Search results

1 – 10 of over 1000
Article
Publication date: 1 September 1999

Helen Macilwaine, Carole Watson and Ian McKenzie

There are considerable differences between the USA and the UK in terms of the practice of in‐patient care, particularly in the use of restraint. The American legal system defines…

Abstract

There are considerable differences between the USA and the UK in terms of the practice of in‐patient care, particularly in the use of restraint. The American legal system defines restraint in terms of physical, mechanical, and chemical restraints, of which only physical and chemical restraints are routinely used in the UK. There is a need to agree a standard definition of restraint as it is used in the UK, which may be valuable as one proxy for quality. Such information would enable nurses to make appropriate use of the published literature, make valid comparisons within and between institutions, and provide evidence about the kind of nursing education and nursing practice development needed to produce quality patient care.

Details

The British Journal of Forensic Practice, vol. 1 no. 3
Type: Research Article
ISSN: 1463-6646

Article
Publication date: 2 March 2012

Krishna Menon, Raghavendra Baburaj and Sarah Bernard

This review seeks to provide an overview of the current research evidence on the use of restraint as an intervention in managing challenging behaviours in relation to children…

1507

Abstract

Purpose

This review seeks to provide an overview of the current research evidence on the use of restraint as an intervention in managing challenging behaviours in relation to children with intellectual disabilities. It also aims to discuss legal frameworks and ethical considerations that underpin the use of restraint in intellectually disabled children who present with challenging behaviours.

Design/methodology/approach

The authors conducted a search of existing literature primarily pertaining to the management of challenging behaviours in intellectual disability on PubMed, PsycInfo and Google Scholar using combinations of the following key words – children, intellectual disabilities, learning disability, mental retardation, challenging behaviour, restraint, seclusion, physical restraint, mechanical restraint, personal restraint, and chemical restraint. Since research on the use of such interventions in children has been hitherto scant, literature relating to their use in intellectually disabled adult populations as well as cognitively able children was also examined to ascertain whether the broad principles informing the use of restraint interventions could be generalised to their use in intellectually disabled children.

Findings

The review finds evidence to suggest that restraint interventions in their myriad forms are widely used to manage challenging behaviours in children with intellectual disabilities and outlines the evidence base, clinical scope, and the risks associated with the use of such interventions in children. It also helps highlight the current absence of comprehensive evidence based guidance that incorporates clinical, ethical, and legal aspects of the use of restraint interventions in children with intellectual disabilities and raises relevant questions in relation to their judicious use in this patient group.

Originality/value

The authors believe that the review completes the first in depth evaluation of the use of restraint interventions in children with intellectual disabilities and are confident that this would serve as useful guidance for professionals working with this patient group who may be considering using restraint interventions in their everyday clinical practice.

Abstract

Details

Health and Illness in the Neoliberal Era in Europe
Type: Book
ISBN: 978-1-83909-119-3

Article
Publication date: 1 February 2002

Heather Sequeira and Simon Halstead

Despite the controversy surrounding physical restraint and seclusion in the care of vulnerable adults, the views of service users have had little impact on current practice. This…

535

Abstract

Despite the controversy surrounding physical restraint and seclusion in the care of vulnerable adults, the views of service users have had little impact on current practice. This paper reviews the literature documenting the personal views and experience of people with learning disabilities and severe mental health problems following these procedures.

Details

The Journal of Adult Protection, vol. 4 no. 1
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 12 December 2016

Tim Riding

The purpose of this paper is to describe the nature and impact of a restraint reduction strategy implemented within a secure learning disability service in response to the…

Abstract

Purpose

The purpose of this paper is to describe the nature and impact of a restraint reduction strategy implemented within a secure learning disability service in response to the national Positive and Safe programme.

Design/methodology/approach

The strategy was comprised of three primary interventions – Safewards, positive behavioural support and data-informed practice – and utilised a programme management approach to ensure effective delivery. Baseline measures were collected from 12 months of data prior to implementation of the programme and the frequency of each category of restrictive intervention was then measured prospectively on a monthly basis throughout the duration of the programme.

Findings

Upon completion of the programme the following results were achieved: elimination of prone restraint – elimination of mechanical restraint – 42 per cent reduction in general use of restraint – 42 per cent reduction in use of seclusion – 52 per cent reduction in rapid tranquilisation.

Originality/value

The paper adds to the growing body of evidence that carefully designed interventions can reduce the frequency of seclusion and restraint. In this case, Safewards and PBS have combined to exert their effect. Data-led practice and senior leadership were also found to be of critical importance. Finally, the need for a stable workforce is considered.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 7 no. 4
Type: Research Article
ISSN: 2050-8824

Keywords

Article
Publication date: 10 October 2011

Joy Duxbury, Frances Aiken and Colin Dale

The practice of restraint is controversial as deaths in care or custody have been a consequence of restraint. The purpose of this paper is to clarify research from national and…

1086

Abstract

Purpose

The practice of restraint is controversial as deaths in care or custody have been a consequence of restraint. The purpose of this paper is to clarify research from national and international literature to ascertain any common findings in order to provide guidance for staff on safe and effective restraint techniques where there is no other resort in the management of violent and aggressive individuals.

