2023 Volume 27 Issue 1 Pages 71-81
Specific procedures to minimize physical restraint in intensive care units have not been well described in the literature. This study aimed to develop and verify the content validity of a standard procedure that promotes appropriate physical restraint practice in intensive care units to guarantee patient safety and human rights. A Delphi survey was implemented with 157 certified nurse specialists in critical care nursing, of whom 68 completed the second survey. A total of 46 statements were extracted from the literature for the questionnaire, and their consistency with published guidelines was confirmed. Participants were asked to rate the degree of agreement with and/or feasibility of each statement, for instance, "Is the statement essential knowledge that individual nurses should know?" "Is the statement effective for appropriate physical restraint practice?" and "Is the statement feasible?" An agreement rate of 70% was assumed to judge the consensus formation regarding each statement. In total, 43 statements were considered to be endowed with content validity. Although agreement regarding effectiveness of staffing measures (e.g., one-on-one without physical restraint) reached around 90%, its feasibility remained low, and thus respondents suggested that innovative staffing measures would be needed. Agreement regarding the recognition, behavior, and attitude of nurse administrators (e.g., avoid blaming if extubation occurred in a restraint-free patient) were high as all reached around 90%, uncovering the nurses' high expectations for support from nurse administrators.
