f https://doi.org/10.1097/01.CCN.000052193... ⁾	2017	Enfermeiro	EUA	Estudo antes e depois	3
Luk E et al.⁽¹²12 Luk E, Burry L, Rezaie S, Mehta S, Rose L. Critical care nurses' decisions regarding physical restraints in two Canadian ICUs: a prospective observational study. Can J Crit care Nurs [Internet]. 2015 [cited 2020 Sep 30];26(4):16-22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26837121 http://www.ncbi.nlm.nih.gov/pubmed/26837... ⁾	2015	Enfermeiro, farmacêutico e médico	Canadá	Estudo transversal	6
Kandeel NA et al.⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000 http://doi.wiley.com/10.1111/nhs.12000... ⁾	2013	Enfermeiro	Egito	Estudo longitudinal	4
Choi E et al.⁽¹⁴14 Choi E, Song M. Physical restraint use in a Korean ICU. J Clin Nurs [Internet]. 2003[cited 2020 Sep 30];12(5):651-9. Available from: http://doi.wiley.com/10.1046/j.1365-2702.2003.00789.x http://doi.wiley.com/10.1046/j.1365-2702... ⁾	2003	Enfermeiro	Coreia do Sul	Estudo transversal	6
Johnson K et al.⁽¹⁵15 Johnson K, Curry V, Steubing A, Diana S, McCray A, McFarren A, et al. A non-pharmacologic approach to decrease restraint use. Intensive Crit Care Nurs [Internet]. 2016 [cited 2020 Sep 30];34:12-9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26652790 http://www.ncbi.nlm.nih.gov/pubmed/26652... ⁾	2016	Enfermeiro	EUA	Estudo antes e depois	3
Turgay AS et al.⁽¹⁶16 Turgay AS, Sari D, Genc RE. Physical restraint use in Turkish intensive care units. Clin Nurse Spec [Internet]. 2009 [cited 2020 Sep 30];23(2):68-72. https://doi.org/10.1097/NUR.0b013e318199125c https://doi.org/10.1097/NUR.0b013e318199... ⁾	2009	Enfermeiro	Turquia	Estudo transversal	6
Perren A et al.⁽¹⁷17 Perren A, Corbella D, Iapichino E, Di Bernardo V, Leonardi A, Di Nicolantonio R, et al. Physical restraint in the ICU: does it prevent device removal? Minerva Anestesiol [Internet]. 2015 [2020 Sep 30];81(10):1086-95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25338282 http://www.ncbi.nlm.nih.gov/pubmed/25338... ⁾	2015	Médico e psicólogo	Suíça	Estudo observacional prospectivo	4
De Jonghe B et al.⁽¹⁸18 De Jonghe B, Constantin JM, Chanques G, Capdevila X, Lefrant JY, Outin H, et al. Physical restraint in mechanically ventilated ICU patients: a survey of French practice. Intensive Care Med [Internet]. 2013[cited 2020 Sep 30];39(1):31-7. Available from: http://link.springer.com/10.1007/s00134-012-2715-9 http://link.springer.com/10.1007/s00134-... ⁾	2013	Médico	França	Estudo transversal	6
Vance DL⁽¹⁹19 Vance DL. Effect of a treatment interference protocol on clinical decision making for restraint use in the intensive care unit: a pilot study. AACN Clin Issues [Internet]. 2003 Feb; 14(1):82-91. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12574706 http://www.ncbi.nlm.nih.gov/pubmed/12574... ⁾	2003	Enfermeiro	EUA	Estudo antes e depois	3
Yönt GH et al.⁽²⁰20 Yönt GH, Korhan EA, Dizer B, Gümüs F, Koyuncu R. Examination of ethical dilemmas experienced by adult intensive care unit nurses in physical restraint practices. Holist NursPract. 2014;28(2):85-90. https://doi.org/10.1097/HNP.0000000000000013 https://doi.org/10.1097/HNP.000000000000... ⁾	2014	Enfermeiro	Turquia	Estudo transversal	6
Gu T et al.⁽²¹21 Gu T, Wang X, Deng N, Weng W. Investigating influencing factors of physical restraint use in China intensive care units: a prospective, cross-sectional, observational study. Aust Crit Care [Internet]. 2019 [cited 2020 Sep 30];32(3):193-8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1036731417303971 https://linkinghub.elsevier.com/retrieve... ⁾	2019	Enfermeiro	China	Estudo transversal	6
Martin B et al.⁽²²22 Martin B, Mathisen L. Use of physical restraints in adult critical care: a bicultural study. Am J Crit Care [Internet]. 2005 [cited 2020 Sep 30];14(2):133-42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15728955 http://www.ncbi.nlm.nih.gov/pubmed/15728... ⁾	2005	Enfermeiro	EUA e Noruega	Estudo transversal	6
Guenette M et al.⁽²³23 Guenette M, Burry L, Cheung A, Farquharson T, Traille M, Mantas I, et al. Psychotropic drug use in physically restrained, critically ill adults receiving mechanical ventilation. Am J Crit Care. 2017;26(5):380-7. https://doi.org/10.4037/ajcc2017677 https://doi.org/10.4037/ajcc2017677... ⁾	2017	Farmacêutico, enfermeiro e médico	Canadá	Estudo transversal	6
Suliman M⁽²⁴24 Suliman M. Prevalence of physical restraint among ventilated intensive care unit patients. J Clin Nurs. 2018;27(19-20):3490-6. https://doi.org/10.1111/jocn.14588 https://doi.org/10.1111/jocn.14588... ⁾	2018	Enfermeiro	Jordânia	Estudo transversal	6
Hevener S et al.⁽²⁵25 Hevener S, Rickabaugh B, Marsh T. Using a decision wheel to reduce use of restraints in a medical-surgical intensive care unit. Am J Crit Care [Internet]. 2016 [cited 2020 Sep 30];25(6):479-86. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27802948 http://www.ncbi.nlm.nih.gov/pubmed/27802... ⁾	2016	Enfermeiro	EUA	Estudo quase experimental	3

