Restraint Monitoring and Training

Restraint is the holding or blocking of movement, stopping from someone from leaving, and the use of staff physical intervention for the purposes of managing an actual or potential escalation in violent, aggressive and/or disruptive behaviour.

The purpose of Restraint Monitoring is to understand the nature of the intervention and what skills and techniques are used to manage it. At a basic level the following information should be recorded:

  • type of restraint technique used (prone, seated, take down, holds used, control of legs, blocks used),
  • duration of intervention,
  • people involved including positions in restraint (arm, leg and head),
  • reason for use of restraint, and
  • identify what happened after the incident.

We support the State Hospital’s introduction of Dynamic Appraisal of Situational Aggression (DASA) tool: to assess the likelihood that a patient or client will become aggressive within a inpatient environment. The tool helps staff to recognise signs of deterioration in a person’s mental state.

Restraint techniques include:

  • prevention and Management of Violence and Aggression (PMVA) restraint techniques
  • spontaneous Protection Enabling Accelerated Response (SPEAR) system – with a focus on one or two reaction styles, and
  • National Federation Personal Safety (NFPS) model – work on seven holds and a combination of these to promote the safety of staff and patients.

De-escalation methods include:

  • therapeutic activities,
  • evening and supper groups,
  • restraint debrief,
  • use of techniques for distraction and calming, ways to encourage relaxation,
  • risk assessment and safety planning with patients – how to respond in situations,
  • recognising the early signs of agitation, irritation, anger and aggression, understanding the likely causes of aggression of violence, both generally and for each service user, and
  • being able to identify between frustrations, stress & distress versus aggression and anger.