基于约束决策轮的外科全麻术后患儿身体约束分级管理方案的实践研究OA

Objective To explore the practical effect of a graded management program for physical restraint in pediatric patients after general anesthesia based on the Constrain Decision Wheel.Methods Using convenience sampling,392 pediatric patients who under-went inpatient surgery at Tianjin Children·s Hospital from August to November 2025 were selected.They were randomly divided into two groups,with 196 cases in each group,according to the random number table method.The control group received traditional postop-erative restraint nursing care after general anesthesia,while the observation group a graded management program for physical restraint based on the Constrained Decision Wheel.The postoperative physical restraint rate,postoperative restraint duration,incidence of re-straint-related complications,unplanned extubation rate,incidence of delirium,utilization rate of restraint alternatives,and patient comfort scores were compared between the two groups.Results Compared to the control group,the observation group had a lower postoperative physical restraint rate of 18.85%(P<0.05),a shorter postoperative restraint duration(P<0.05),and a lower incidence of re-straint-related complications[0.51%(1/196),P<0.05].Both groups did not experience delirium.Compared to the control group,the observation group showed a higher utilization rate of restraint alternatives(67.86%)and a lower FLACC(the Face,Legs,Activity,Cry,Consolability scale)comfort score(P<0.05).Conclusion The application of a graded management program for physical restraint based on the Constraint Decision Wheel in pediatric patients undergoing general anesthesia can significantly reduce the rate of physi-cal restraint,promote the reduction of constraint duration,and lower the incidence of related complications.It can also improve the uti-lization rate of restraint alternatives,thereby enhancing the comfort of pediatric patients.