Indicações
Evitar a perda ou deslocamento de dispositivos⁽⁷7 Van der Kooi AW, Peelen LM, Raijmakers RJ, Vroegop RL, Bakker DF, Tekatli H, et al. Use of physical restraints in Dutch intensive care units: a prospective multicenter study. Am J Crit Care [Internet]. 2015[cited 2020 Sep 30];24(6):488-95. Available from: http://ajcc.aacnjournals.org/cgi/doi/10.4037/ajcc2015348
http://ajcc.aacnjournals.org/cgi/doi/10....

8 Benbenbishty J, Adam S, Endacott R. Physical restraint use in intensive care units across Europe: the PRICE study. Intensive Crit Care Nurs [Internet]. 2010 [cited 2020 Sep 30];26(5):241-5. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0964339710000686
https://linkinghub.elsevier.com/retrieve... ^-⁹9 Lin YL, Liao CC, Yu WP, Chu TL, Ho LH. A multidisciplinary program reduces over 24 hours of physical restraint in neurological intensive care unit. J Nurs Res. 2018;26(4):288-96. https://doi.org/10.1097/jnr.0000000000000251
https://doi.org/10.1097/jnr.000000000000... ^,¹²12 Luk E, Burry L, Rezaie S, Mehta S, Rose L. Critical care nurses' decisions regarding physical restraints in two Canadian ICUs: a prospective observational study. Can J Crit care Nurs [Internet]. 2015 [cited 2020 Sep 30];26(4):16-22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26837121
http://www.ncbi.nlm.nih.gov/pubmed/26837...

13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ^-¹⁴14 Choi E, Song M. Physical restraint use in a Korean ICU. J Clin Nurs [Internet]. 2003[cited 2020 Sep 30];12(5):651-9. Available from: http://doi.wiley.com/10.1046/j.1365-2702.2003.00789.x
http://doi.wiley.com/10.1046/j.1365-2702... ^,¹⁶16 Turgay AS, Sari D, Genc RE. Physical restraint use in Turkish intensive care units. Clin Nurse Spec [Internet]. 2009 [cited 2020 Sep 30];23(2):68-72. https://doi.org/10.1097/NUR.0b013e318199125c
https://doi.org/10.1097/NUR.0b013e318199... ^-¹⁷17 Perren A, Corbella D, Iapichino E, Di Bernardo V, Leonardi A, Di Nicolantonio R, et al. Physical restraint in the ICU: does it prevent device removal? Minerva Anestesiol [Internet]. 2015 [2020 Sep 30];81(10):1086-95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25338282
http://www.ncbi.nlm.nih.gov/pubmed/25338... ^,¹⁹19 Vance DL. Effect of a treatment interference protocol on clinical decision making for restraint use in the intensive care unit: a pilot study. AACN Clin Issues [Internet]. 2003 Feb; 14(1):82-91. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12574706
http://www.ncbi.nlm.nih.gov/pubmed/12574...

