Breakaway and physical restraint techniques in acute psychiatric nursing: Results from a national survey of training and practice

Abstract

The survey examined training and practice in the prevention and management of violence in nurses working in acute in-patient psychiatric services throughout the UK. Out of 2,152 questionnaires sent out, 771 completed responses were returned (36%). While the response rate was low, there were no obvious biases affecting it, and a high level of statistical power was attained. The study is the largest survey of training in the prevention and management of violence in this population conducted so far. Most respondents reported an acceptable ratio of theoretical input to practical skills training, although some important theoretical aspects received insufficient attention. The use of wrist flexion and pain compliance elements in the restraining holds taught were frequently reported. In clinical practice, breakaway techniques were reported as more frequently used than has been suggested in earlier research. Some redundancies in restraint training were also found, with some commonly-taught techniques being seldom or never used. Respondents were not particularly confident in their ability to use their skills safely or effectively. Training sessions were generally considered to have been safely and well run. The need for national standards in training that the findings suggest, and directions for further research are discussed.