目的：探讨保护性约束规范化流程在精神科的临床意义。方法选择实施保护性约束规范化流程前5个月（2015年1月1日－5月31日）住院期间被约束的患者和实施保护性约束规范化管理后5个月（2015年6月1日－10月31日）住院期间被约束的患者，对进行约束时间、频次等进行比较。结果规范化流程实施前保护性约束病人297例482例次（162．3％），实施后保护性约束病人223例310例次（130．0％），保护约束总时间由实施前的4981 h下降为1547 h。其保护性约束时间、约束次数及不良事件发生率均低于规范化流程实施前，差异有统计学意义（P ＜0．05）；保护性约束原因以暴力攻击为主，除自杀、外逃外，其余3项差异均有统计学意义（P ＜0．05）。结论精神科实施保护性约束规范化流程可有效降低保护性约束使用率，提高护士执行保护性约束的规范性，减少不良事件的发生，符合时代要求。%Objective To explore the clinical significance of the standard protective constraint process used in psychiatric department.Methods Before the standard protective constraint process was implemented, inpatients who have been used the protective constraint process for five months were enrolled as the first group from January 1,2015 to May 31,2015.From June 1,2015 to October 31,2015,inpatients who have been used the standard protective constraint process for five months were enrolled as the second group.The protective constraint time and frequency of two groups of patients were compared.Results Be-fore carrying out the standard protective constraint process,total protective constraint ratio was 162.3%and total protective constraint time were 4 981 hours.After implementing the standard protective con-straint process,total protective constraint ratio decreased to 130.0% and total protective constraint time decreased to 1 547 hours.The ratio of protective constraint,time and the incidence rate of undesirable e-vents were decreased obviously in the second group,and the differences had statistical significance (P <0.05).The main reason for protective constraint was violent attacks,except the suicide and escaping,the other three differences had the statistical significance (P<0.05).Conclusion For psychiatric department, implementing the standard protective constraint process can reduce the protective constraint ratio and regu-late the nurses'protective constraint and reduce the undesirable events,too.This is a technique which is conform to the requirements of the times.
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