20 Yönt GH, Korhan EA, Dizer B, Gümüs F, Koyuncu R. Examination of ethical dilemmas experienced by adult intensive care unit nurses in physical restraint practices. Holist NursPract. 2014;28(2):85-90. https://doi.org/10.1097/HNP.0000000000000013
https://doi.org/10.1097/HNP.000000000000...

21 Gu T, Wang X, Deng N, Weng W. Investigating influencing factors of physical restraint use in China intensive care units: a prospective, cross-sectional, observational study. Aust Crit Care [Internet]. 2019 [cited 2020 Sep 30];32(3):193-8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1036731417303971
https://linkinghub.elsevier.com/retrieve... ^-²²22 Martin B, Mathisen L. Use of physical restraints in adult critical care: a bicultural study. Am J Crit Care [Internet]. 2005 [cited 2020 Sep 30];14(2):133-42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15728955
http://www.ncbi.nlm.nih.gov/pubmed/15728... ^,²⁵25 Hevener S, Rickabaugh B, Marsh T. Using a decision wheel to reduce use of restraints in a medical-surgical intensive care unit. Am J Crit Care [Internet]. 2016 [cited 2020 Sep 30];25(6):479-86. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27802948
http://www.ncbi.nlm.nih.gov/pubmed/27802... ⁾ (eventos adversos), garantir continuidade do tratamento⁽¹¹11 Lynn LL, Brookes JM. Changing perceptions of physical restraint use in the ICU. Nurs Crit Care. 2017;12(6):41-4. https://doi.org/10.1097/01.CCN.0000521939.91085.6f
https://doi.org/10.1097/01.CCN.000052193... ^,¹⁹19 Vance DL. Effect of a treatment interference protocol on clinical decision making for restraint use in the intensive care unit: a pilot study. AACN Clin Issues [Internet]. 2003 Feb; 14(1):82-91. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12574706
http://www.ncbi.nlm.nih.gov/pubmed/12574... ^,²³23 Guenette M, Burry L, Cheung A, Farquharson T, Traille M, Mantas I, et al. Psychotropic drug use in physically restrained, critically ill adults receiving mechanical ventilation. Am J Crit Care. 2017;26(5):380-7. https://doi.org/10.4037/ajcc2017677
https://doi.org/10.4037/ajcc2017677... ^,²⁵25 Hevener S, Rickabaugh B, Marsh T. Using a decision wheel to reduce use of restraints in a medical-surgical intensive care unit. Am J Crit Care [Internet]. 2016 [cited 2020 Sep 30];25(6):479-86. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27802948
http://www.ncbi.nlm.nih.gov/pubmed/27802... ⁾, alteração do nível de consciência (agitação, inquietação, desorientação, confusão, agressividade, comatoso, sonolência⁽⁷7 Van der Kooi AW, Peelen LM, Raijmakers RJ, Vroegop RL, Bakker DF, Tekatli H, et al. Use of physical restraints in Dutch intensive care units: a prospective multicenter study. Am J Crit Care [Internet]. 2015[cited 2020 Sep 30];24(6):488-95. Available from: http://ajcc.aacnjournals.org/cgi/doi/10.4037/ajcc2015348
http://ajcc.aacnjournals.org/cgi/doi/10....

8 Benbenbishty J, Adam S, Endacott R. Physical restraint use in intensive care units across Europe: the PRICE study. Intensive Crit Care Nurs [Internet]. 2010 [cited 2020 Sep 30];26(5):241-5. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0964339710000686
https://linkinghub.elsevier.com/retrieve... ^-⁹9 Lin YL, Liao CC, Yu WP, Chu TL, Ho LH. A multidisciplinary program reduces over 24 hours of physical restraint in neurological intensive care unit. J Nurs Res. 2018;26(4):288-96. https://doi.org/10.1097/jnr.0000000000000251
https://doi.org/10.1097/jnr.000000000000... ^,¹²12 Luk E, Burry L, Rezaie S, Mehta S, Rose L. Critical care nurses' decisions regarding physical restraints in two Canadian ICUs: a prospective observational study. Can J Crit care Nurs [Internet]. 2015 [cited 2020 Sep 30];26(4):16-22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26837121
http://www.ncbi.nlm.nih.gov/pubmed/26837... ^,¹⁴14 Choi E, Song M. Physical restraint use in a Korean ICU. J Clin Nurs [Internet]. 2003[cited 2020 Sep 30];12(5):651-9. Available from: http://doi.wiley.com/10.1046/j.1365-2702.2003.00789.x
http://doi.wiley.com/10.1046/j.1365-2702... ^,¹⁶16 Turgay AS, Sari D, Genc RE. Physical restraint use in Turkish intensive care units. Clin Nurse Spec [Internet]. 2009 [cited 2020 Sep 30];23(2):68-72. https://doi.org/10.1097/NUR.0b013e318199125c
https://doi.org/10.1097/NUR.0b013e318199...

