关键词: ICU；儿童；身体约束；最小化；循证护理；i-PARIHS框架

Abstract: Objective: To develop an evidence-based practice protocol for minimizing physical restraints in ICU children and evaluate its application effect, aiming to reduce the rate of physical restraint in ICU children and decrease related complications. Methods: Guided by the i-PARIHS framework, an evidence-based nursing plan was constructed through evidence acquisition, current situation review, and evidence introduction. From March to May 2025, this practice was applied in a tertiary grade A children's hospital in Beijing. The differences in outcome indicators such as the knowledge, attitude and practice score of physical restraint among nurses, the implementation rate of review indicators, the restraint rate, complication incidence, restraint alternative rate, and the average number of restraints before and after the practice were compared. Results: After implementing evidence-based practice, the implementation rate of the indicators and the total score of the knowledge, attitude and practice questionnaire of the nurses increased; the restraint rate decreased from 71.2% to 61.8%, the incidence of restraint complications decreased from 1.3% to 0.3%, and the substitution rate of restraint increased from 0.5% to 4.0%, and all the differences were statistically significant (P<0.05). Conclusion: The evidence-based practice of minimizing physical restraints for children in the ICU standardizes the assessment, operation and behavior of physical restraint care, reduces the restraint rate, and improves the comfort level and outcome indicators of the children.

Key words: Intensive Care Units; child; physical restraint; minimization; evidence-based nursing; i-PARIHS framework