Evaluation of complication development in extremitites with physical restraint in intensive care patients

Title: Evaluation of Complication Development in Extremities with Physical Restraint in Intensive Care Patients Objective: This research aimed to determine the occurrence and factors affecting the development of complications in the extremitites of patients undergoing physical restraint in the intensive care unit. Methods: A prospective analytical design was conducted with the follow-up of patients admitted to an ICU in Eskişehir between September 1,2022, and March 31, 2023. These patients were applied physical restraint upon the physician's request. Research data and follow up of patients were collected using the Individual Identification Form, Glaskow Coma Scale, Intensive Care Pain Observation Form and Physical Restriction Follow-up Form. In addition, intensive care nurses regularly monitored the physical restraint area, patients' level of consciousness, and pain status on an hourly basis, recording the information in Physical Restriction Follow-up Form. Complications that developed at least once in the physical restraint area in all follow-ups were included in the analysis. Results: It was determined that physical restraint was terminated in 11 of 112 patients due to the complication that developed in the physical restraint area, in an evaluation performed on average 230.12 times in the physical restraint area. The occurrence of complications was higher in patients with an endotracheal tube, low GCS scores, and high INR values. Notably, patients with skin ulceration in the restricted area received an increased frequency of massage and cream applications. In addition, patients with a nasogastric tube experienced higher pain levels, resulting in greater application of cream. Conclusion: Complications may arise in the area subjected to physical restraint among ICU patients. Close monitoring by nurses and implementation of appropriate care interventions are essential to prevent and improve these complications. Keywords: Physical restraint, complications, intensive care unit, nurses.