The National Institute of Clinical Excellence (NICE), (2005) recommend the use of physical restraint as the last resort to dissipate the impact of a severe physically aggressive behaviour. Harris (1996) cited in Hollins (2010) defines physical intervention/restraint as any method that involves some degree of direct force to limit or restrict movement and mobility. NICE (2005) states that physical restraint is hands on skill method of restraint that can prevent self-harm and harm to others. The purpose of the intervention is to safely immobilise the individual concerned Rationale The reported incident resulting in a service user’s death whilst being restrained (Blofeld, 2004), has resulted in a scrutiny of the intervention. As a result of the generated debate I would like to assess the challenges associated with employing physical restraint in managing aggression and violence in acute psychiatric settings. There is also a need to examine the supporting evidence base for the use of physical restraint as well as its implication for safe and effective practices. In view of the challenges faced by mental health nurses in tackling the problem of aggression and violence in acute settings, I would like to identify the legal frameworks or policies supporting the use of physical restraint as an intervention and whether there is suitable training for staff. Background. 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 endeavouring 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 behaviour 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 behaviour 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 show an increase of assaults on National Health Service staff within mental health settings, in 2002/03 there were 95,501 assaults reported compared 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 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 physic
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Effectiveness and safety of physical restraint in managing violence and aggressive behaviour in acute psychiatric settings Introduction Management of violent and aggressive behaviour in acute psychiatric settings is a reality for mental health nurses, and physical restraint does represent one of the open options for them (Hollins and Stubbs, 2010)…
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24 pages (6000 words)Literature review
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