17 Perren A, Corbella D, Iapichino E, Di Bernardo V, Leonardi A, Di Nicolantonio R, et al. Physical restraint in the ICU: does it prevent device removal? Minerva Anestesiol [Internet]. 2015 [2020 Sep 30];81(10):1086-95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25338282
http://www.ncbi.nlm.nih.gov/pubmed/25338... ^-¹⁸18 De Jonghe B, Constantin JM, Chanques G, Capdevila X, Lefrant JY, Outin H, et al. Physical restraint in mechanically ventilated ICU patients: a survey of French practice. Intensive Care Med [Internet]. 2013[cited 2020 Sep 30];39(1):31-7. Available from: http://link.springer.com/10.1007/s00134-012-2715-9
http://link.springer.com/10.1007/s00134-... ^,²²22 Martin B, Mathisen L. Use of physical restraints in adult critical care: a bicultural study. Am J Crit Care [Internet]. 2005 [cited 2020 Sep 30];14(2):133-42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15728955
http://www.ncbi.nlm.nih.gov/pubmed/15728... ^-²³23 Guenette M, Burry L, Cheung A, Farquharson T, Traille M, Mantas I, et al. Psychotropic drug use in physically restrained, critically ill adults receiving mechanical ventilation. Am J Crit Care. 2017;26(5):380-7. https://doi.org/10.4037/ajcc2017677
https://doi.org/10.4037/ajcc2017677... ⁾, manter a segurança da equipe⁽⁷7 Van der Kooi AW, Peelen LM, Raijmakers RJ, Vroegop RL, Bakker DF, Tekatli H, et al. Use of physical restraints in Dutch intensive care units: a prospective multicenter study. Am J Crit Care [Internet]. 2015[cited 2020 Sep 30];24(6):488-95. Available from: http://ajcc.aacnjournals.org/cgi/doi/10.4037/ajcc2015348
http://ajcc.aacnjournals.org/cgi/doi/10.... ⁾, manter a segurança de outros pacientes, manter a segurança do paciente⁽⁷7 Van der Kooi AW, Peelen LM, Raijmakers RJ, Vroegop RL, Bakker DF, Tekatli H, et al. Use of physical restraints in Dutch intensive care units: a prospective multicenter study. Am J Crit Care [Internet]. 2015[cited 2020 Sep 30];24(6):488-95. Available from: http://ajcc.aacnjournals.org/cgi/doi/10.4037/ajcc2015348
http://ajcc.aacnjournals.org/cgi/doi/10.... ^-⁸8 Benbenbishty J, Adam S, Endacott R. Physical restraint use in intensive care units across Europe: the PRICE study. Intensive Crit Care Nurs [Internet]. 2010 [cited 2020 Sep 30];26(5):241-5. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0964339710000686
https://linkinghub.elsevier.com/retrieve... ^,¹⁰10 Hall DK, Zimbro KS, Maduro RS, Petrovitch D, Ver Schneider P, Morgan M. Impact of a restraint management bundle on restraint use in an intensive care unit. J Nurs Care Qual [Internet]. 2018 [cited 2020 Sep 30];33(2):143-8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28658189
http://www.ncbi.nlm.nih.gov/pubmed/28658...

11 Lynn LL, Brookes JM. Changing perceptions of physical restraint use in the ICU. Nurs Crit Care. 2017;12(6):41-4. https://doi.org/10.1097/01.CCN.0000521939.91085.6f
https://doi.org/10.1097/01.CCN.000052193...

12 Luk E, Burry L, Rezaie S, Mehta S, Rose L. Critical care nurses' decisions regarding physical restraints in two Canadian ICUs: a prospective observational study. Can J Crit care Nurs [Internet]. 2015 [cited 2020 Sep 30];26(4):16-22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26837121
http://www.ncbi.nlm.nih.gov/pubmed/26837... ^-¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000...

14 Choi E, Song M. Physical restraint use in a Korean ICU. J Clin Nurs [Internet]. 2003[cited 2020 Sep 30];12(5):651-9. Available from: http://doi.wiley.com/10.1046/j.1365-2702.2003.00789.x
http://doi.wiley.com/10.1046/j.1365-2702...

