TY - JOUR
T1 - Staff experiences and understandings of the REsTRAIN Yourself initiative to minimize the use of physical restraint on mental health wards
AU - Duxbury, Joy
AU - Thomson, Gill
AU - Scholes, Amy
AU - Jones, Fiona
AU - Baker, John
AU - Downe, Soo
AU - Greenwood, Paul
AU - Price, Owen
AU - Whittington, Richard
AU - McKeown, Mick
PY - 2019
Y1 - 2019
N2 - International efforts to minimize coercive practices include the US Six Core Strategiesé (6CS). This innovative approach has limited evidence of its effectiveness, with few robustly designed studies, and has not been formally implemented or evaluated in the UK. An adapted version of the 6CS, which we called ‘REsTRAIN Yourself’ (RY), was devised to suit the UK context and evaluated using mixed methods. RY aimed to reduce the use of physical restraint in mental health inpatient ward settings through training and practice development with whole teams, directly in the ward settings where change was to be implemented and barriers to change overcome. In this paper, we present qualitative findings that report on staff perspectives of the impact and value of RY following its implementation. Thirty-six staff participated in semi-structured interviews with data subject to thematic analysis. Eight themes are reported that highlight perceived improvements in every domain of the 6CS after RY had been introduced. Staff reported more positively on their relationships with service users and felt their attitudes towards the use of coercive practices such as restraint were changed; the service as a whole shifted in terms of restraint awareness and reduction; and new policies, procedures, and language were introduced despite certain barriers. These findings need to be appreciated in a context wherein substantial reductions in the use of physical restraint were proven possible, largely due to building upon empathic and relational alternatives. However, yet more could be achieved with greater resourcing of inpatient care. é 2019 Australian College of Mental Health Nurses Inc.
AB - International efforts to minimize coercive practices include the US Six Core Strategiesé (6CS). This innovative approach has limited evidence of its effectiveness, with few robustly designed studies, and has not been formally implemented or evaluated in the UK. An adapted version of the 6CS, which we called ‘REsTRAIN Yourself’ (RY), was devised to suit the UK context and evaluated using mixed methods. RY aimed to reduce the use of physical restraint in mental health inpatient ward settings through training and practice development with whole teams, directly in the ward settings where change was to be implemented and barriers to change overcome. In this paper, we present qualitative findings that report on staff perspectives of the impact and value of RY following its implementation. Thirty-six staff participated in semi-structured interviews with data subject to thematic analysis. Eight themes are reported that highlight perceived improvements in every domain of the 6CS after RY had been introduced. Staff reported more positively on their relationships with service users and felt their attitudes towards the use of coercive practices such as restraint were changed; the service as a whole shifted in terms of restraint awareness and reduction; and new policies, procedures, and language were introduced despite certain barriers. These findings need to be appreciated in a context wherein substantial reductions in the use of physical restraint were proven possible, largely due to building upon empathic and relational alternatives. However, yet more could be achieved with greater resourcing of inpatient care. é 2019 Australian College of Mental Health Nurses Inc.
UR - https://hdl.handle.net/1959.7/uws:64164
U2 - 10.1111/inm.12577
DO - 10.1111/inm.12577
M3 - Article
SN - 1445-8330
VL - 28
SP - 845
EP - 856
JO - International Journal of Mental Health Nursing
JF - International Journal of Mental Health Nursing
IS - 4
ER -