Andrew Masterman, NHS Protect. Restraint Reduction Conference Keynote 26th June '14
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Andrew Masterman, Policy Lead, Violence Strategy, NHS Protect Andrew leads on national initiatives to help maintain a safe and secure environment for NHS staff, patients and visitors. Andrew works collaboratively with key stakeholders to prevent violence, and has advised the All Party Parliamentary Group on Preventing Work-related Violence. Andrew chairs a clinically led Expert Group for the Prevention of Clinically Related Challenging Behaviour and was responsible for overseeing the successful launch of the work programme: Meeting needs and reducing distress: the prevention and management of clinically related challenging behaviour in NHS settings Presentation Topic: 'The prevention and management of clinically related challenging behaviour in NHS settings.
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Andrew Masterman, NHS Protect. Restraint Reduction Conference Keynote 26th June '14
- 1. www.nhsprotect.nhs.uk Andrew Masterman Policy Lead Violence Strategy Date 26 06 14
- 3. Timeline Zero Toleranc e NHS SMS NHS Protect Winter bourne / Mid Staffs MIND Meeting Needs DH guidance
- 4. Minimising the use of physical restraint RCN - Positive and Proactive Care SfHealth/Care - Positive and Proactive WorkforceNHS Protect - Meeting Needs and Reducing Distress MH Crisis Care Concordat MoJ - Death in Custody principles / NHS Care in Custody NICE - Guidelines • Violence & Aggression • LD Challenging Behaviour RCN Forum NHS England -NRLS and Patient Safety Incidents RCPsych CQC Research Health Education England National picture DH Positive & Safe Programme
- 5. •Vulnerable patients •Other patients •Staff •Relatives and carers •Organisational reputation Why is this guidance important?
- 7. Understand • What is meant by clinically related challenging behaviour • Clinical condition or other factors • How it presents and early signs • Antecedents and triggers • Common reasons - physical, cognitive, psychological/emotional, environmental/social • Translate unmet needs into delivery of care
- 8. Manage risk • Recognise a person’s vulnerability • Implement strategies to stay safe • Manage escalating situations • Deal with immediate, obvious causes • Consider other strategies, e.g. assistance, observations • Know when to use physical interventions in emergency situations • Review incident
- 9. Prevent • Recognise individual's rights and dignity • Positive engagement, attitudes, communication critical to prevent challenging behaviour • Information gathering, observation and assessing behaviours when planning care • Plan individualised care: understand what causes behaviour, what alleviates it, what can we do differently; document and share with colleagues • Factors: communication, environment, activities, independence, mobility, sleep, rest and nutrition • Review care plan
- 10. Training Level Core Role specific Targeted (risk based) Module Challenging behaviour awareness CRT Assessment and planning Assault reduction Physical intervention Content • Awareness • Recognise • Prevent • Manage risks • Responsibilitie s • Support • Risk awareness • Dynamic risk assessment • Communication • Calming • Responsibilities • Reporting • Support • Assess & diagnose • Care planning • Individualised care • Prevention • Special observation • Behaviour management • Problem solving • Recording • Support • Risk awareness • Positionin g • Safer practices • Avoiding blows • Releases • Guiding & redirecting • Policy, law, ethics • Appropriate restrictive skills • Medical risks • Duty of care • Teamwork • Leadership • Emergency response Audience All staff with direct patient contact Nurses, doctors, AHP Nurses, doctors, AHP in high risk areas Response teams, security function
- 11. Resources • Versatile video resource • Supports guidance • Learning outcomes • Relevant to clinical and non-clinical staff • Scenarios to understand, prevent, manage behaviour • Shared expertise and practical advice
- 13. The future? • Guidance, website and video resources • Project implementation and evaluation • Future engagement: participate in work streams to minimise restrictive interventions • Identify opportunities for further work • Training