15 Johnson K, Curry V, Steubing A, Diana S, McCray A, McFarren A, et al. A non-pharmacologic approach to decrease restraint use. Intensive Crit Care Nurs [Internet]. 2016 [cited 2020 Sep 30];34:12-9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26652790
http://www.ncbi.nlm.nih.gov/pubmed/26652...

16 Turgay AS, Sari D, Genc RE. Physical restraint use in Turkish intensive care units. Clin Nurse Spec [Internet]. 2009 [cited 2020 Sep 30];23(2):68-72. https://doi.org/10.1097/NUR.0b013e318199125c
https://doi.org/10.1097/NUR.0b013e318199...

17 Perren A, Corbella D, Iapichino E, Di Bernardo V, Leonardi A, Di Nicolantonio R, et al. Physical restraint in the ICU: does it prevent device removal? Minerva Anestesiol [Internet]. 2015 [2020 Sep 30];81(10):1086-95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25338282
http://www.ncbi.nlm.nih.gov/pubmed/25338...

18 De Jonghe B, Constantin JM, Chanques G, Capdevila X, Lefrant JY, Outin H, et al. Physical restraint in mechanically ventilated ICU patients: a survey of French practice. Intensive Care Med [Internet]. 2013[cited 2020 Sep 30];39(1):31-7. Available from: http://link.springer.com/10.1007/s00134-012-2715-9
http://link.springer.com/10.1007/s00134-...

