Effect of Implementing Physical Restraint Nursing Guidelines on Accidental Endotracheal Tube Displacement and Neurovascular Complications among Critically Ill Patients

Background: Most of critically ill patients are mechanically ventilated and attached tomultiple invasive devices. Physical restraint is used to protect these patients fromremoving medical equipments connected to their body. Aim: This study evaluated theeffect of implementing physical restraint nursing guidelines on accidental endotrachealtube displacement and neurovascular complications among critically ill patients.Design & Setting: A quasi- experimental research design was utilized in SurgicalIntensive Care Unit at Tanta Emergency Hospital affiliated to Ministry of HigherEducation and Scientific Research. Subjects: Convenience sampling of (80) adultpatients divided into two equal groups. Control group who received routine nursingcare. Study group who received nursing guidelines of physical restraint by theresearcher. Tools: Data were collected using Tool I, critically ill patient's assessmenttool and Tool II, physically restraint patient's clinical outcomes. Results: Followingthe implementation of the physical restraint nursing guidelines, regards study groupafter applying physical restrain in 1st day, near half (47.5%) of the studies patientswere restless. While, at 4th day more than two third (75.0%) of patients in study groupwere alert & calm. Regarding control study the group about (45.0%) of patient'simprovement neurological disorders at 4th day. Conclusions the findings of the studyindicated that the implementing of physical restraint guidelines in critical care settingsignificantly reduced the incidence of accidental tube displacement and minimizedneurovascular complications such as (no changes at skin colour, normal capillary refilland normal pulse). Recommendations: Implementation of standardized physicalrestraint nursing guidelines should be adopted to all critical care units to reduce therisk of accidental tube displacement. Continuous in-service training program for nursesshould be conducted regularly to improve the staff knowledge and skills