Patient centred physical restraint: a case study of two NHS mental health inpatient wards

The nursing staffs who work in the NHS mental health in-patient wards sometimes physically restrain their patients. Whilst there are studies that have looked at the different aspects of the use of physical restraint, none has specifically investigated the experiences and perceptions of the staff on the use of the patient centred model of physical restraint in managing untoward incidents in the setting. As a trainer on the General Services Association model of physical intervention, I worked collaboratively with staff from two NHS mental health inpatient wards, users of physical restraint techniques, to explore their experiences, perspectives and indeed the effectiveness of the patient centred approach to physical restraint in their respective wards. Following a review of the relevant literature, the choice of a qualitative type of investigation based on the unmodified Husserlian phenomenological framework was made. To complement this style of investigation, focus group and semi-structured interviews were used to collect primary data from the study participants. Phenomenological recommendations were adopted in the analysis of data. Six core themes including: physical restraint of a patient is for safety and patient centred practices during restraint process emerged from the huge data. The findings confirmed that patient centred approach to physical restraint was effective with the patient groups in the participating wards. Participants emphatically stated that the model enabled a quick retrieval of the therapeutic relationship with their patients. This is in keeping with the ethos of mental health care which is reliant on therapeutic relationship with the patient