19 Vance DL. Effect of a treatment interference protocol on clinical decision making for restraint use in the intensive care unit: a pilot study. AACN Clin Issues [Internet]. 2003 Feb; 14(1):82-91. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12574706
http://www.ncbi.nlm.nih.gov/pubmed/12574... ^-²⁰20 Yönt GH, Korhan EA, Dizer B, Gümüs F, Koyuncu R. Examination of ethical dilemmas experienced by adult intensive care unit nurses in physical restraint practices. Holist NursPract. 2014;28(2):85-90. https://doi.org/10.1097/HNP.0000000000000013
https://doi.org/10.1097/HNP.000000000000... ⁾, delirium⁽⁷7 Van der Kooi AW, Peelen LM, Raijmakers RJ, Vroegop RL, Bakker DF, Tekatli H, et al. Use of physical restraints in Dutch intensive care units: a prospective multicenter study. Am J Crit Care [Internet]. 2015[cited 2020 Sep 30];24(6):488-95. Available from: http://ajcc.aacnjournals.org/cgi/doi/10.4037/ajcc2015348
http://ajcc.aacnjournals.org/cgi/doi/10.... ^-⁸8 Benbenbishty J, Adam S, Endacott R. Physical restraint use in intensive care units across Europe: the PRICE study. Intensive Crit Care Nurs [Internet]. 2010 [cited 2020 Sep 30];26(5):241-5. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0964339710000686
https://linkinghub.elsevier.com/retrieve... ^,¹²12 Luk E, Burry L, Rezaie S, Mehta S, Rose L. Critical care nurses' decisions regarding physical restraints in two Canadian ICUs: a prospective observational study. Can J Crit care Nurs [Internet]. 2015 [cited 2020 Sep 30];26(4):16-22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26837121
http://www.ncbi.nlm.nih.gov/pubmed/26837... ^,¹⁷17 Perren A, Corbella D, Iapichino E, Di Bernardo V, Leonardi A, Di Nicolantonio R, et al. Physical restraint in the ICU: does it prevent device removal? Minerva Anestesiol [Internet]. 2015 [2020 Sep 30];81(10):1086-95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25338282
http://www.ncbi.nlm.nih.gov/pubmed/25338... ^,²¹21 Gu T, Wang X, Deng N, Weng W. Investigating influencing factors of physical restraint use in China intensive care units: a prospective, cross-sectional, observational study. Aust Crit Care [Internet]. 2019 [cited 2020 Sep 30];32(3):193-8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1036731417303971
https://linkinghub.elsevier.com/retrieve... ⁾, pacientes com comunicação verbal prejudicada⁽⁹9 Lin YL, Liao CC, Yu WP, Chu TL, Ho LH. A multidisciplinary program reduces over 24 hours of physical restraint in neurological intensive care unit. J Nurs Res. 2018;26(4):288-96. https://doi.org/10.1097/jnr.0000000000000251
https://doi.org/10.1097/jnr.000000000000... ⁾, idade acima de 75 anos⁽²¹21 Gu T, Wang X, Deng N, Weng W. Investigating influencing factors of physical restraint use in China intensive care units: a prospective, cross-sectional, observational study. Aust Crit Care [Internet]. 2019 [cited 2020 Sep 30];32(3):193-8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1036731417303971
https://linkinghub.elsevier.com/retrieve... ⁾, prevenir a contaminação de ferida⁽¹¹11 Lynn LL, Brookes JM. Changing perceptions of physical restraint use in the ICU. Nurs Crit Care. 2017;12(6):41-4. https://doi.org/10.1097/01.CCN.0000521939.91085.6f
https://doi.org/10.1097/01.CCN.000052193... ⁾, equipe de enfermagem em número insuficiente⁽⁸8 Benbenbishty J, Adam S, Endacott R. Physical restraint use in intensive care units across Europe: the PRICE study. Intensive Crit Care Nurs [Internet]. 2010 [cited 2020 Sep 30];26(5):241-5. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0964339710000686
https://linkinghub.elsevier.com/retrieve... ^,¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ⁾, incompreensão/resistência sobre a necessidade de cuidados ou dispositivos terapêuticos⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ⁾, solicitação de mais de um membro da equipe, paciente, família ou de outros médicos⁽¹⁴14 Choi E, Song M. Physical restraint use in a Korean ICU. J Clin Nurs [Internet]. 2003[cited 2020 Sep 30];12(5):651-9. Available from: http://doi.wiley.com/10.1046/j.1365-2702.2003.00789.x
http://doi.wiley.com/10.1046/j.1365-2702... ^,¹⁶16 Turgay AS, Sari D, Genc RE. Physical restraint use in Turkish intensive care units. Clin Nurse Spec [Internet]. 2009 [cited 2020 Sep 30];23(2):68-72. https://doi.org/10.1097/NUR.0b013e318199125c
https://doi.org/10.1097/NUR.0b013e318199... ⁾, paciente em quarto isolado⁽¹²12 Luk E, Burry L, Rezaie S, Mehta S, Rose L. Critical care nurses' decisions regarding physical restraints in two Canadian ICUs: a prospective observational study. Can J Crit care Nurs [Internet]. 2015 [cited 2020 Sep 30];26(4):16-22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26837121
http://www.ncbi.nlm.nih.gov/pubmed/26837... ⁾, recuperação pós-anestésica⁽⁹9 Lin YL, Liao CC, Yu WP, Chu TL, Ho LH. A multidisciplinary program reduces over 24 hours of physical restraint in neurological intensive care unit. J Nurs Res. 2018;26(4):288-96. https://doi.org/10.1097/jnr.0000000000000251
https://doi.org/10.1097/jnr.000000000000... ⁾, desmame de sedação e sedação insuficiente⁽¹⁷17 Perren A, Corbella D, Iapichino E, Di Bernardo V, Leonardi A, Di Nicolantonio R, et al. Physical restraint in the ICU: does it prevent device removal? Minerva Anestesiol [Internet]. 2015 [2020 Sep 30];81(10):1086-95. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25338282
http://www.ncbi.nlm.nih.gov/pubmed/25338... ^-¹⁸18 De Jonghe B, Constantin JM, Chanques G, Capdevila X, Lefrant JY, Outin H, et al. Physical restraint in mechanically ventilated ICU patients: a survey of French practice. Intensive Care Med [Internet]. 2013[cited 2020 Sep 30];39(1):31-7. Available from: http://link.springer.com/10.1007/s00134-012-2715-9
http://link.springer.com/10.1007/s00134-... ⁾, presença de fratura instável⁽⁷7 Van der Kooi AW, Peelen LM, Raijmakers RJ, Vroegop RL, Bakker DF, Tekatli H, et al. Use of physical restraints in Dutch intensive care units: a prospective multicenter study. Am J Crit Care [Internet]. 2015[cited 2020 Sep 30];24(6):488-95. Available from: http://ajcc.aacnjournals.org/cgi/doi/10.4037/ajcc2015348
http://ajcc.aacnjournals.org/cgi/doi/10.... ⁾ e posicionamento adequado do paciente⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ^,²⁰20 Yönt GH, Korhan EA, Dizer B, Gümüs F, Koyuncu R. Examination of ethical dilemmas experienced by adult intensive care unit nurses in physical restraint practices. Holist NursPract. 2014;28(2):85-90. https://doi.org/10.1097/HNP.0000000000000013
https://doi.org/10.1097/HNP.000000000000... ⁾.