Design/methodology/approach

The researchers undertook a review of the literature on the medical theories relating to restraint‐related deaths and an analysis of deaths in custody in the UK for the time period 1 Jan 1999 to 1 Jan 2010.

Findings

Findings showed that certain groups are particularly vulnerable to risks while being restrained. There are also biophysiological mechanisms which staff need to be aware of when restraining an aggressive or violent individual.

Originality/value

It is evident that those in vulnerable groups when restrained in a prone position, or in a basket hold, for a prolonged period and who are agitated and resistive, are most at risk of death in custody. Consistency in reporting relevant deaths locally and nationally is necessary to facilitate analysis of key information and prevent deaths in custody in the future. Staff training and awareness are also key factors.

Details

Journal of Learning Disabilities and Offending Behaviour, vol. 2 no. 4
Type: Research Article
ISSN: 2042-0927

Keywords

Content available
Article
Publication date: 12 December 2016

Colin Dale

314

Abstract

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 7 no. 4
Type: Research Article
ISSN: 2050-8824

Article
Publication date: 21 January 2020

Roy Deveau and Sarah Leitch

Concerns about the overuse, misuse and potential abuse of restrictive interventions used to manage people who may exhibit behaviour described as challenging led to revised…

463

Abstract

Purpose

Concerns about the overuse, misuse and potential abuse of restrictive interventions used to manage people who may exhibit behaviour described as challenging led to revised guidance in England. The purpose of this paper is to examine the implementation of this guidance in organisations providing services for people with learning disabilities.

Design/methodology/approach

A survey collected data from professionals, on leadership, data use, staff issues and post-incident review.

Findings

Most senior leaders were seen as acting on the guidance. Data collected were regarded as generally accurate, but less than half of the managers were seen as likely to respond to consistently high or increasing use of restrictive practices. Frontline staff and managers were seen as very significant for reducing restrictive practices. Uncertainty was shown regarding the goals and activities needed to provide post-incident review.

Research limitations/implications

This exploratory survey may be useful for organisations wanting to audit their implementation of government policy and/or for research on a wider scale to indicate how well societies are implementing policy to reduce restrictive practices. Further research on the survey’s validity and reliability is required.

Practical implications

Further action is needed to encourage all organisations to implement best practice and government policy. This survey showed that some organisations appear to be committed to and potentially achieving reductions in restrictive practices.

Originality/value

This paper describes the first survey designed to evaluate organisational efforts to implement an important policy initiative.

Details

Tizard Learning Disability Review, vol. 25 no. 1
Type: Research Article
ISSN: 1359-5474

Keywords

Article
Publication date: 9 September 2013

Nicola Bethel and Nigel Beail

There continues to be a small group of people who have intellectual disabilities who need some form of restraint in their support plan due to their self-injurious behaviour. The…

Abstract

Purpose

There continues to be a small group of people who have intellectual disabilities who need some form of restraint in their support plan due to their self-injurious behaviour. The mechanical restraint restricts their freedom of movement to help prevent injury. Despite the growing literature on the use of such devices, there is very limited literature looking at the impact the use of mechanical restraints has upon service users and support staff using them. The aim of this study was to ascertain the experiences of support staff who apply the restraints to the people they support.

Design/methodology/approach

Qualitative methodology was utilised. A semi-structured interview was conducted with nine support workers who: directly worked with a client with intellectual disabilities who engage in self-injurious behaviours; followed positive behavioural support plans developed with a multi-disciplinary team; applied restraints as a response to severe self-injurious behaviours to prevent harm; and they had to have been directly involved in the application and removal of the mechanical restraints in the last week. Content analysis utilising emergent coding was used to analyse the data.

Findings

All participants described using mechanical restraints as having a negative impact upon them. Participants said they manage the negative impact by reframing, inhibiting their emotions, following support plans closely and gaining support from other staff. Participants described concerns and unmet needs regarding whether they were applying the restraints correctly, the responsibility of teaching others to use restraints, not feeling prepared on starting their current job and that the impact/concerns of using restraints is not talked about. Recommendations for practice are made.

Originality/value

This is the first study to explore the views of care staff who are required to use mechanical restraint. It provides insight on the impact of this on them.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 7 no. 5
Type: Research Article
ISSN: 2044-1282

Keywords

Abstract

Details

Tizard Learning Disability Review, vol. 3 no. 4
Type: Research Article
ISSN: 1359-5474

1 – 10 of over 1000