Construction And Application Of A Management Scheme Of Physical Restraint For Postoperative Critical Patients Based On Fault Tree Theory

ObjectiveBased on the theory of Fault Tree Analysis to figure out the existing problems of physical restraint procedures,a management program was developed,and a comprehensive intervention strategy for reducing physical restraint among postoperative critical patients was discussed through the implementation of the physical restraint management program,so as to provide a basis for the standardized management of physical restraint.Methods1.The literature that was relevant to the problems of ICU physical restraint management procedures was reviewed.Fault Tree Analysis(FTA)was conducted to construct a fault tree which was qualitatively analyzed and quantitatively analyzed,and then a physical management program was formulated.2.The physical restraint management program based on the concept of Fault Tree Theory was implemented,and before and after the implementation of the scheme,we investigated the status quo of physical restraint.3.The data was statistically analyzed by using the SPSS26.0 software,the qualitative data was described by count and percentage whereas the quantitative data was described by mean and standard deviation(SD).Enumeration data and measurement data were analyzed byχ2 and t tests,respectively.The rank-sum test was used for the comparison of the constraint time between the two groups.P<0.05 was considered statistically significant.Results1.A fault tree of physical restraint management problems of ICU patients including eight intermediate events,fifteen bottom events and nine logical OR gates is constructed.The model includes fifteen minimum cut sets.According to the smaller the number of basic events in the minimum cut sets,the greater influence on the top events,equal attention should be paid to the occurrence of the basic events in each cut set,and by the quantitative analysis of the fault tree,the root cause of the physical restraint management problems of ICU patients can be finally obtained.2.The physical restraint management interventions based on Fault Tree Analysis can reduce the utilization rate of physical restraint and the duration of the physical restraint among postoperative critical patients in ICU(P<0.05),but do not increase the rate of unplanned extubation(P>0.05)and the incidence of restrained complications.3.Comprehensive intervention strategy can increase the rate of analgesic compliance(P<0.05).the sedation rate and the delirium incidence were not statistically significant before and after the implementation of the program(P>0.05).Conclusion1.The fault tree analysis can figure out the existing problems of physical restraint procedures,find out the root cause of unreasonable physical restraint problems,and play an effective guiding role in the standardized management of physical restraint.2.The physical restraint management program based on the concept of Fault Tree Theory can reduce the rate of physical restraint and restraint time and improve the analgesic compliance rate.3.The implementation of physical restraint management scheme based on fault tree theory does not in crease the incidence of unplanned extubation and other constraint-related complications.