Complicações
Lesões na pele⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ^,¹⁶16 Turgay AS, Sari D, Genc RE. Physical restraint use in Turkish intensive care units. Clin Nurse Spec [Internet]. 2009 [cited 2020 Sep 30];23(2):68-72. https://doi.org/10.1097/NUR.0b013e318199125c
https://doi.org/10.1097/NUR.0b013e318199... ⁾, hiperemia⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ^,²⁴24 Suliman M. Prevalence of physical restraint among ventilated intensive care unit patients. J Clin Nurs. 2018;27(19-20):3490-6. https://doi.org/10.1111/jocn.14588
https://doi.org/10.1111/jocn.14588... ⁾, edema do membro restrito⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ^,²⁴24 Suliman M. Prevalence of physical restraint among ventilated intensive care unit patients. J Clin Nurs. 2018;27(19-20):3490-6. https://doi.org/10.1111/jocn.14588
https://doi.org/10.1111/jocn.14588... ^-²⁵25 Hevener S, Rickabaugh B, Marsh T. Using a decision wheel to reduce use of restraints in a medical-surgical intensive care unit. Am J Crit Care [Internet]. 2016 [cited 2020 Sep 30];25(6):479-86. Available from: http://www.ncbi.nlm.nih.gov/pubmed/27802948
http://www.ncbi.nlm.nih.gov/pubmed/27802... ⁾, agitação psicomotora⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ^,²²22 Martin B, Mathisen L. Use of physical restraints in adult critical care: a bicultural study. Am J Crit Care [Internet]. 2005 [cited 2020 Sep 30];14(2):133-42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15728955
http://www.ncbi.nlm.nih.gov/pubmed/15728... ^-²³23 Guenette M, Burry L, Cheung A, Farquharson T, Traille M, Mantas I, et al. Psychotropic drug use in physically restrained, critically ill adults receiving mechanical ventilation. Am J Crit Care. 2017;26(5):380-7. https://doi.org/10.4037/ajcc2017677
https://doi.org/10.4037/ajcc2017677... ⁾, lesão por pressão⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ⁾, hematomas no membro restrito⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ⁾, morte⁽²⁴24 Suliman M. Prevalence of physical restraint among ventilated intensive care unit patients. J Clin Nurs. 2018;27(19-20):3490-6. https://doi.org/10.1111/jocn.14588
https://doi.org/10.1111/jocn.14588... ⁾, necrose da pele no membro restrito⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ⁾, ansiedade⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ⁾, choro⁽¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ⁾, desconforto do paciente, perda percebida de dignidade⁽¹⁸18 De Jonghe B, Constantin JM, Chanques G, Capdevila X, Lefrant JY, Outin H, et al. Physical restraint in mechanically ventilated ICU patients: a survey of French practice. Intensive Care Med [Internet]. 2013[cited 2020 Sep 30];39(1):31-7. Available from: http://link.springer.com/10.1007/s00134-012-2715-9
http://link.springer.com/10.1007/s00134-... ⁾, transtorno de estresse pós-traumático⁽¹⁸18 De Jonghe B, Constantin JM, Chanques G, Capdevila X, Lefrant JY, Outin H, et al. Physical restraint in mechanically ventilated ICU patients: a survey of French practice. Intensive Care Med [Internet]. 2013[cited 2020 Sep 30];39(1):31-7. Available from: http://link.springer.com/10.1007/s00134-012-2715-9
http://link.springer.com/10.1007/s00134-... ⁾ e remoção de dispositivos⁽²²22 Martin B, Mathisen L. Use of physical restraints in adult critical care: a bicultural study. Am J Crit Care [Internet]. 2005 [cited 2020 Sep 30];14(2):133-42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15728955
http://www.ncbi.nlm.nih.gov/pubmed/15728... ⁾.

