Pressure injury associated with mechanical restraint: a cross-sectional study

Livia Maria Da Silva Souza,Arianna Kassiadou Menezes,Marcia Verissimo De Souza,Simone Martins Rembold,Rosimere Ferreira Santana

doi:10.30886/estima.v17.703_in

Livia Maria Da Silva Souza, Arianna Kassiadou Menezes + Show 3 more

Open Access

https://doi.org/10.30886/estima.v17.703_in

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Abstract

Objective: To verify the association of the practice of mechanical restraint with pressure injury (PI) in hospitalized patients. Method: A cross-sectional study of 111 patients from medical, surgical and intensive care units at a public hospital in the state of Rio de Janeiro, Brazil. To analyze the association between variables, the [odds ratio (OR)] was adopted. Results: It were found 57 patients in mechanical restraint (51.4%). In the group of patients contained, the occurrence of PI was estimated in 43.9% and in the group of patients not contained in 5.6%. The chance of the contained patient to present PI was 13 times higher than in patients not contained. The location of the injury was more frequently in the sacral region, classified as stage 2 (21.1%) and stage 3 (12.3%), followed by trochanter (15.8%) and calcaneus (10.5%). Conclusion: It is recommended the adoption of nursing practices of suppression or reduction of the time in the use of mechanical restraint, adopting educational measures and prevention of PI.

Highlights

Mechanical restraint is often used in hospitals to prevent falls, to control patients with psychomotor agitation, and to avoid discontinuation of treatment
Information on adverse events associated with mechanical restraint in general hospitals is still limited
E most prevalent type of mechanical restraint was the use of lateral bed grids (100%); in 70.2% of the patients, only the grid was used and 29.8% of the patients were with the pulses contained. e most common reason for the contention was the risk of falls (100%) followed by the use of invasive devices (57.9%)

Summary

Introduction

Mechanical restraint is often used in hospitals to prevent falls, to control patients with psychomotor agitation, and to avoid discontinuation of treatment. Its use is questioned because it restricts the autonomy and freedom of the patient, besides it being related to potential adverse events[1,2] It is considered mechanical restraint the use of devices that restrict the individual’s movement to a position of its choice and/or access to its own body[5]. E inappropriate use of mechanical restraint, widely studied in long-term institutions for the elderly (LTIFEs), can cause damage that varies in intensity. It is cited from impairment of cognitive abilities, muscular atrophy or worsening of existing atrophy, pressure injury (PI), urinary and fecal incontinence, contractures, injuries, pneumonia, deep vein thrombosis, until fatal damage due to asphyxia[2,4,5,22]. Complications result in increased morbidity, mortality and costs[6]

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