De-escalation and dignity when managing challenging behaviour
“Physical restraint should be your last resort, always,” said Dr Mary E Braine to delegates at the RCN Neurosciences Forum event, which explored de-escalation and dignity when managing challenging behaviour – a term used to describe any patient who displays aggressive, violent or difficult-to-manage behaviour.
Dr Braine, from the University of Salford, and RCN Neurosciences Forum member Cath Waterhouse, from Sheffield Teaching Hospitals NHS Foundation Trust, summarised factors associated with caring for patients presenting with challenging behaviour. They outlined how best to manage those who are particularly vulnerable to the instigation of restrictive measures.
Delegates heard about the different types of restraint, and the key role all nursing staff can play in identifying possible triggers, modifying the environment to protect patients and staff, and maintaining dignity.
Cath said that there is currently little available to help nursing staff promote dignity in restraint and that common sense is vital. “There can be confusion and angst with nurses that they are infringing their duty of care when they are actually fulfilling it,” she added. “We have a responsibility to keep patients safe.”
Dr Braine highlighted the importance of risk assessment when confronted with challenging behaviour and looked at specific intervention strategies. “If physical restraint must be used, it must be when all other alternatives have been exhausted,” she concluded.