Estratégias alternativas
Administração de analgésicos e de medicamentos para sedação⁽¹²12 Luk E, Burry L, Rezaie S, Mehta S, Rose L. Critical care nurses' decisions regarding physical restraints in two Canadian ICUs: a prospective observational study. Can J Crit care Nurs [Internet]. 2015 [cited 2020 Sep 30];26(4):16-22. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26837121
http://www.ncbi.nlm.nih.gov/pubmed/26837... ^-¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ^,²¹21 Gu T, Wang X, Deng N, Weng W. Investigating influencing factors of physical restraint use in China intensive care units: a prospective, cross-sectional, observational study. Aust Crit Care [Internet]. 2019 [cited 2020 Sep 30];32(3):193-8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1036731417303971
https://linkinghub.elsevier.com/retrieve... ⁾, extensão do período de permanência de familiares e cuidadores com o paciente⁽¹¹11 Lynn LL, Brookes JM. Changing perceptions of physical restraint use in the ICU. Nurs Crit Care. 2017;12(6):41-4. https://doi.org/10.1097/01.CCN.0000521939.91085.6f
https://doi.org/10.1097/01.CCN.000052193... ^,¹³13 Kandeel NA, Attia AK. Physical restraints practice in adult intensive care units in Egypt. Nurs Health Sci [Internet]. 2013[cited 2020 Sep 30];15(1):79-85. Available from: http://doi.wiley.com/10.1111/nhs.12000
http://doi.wiley.com/10.1111/nhs.12000... ^,¹⁵15 Johnson K, Curry V, Steubing A, Diana S, McCray A, McFarren A, et al. A non-pharmacologic approach to decrease restraint use. Intensive Crit Care Nurs [Internet]. 2016 [cited 2020 Sep 30];34:12-9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26652790
http://www.ncbi.nlm.nih.gov/pubmed/26652... ⁾, relação enfermeiropaciente adequada⁽²¹21 Gu T, Wang X, Deng N, Weng W. Investigating influencing factors of physical restraint use in China intensive care units: a prospective, cross-sectional, observational study. Aust Crit Care [Internet]. 2019 [cited 2020 Sep 30];32(3):193-8. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1036731417303971
https://linkinghub.elsevier.com/retrieve... ⁾, coparticipação e corresponsabilidade da equipe multidisciplinar no cuidado ao paciente⁽¹¹11 Lynn LL, Brookes JM. Changing perceptions of physical restraint use in the ICU. Nurs Crit Care. 2017;12(6):41-4. https://doi.org/10.1097/01.CCN.0000521939.91085.6f
https://doi.org/10.1097/01.CCN.000052193... ⁾, promoção de higiene do sono⁽¹⁵15 Johnson K, Curry V, Steubing A, Diana S, McCray A, McFarren A, et al. A non-pharmacologic approach to decrease restraint use. Intensive Crit Care Nurs [Internet]. 2016 [cited 2020 Sep 30];34:12-9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26652790
http://www.ncbi.nlm.nih.gov/pubmed/26652... ⁾, estratégias terapêuticas de distração como televisão, jogos, exercícios, música, revistas e lápis para manter as mãos ocupadas⁽¹¹11 Lynn LL, Brookes JM. Changing perceptions of physical restraint use in the ICU. Nurs Crit Care. 2017;12(6):41-4. https://doi.org/10.1097/01.CCN.0000521939.91085.6f
https://doi.org/10.1097/01.CCN.000052193... ⁾.

Categoria	Cuidados
Avaliação do paciente	Avaliação frequente do membro restrito relacionada à integridade cutânea, perfusão periférica e presença de garroteamento, avaliação de dor, delirium, sedação, agitação, estado cognitivo e comportamental do paciente, avaliação frequente de estratégias alternativas para a substituição da restrição física, reavaliação da indicação de restrição física a cada oito horas, avaliação da mobilidade e sensibilidade do membro restrito e avaliação do nível adequado de sedação do paciente.
Comunicação	Reorientação do paciente, frequentemente sobre o uso de restrição física, prescrição de restrição física por no máximo 24 horas, orientação ao paciente sobre o propósito e importância dos dispositivos na qualidade do cuidado, documentação detalhada do procedimento de restrição física, participação da equipe médica na indicação da restrição física, comunicação eficaz entre paciente, profissional e família e obtenção do consentimento sobre o uso de restrição física com o próprio paciente, representante legal e família.
Segurança do paciente	Promoção de conforto do paciente com sedação, analgesia narcótica, posicionamento do paciente e uso de colchões ou camas especiais, liberação do membro restrito a cada duas horas durante 15 minutos, utilização de restrição confeccionada com tecidos menos lesivos à pele, manutenção da segurança do paciente, posicionamento adequado dos dispositivos, utilização de estratégias que promovam a calma e tranquilidade do paciente, tratamento da dor, administração de medicamentos para sedação quando necessário, utilização de restrições que permitam o movimento dos membros, mas evitem funções motoras refinadas, padronização de cuidados e indicações relacionadas ao uso de restrição física, utilização de opções farmacológicas antes e depois do uso da restrição física.

[1] Autor Correspondente: Ester Góes Oliveira. E-mail: ego990@hotmail.com

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Boas práticas para restrição física em unidades de terapia intensiva: revisão integrativa

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