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
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)…
Consumers have different perceptions towards food safety. Consumers’ perceptions of food safety have been changing over the years. This change is attributed to many factors including information, changes in income, demographic changes, and food safety policies among others.
nt of NIV (Balami et al., 2006) 13 Table 6: Results & Outcomes (Squadrone et al., 2004) 16 Table 7: Causes of Death (Chung et al., 2010) 18 Table 8: Hospital Outcomes for Study Groups (Keenan et al., 2005) 20 Table 9: Indications & Contradictions for NIV in acute care (Nava & Hill, 2009) 22 Table 10: Literature Review (Outcomes & Recommendations) 23 Table 11: CEBM based steps in finding evidence for different types of questions (CEBM) 29 Table 12: CEBM 30 Figure 1: Eligibility Criteria in addition to ARF for study selection (patients with any three of above criteria were selected) (Honrubia et al., 2005) 9 Figure 2: Survival to hospital discharge per diagnostic category (Levy et al., 2004) 12
Hand hygiene prevents infections associated with healthcare by lowering the incidence across infections. Although it is a simple measure, healthcare hygiene is often poorly carried out and compliance with its recommendations is usually a problem for most healthcare professionals (NHS, 2008).
Each item is rated true/false. The MVQ comprises two factors: Machismo, which relates to embarrassment over backing down, violence as an aspect of being male, justification of violence as a way of responding to a threat and/or an attack, and the strength and weakness associated with non-violence and fear; Acceptance of violence including overt acceptance and enjoyment of violence, in sport and in the media as well injunctions against violence as a behavior that is acceptable (Walker, 2005; Gilligan, 1996).
In the next section the study will try to address the research questions by conducting a literature review on the topic. The researcher has selected hotel industry in order to understand the role of diversity management in fulfilling the strategic objectives of hotels.
The MVQ comprises two factors: Machismo, which relates to embarrassment over backing down, violence as an aspect of being male, justification of violence as a way of responding to a threat and/or an attack, and the strength and weakness associated with
The theories that help in understanding the pros and cons of the process include Kants Ethical Theory (Peterson, 2012; Stewart, 2009; Fernandes, 2008), The natural law theory (Peterson, 2008; Morrison, 2009), Slippery slope or the Domino theory
It plays a significant role to improve health and quality life. Physical activities have advantageous effects on different age of people, children, adults or older adults. According to the Health and Human Service Report (2012)
24 pages (6000 words)Literature review
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