Effectiveness of Strategies, Models, or Training programmes on Reducing Physical Restraints for Managing Challenging Behaviour in Mental Health Nursing Settings: A Systematic Review.
Abstract
Background: The use of physical restraints to handle challenging behaviour in mental health nursing settings is a controversial issue that can have unfavourable effects on patients and staff. To decrease the use of physical constraints, it is critical to identify successful strategies, models, or training programmes.
Objectives: This systematic review aimed to evaluate the effectiveness of various strategies, models, or training programmes used to reduce physical restraints for managing challenging behaviour in mental health nursing settings. To achieve this aim and guide the review, three objectives were determined.
Methods: The review included studies published from 2012 to 2022 and adhered to PRISMA guidelines. A systematic search was undertaken of the following electronic databases: CINAHL (Cumulative Index to Nursing and Allied Health Literature), PubMed, PsycINFO, Scopus, and Medline. The systematic search strategy was created with the help of a professional librarian. In addition, manual article searches were conducted, and the reference lists of relevant papers were examined. The quality of each study was evaluated using a predetermined framework.
Results: A total of 14 studies met the inclusion criteria and were included in the review. These assessed a variety of interventions, including the use of alternative interventions such as de-escalation methods, the Six Core Strategies, the Safewards Model, training programmes for healthcare workers, and policy implementations. The findings demonstrated that staff training programmes were successful in lowering the frequency and length of physical restraint usage. Moreover, the introduction of these programmes was associated with a boost in employee attitude and confidence as well as a decline in violence and injuries.
Conclusion: This review suggests that strategies, models, and training programmes designed to reduce the use of physical restraints in mental health nursing settings can be effective. However, the heterogeneity of the interventions, duration of the training, and the reported outcomes emphasize the need for additional research to determine the most successful approaches. Nonetheless, this review offers significant insights into possible alternatives to physical restraints that can enhance patient outcomes and uphold human rights principles in mental health care.
Description
In this review, the efficacy of several strategies, models, or education programmes for lowering the usage of PR was investigated. The review included 14 studies that used a range of methods, including randomized controlled trials, a non-randomized controlled trial, quasi-experimental designs, and pre- and post-test designs. These were conducted in various nations throughout the world and published between 2012 and 2022.
The findings of this systematic review provide valuable insights into strategies, models, and training programmes to reduce PR and point to the possibility that physical restriction may be successfully decreased in mental health nursing settings through their use. Particularly, the utilization of person-centred care using the Safewards Model, the Six Core Strategies, and the adoption of proper leadership, specific policies, and guidelines helps decrease the use of PR. In addition, staff training programmes that include communication and de-escalation strategies are beneficial for minimizing the need for PR. The review also presents evidence that strategies and training programmes designed to minimize physical restriction can improve the attitudes and confidence of mental health professionals. There is little evidence to show the efficacy of such programmes in lowering staff violence rates and sick days, however.
Keywords
Effectiveness, Strategies, Models, Training programs, Reducing physical restraints, Challenging behavior, Mental health nursing settings, Restraint reduction, Intervention programs, Alternative approaches, Risk assessment, Behavioral management
Citation
Harvard Referencing