Effectiveness and Safety of Physical Restraint in Managing Violence - Literature review Example

Download file to see previous pages The practice of physically restraining violent and aggressive inpatients in mental health care settings is longstanding and is rooted in the prison services control and restraint model (Rogers et al, 2007). Patient safety in acute psychiatric settings is a consistently topical issue, particularly when it concerns the management of aggression and violence (Butterworth and Harbison, 2010). Furthermore, the use of physical restraint when endeavoring to address this problem is of particular concern in regards to its efficacy and safety (Paterson and Duxbury, 2007). The use of physical restraint in the management of violent and aggressive behavior in acute psychiatric settings is employed as the last resort when all other management strategies have failed to calm the service user (National Institute of Clinical Excellence, 2005). It has been noted that the incidence of violence and aggressive behavior by inpatients in acute psychiatric settings is a significant occurrence and raises many questions as to the safety of both patients and staff (Duxbury and Paterson, 2005). A National Audit Office (NAO) survey shows an increase of assaults on National Health Service staff within mental health settings, in 2002/03 there were 95,501 assaults reported compared to 65,000 the previous year (NAO, 2003).

Aims and Objectives
The aim of this review is to explore the effectiveness and safety of physical restraint as an intervention in managing violence and aggression in acute psychiatric settings. The review will assess service user and staff perspectives on the use of physical restraint as an intervention. Furthermore, the review will evaluate the use of physical restraint and the risks associated with its use (safety of physical restraint). The review hopes to stimulate discussion on the use of physical restraint and its implication for nursing practice as well as areas for future research and development.

Research Parameters
The literature search included all English publications that described, evaluated, or investigated the use of physical restraint in managing or tackling the problem of violence and aggression in mental health care settings. The focus was mainly on the United Kingdom (UK) published papers because they fall within the UK legal framework. There was a great deal of reading around the subject area to have a wider understanding of aggression and violence within health care, with a focus on containment. The wider reading was helpful in gaining a good background to the origins of the intervention and how it was adopted in the health care system.

Electronic searches of the main databases were conducted using the search engine EBSCO and the databases searched were: Swestwise, PsycInfo, Medline, CINAHL, and Science-Direct. The publications searched were from 2002 to date. The rationale was to capture the most up-to-date articles.

The topics of papers were searched using the following search terms: physical intervention, restraint, inpatient, psychiatry, and limiting the search to the United Kingdom or Britain, or England. The search included the age group 18years and older both male and female.

Chapter 2
National Audit Survey (NAO), (2003) reported a high prevalence of physical restraint practice in mental health trusts in the UK in managing violence and aggression. ...Download file to see next pages Read More