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Restraint policy ‘not backed by evidence’

RCN report, Positive and Proactive Care: Reducing the Need for Restrictive Interventions, highlights specific concerns.
Restraint

The RCN has called for evidence to support efforts by the Department of Health to reduce the use of force and restraint in nursing practice.

In a report published last month, the RCN backed the aims of the DH 2014 Positive and Proactive Care policy document, but said this needs to be balanced ‘with the harsh realities of clinical practice’.

The college’s report, Positive and Proactive Care: Reducing the Need for Restrictive Interventions, cites NHS Protect figures showing almost 68,000 assaults on staff in 2014-15.

Specific concerns

The report, written by the RCN forensic nursing forum, said it is widely recognised that nurses are struggling in difficult situations. It highlights specific concerns regarding the ‘banning’ of face-down or ‘prone’ restraint, the process for reviewing incidents, and the wholesale implementation of positive behaviour support in mental health services.

It argues there is a lack of evidence for these policies, and the evidence that does exist contradicts guidelines in the DH report, published in the wake of the Winterbourne View scandal and resulting investigation.

Regulation needed

The report repeats the RCN’s call for regulation of training in the use of physical restraint, which it says remains high on the agenda for the college.

The RCN raised UK accreditation and regulation of training in physical restraint in 2013. The proposal was debated at congress that year and backed by 99.8% of delegates.

RCN professional lead for mental health Ian Hulatt, who helped produce the report, said RCN congress made clear that this training, which is carried out by more than 600 different providers, ‘needs to be accredited and regulated’.

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