Being tied down-The experience of being physically restrained while mechanically ventilated in ICU.

Abstract

To explore the experience of physical restraints during mechanical ventilation in intensive care from the perspectives of patients and family members. This research was a qualitative study with a naturalistic inquiry framework adhering to the Consolidated Criteria for Reporting Qualitative Research guidelines. In-depth, semi-structured conversations were conducted with five patients and six family members who had either personally experienced or witnessed their loved ones being physically restrained during mechanical ventilation in intensive care. Data collection occurred between March 2018 and June 2019. These conversations were audio-recorded and transcribed. Reflexive thematic analysis was used to analyse the data. Three major themes emerged from the data. These themes were: Being tied down; Feeling helpless; and Finding light in the darkness. The experience of physical restraints during mechanical ventilation in intensive care leads to traumatic experiences which can impact patients and families long after their ICU stay. Holistic care, which considers the physical, emotional and psychological needs of patients and families, should be more thoroughly explored when managing treatment interference to minimize harm. This study gained insight into the physical, emotional and psychological consequences of applying physical restraints to patients who are mechanically ventilated as an intervention for preventing treatment interference. The findings of this study have the potential to improve ICU patient and family outcomes by influencing current physical restraint practices. Recommendations from this research can contribute to practice change by informing policy, shifting workplace culture and norms about restraints, and encouraging education and training.