Southcott John, Howard Alison, Collins Eddie
Institute of Health and Community Studies, Bournemouth University, Bournemouth, Dorset.
Nurs Stand. 2002;16(27):33-6. doi: 10.7748/ns2002.03.16.27.33.c3169.
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.
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.
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.
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.
本文描述了一个研究项目的第一阶段。其目的是确定在一家心理健康患者重症监护病房中攻击行为的频率和模式，以及挣脱和约束技术的使用情况、有效性和安全性。同时还探讨了护理人员对培训及约束使用的看法。
该研究对一家拥有16张床位的心理健康重症监护病房在32个月期间的346份不良事件报告进行了定性分析。通过与19名护士进行面对面的半结构化访谈，收集了关于工作人员对挣脱和约束技术看法的数据。
在确定的85起事件中，11起是企图对工作人员造成身体伤害的攻击行为。其余74起涉及与患者实际接触或其持有或投掷的物品。据报告，拳打脚踢是最常见的攻击形式。记录到66起约束事件。最常见的原因是对工作人员的攻击或企图攻击。
工作人员对他们在控制和约束课程中接受的培训总体上感到满意，但也发现了一些问题。攻击模式与应对攻击的准备之间似乎存在不匹配。约束的一些方面，如控制动作的确定，在应用中存在问题。尽管拳打脚踢是报告中最常见的攻击形式，但培训中在这些方面花费的时间较少。
