Restrictive interventions: a service evaluation

Abstract

Background Restrictive interventions (RIs) are defined as the use of deliberate acts that restrict a person’s movement, liberty or freedom to act independently. RIs such as seclusion and physical intervention are practices commonly used to manage violence and aggression.Aims To investigate the frequency and rationale for use of RIs at an NHS inpatient service.Methods A service evaluation was carried out for six inpatient wards that offer adult and later-life services. Data were collected from patient incident and adverse events reports and from electronic patient records.Results There were 424 incidents of physical intervention and 184 incidents of seclusion reported. The use of physical intervention was more frequent between 10am and 12pm, when personal care was carried out. Physical and non-physical assaults were most commonly reported as the reasons for use of RIs.Conclusion Analysing the frequency and the rationale for the use of RIs has enabled changes to be made to practice and how staff are trained. It is hoped that other services will reflect on their use of RIs to improve practice.