Control and restraint training in acute mental health care.

AIM

This article describes the first stage of a research project. The aim was to establish the frequency and pattern of assault, and the use, effectiveness and safety of breakaway and restraint techniques, in an intensive care unit for mental health patients. Views of nursing staff with regard to training and the use of restraint were also explored.

METHOD

The study involved a qualitative analysis of 346 adverse incident reports in a 16-bed mental health intensive care unit over a 32-month period. Data on staff perceptions of breakaway and restraint techniques were collected using face-to-face, semi-structured interviews with 19 nurses.

RESULTS

Of the 85 incidents identified, 11 were attempted assaults intended to cause physical harm to a member of staff. The remaining 74 involved actual contact with a client or an object held or thrown by him or her. Punches and kicks were the most common forms of assault reported. There were 66 incidents of restraint recorded. The most common reason for this was attack or attempted attack on a member of staff.

CONCLUSION

Staff were generally satisfied with the training they received on control and restraint courses, however some problems were identified. There appears to be a mismatch between patterns of assault and preparation for dealing with assaults. Aspects of restraint, such as establishment of holds, are problematic in application. Although punches and kicks were the most common form of assault reported, less time is spent on these during training.