Danielis, M.

Froncillo, A.

Mattiussi, E.

Palese, A.

English

Froncillo, Antonio

Institutional Research Information System

Freedom from physical restraints in ICU: result from a scoping review

E. Mattiussi

M. Danielis

FRONCILLO, ANTONIO

A. Palese

Archivio istituzionale della ricerca - Università degli Studi di Udine

Intensive Care Medicine Experimental 2018, 6(Suppl 2):40 Page 195 of 6900378Worldwide qualitative investigation of nursing after death ritualsJ. Benbenishty1, M.B. Bennun2, R. Lind31Hadassah Hebrew University Medical Center, Jerusalem, Israel, 2BelinsonMedical Center, ICU, Petuch Tikva, Israel, 3Norges Arktiske Universitet,Campus Harstad Institutt for helse- og omsorgsfag, Health Sciences,Tromso, NorwayCorrespondence: J. BenbenishtyIntensive Care Medicine Experimental 2018, 6(Suppl 2):0378INTRODUCTION. Worldwide, both religious and non-religious groupshave developed rituals to help provide structure and support tothose who mourn and to mark the death of the deceased. Care ofthe dying is a significant component of nursing practice particularlyin hospitals. Nurses who work in certain areas like oncology, inten-sive care unit (ICU) face the care of the dying, more so than otherunits. No literature was found regarding country multi culture reviewof nursing care in the after death practices.OBJECTIVES. Worldwide investigation of ICU nursing care duringafter death ritualsMETHODS. Multi country nurse investigators researched by usingProspective qualitative interviews of ICU nurses describing theafter death care of their patients and delivery of bereavementcare to family as well as the reasoning behind the ritual.RESULTS. 15 nurses from 18 countries from Scandinavia throughMediterranean to African regions were interviewed. Themes foundincluded much about the physical care of the bodies, emphasis ondignity; Family presence and composure of nurse regulating theritual;Follow up care was described in Northern European ICUs;Spiritual care was provided in diverse fashions including biblereading, insuring a religious leader was present and others. Protocolsdirecting specific care policies were discussed;Introspective feelings and beliefs were exposed.CONCLUSIONS. This is the first examination of after death ritualsinvestigated in Europe. Nurses can learn from other cultures in orderto be empathetic and sensitive to others at this challenging time.This work can demonstrate several models of after death careREFERENCE(S)noneGRANT ACKNOWLEDGMENTnoneFig. 3 (abstract 0377). MRC-Progression0379Freedom from physical restraints in ICU: result from a scopingreviewE. Mattiussi, M. Danielis, A. Froncillo, A. PaleseUniversità degli Studi di Udine, Udine, ItalyCorrespondence: E. MattiussiIntensive Care Medicine Experimental 2018, 6(Suppl 2):0379INTRODUCTION. Physical restraint (PR) has been defined as “anyaction or procedure that prevents a person's free body movement toa position of choice and/or normal access to his/her body by the useof any method that is attached or adjacent to a person's body andthat he/she cannot control or remove easily”. To date several studieshave been performed in acute and chronic settings but little data isavailable on ICUs.OBJECTIVES. To map all the relevant literature focusing on the use,prevention ad avoidability of PR inside ICU setting.METHODS. A systematic scoping review was performed.1) The following databases were examinated: PubMed, Scopus,the Cochrane Library, CINHAL and TripDatabase.2) Different key words were matched to find any other relevantliterature.3) All references were considered to find other studies of interest.4) Two independent reviewers screened all eligibile articles tomeet inclusion criteria.5) All studies were individually analysed and all data extractedby using a semi-structured form. 6) Literature selected wassummarised with both qualitative and quantitative methodto find out cathegories and themes.RESULTS. On a total of 44 studies identified the main areas exploredby literature were:a) prevalence of PR in ICU;b) policies and guidelines focusing on actual strategies aiming atpreventing the use of PR in ICU;c) the determinants and the consequences of PR use;d) patients, caregivers and healthcare professionals' perceptions.The prevalence ranges from 0% to 100% depending on thedefinition of PR considered and on organizational aspects of ICU(i.e. nurse/patient ratio). There were few policies across countriesguiding the use of PR in ICUs. The main determinants of the PRuse aimed at assuring patients safety: the risk of device removal,the cognitive state of patients and the risk of fall. Theconsequences of PR were: direct damages (i.e. skin sores) andindirect damages (i.e. patient's agitation and device removal). Mostof patients admitted in ICU reported that PR determined anxietyand frustration; some others did not remember or understood itsuse. Personnel's perception varied on their knowledge and skillsabout PR use.CONCLUSIONS. As a novel approach for mapping relevantliterature on a topic, we focused in performing a broad study ofliterature concerning the use, prevention and avoidability of PRin ICUs. The results confirmed that there should be a continuousupdating of knowledge about PR in ICU, both to ensure patients'outcomes and to improve knowledge and skills of health carepersonnel.REFERENCE(S)Arksey, H, O'Malley, L (2005). Scoping studies: towards a methodologicalframework. International Journal of Social Research Methodology,8:19-32.

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Freedom from physical restraints in ICU: result from a scoping review

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