Developing a perspective on restraint and the least intrusive intervention

Citation

Paterson B (2006) Developing a perspective on restraint and the least intrusive intervention. British Journal of Nursing, 15 (22), pp. 1235-1241. https://doi.org/10.12968/bjon.2006.15.22.22562

Abstract
This article explores contemporary practice in the use of restraint in the light of recent European Council Guidance endorsing the principles of least restrictive environment/least intrusive intervention. Violence is a source of concern in many European mental health services but approaches to its immediate management continue to display remarkable diversity reflecting the adoption of differing perspectives on what constitutes 'least intrusiveness'. This article examines the basis for practice in terms of the range of procedures available, reviews the literature on restraint safety and presents a model based on the concept of reasonableness which can be used to evaluate whether a given intervention meets the European guidance. Current practice across Europe is largely a function of tradition and local values rather then evidence based. Collaborative large-scale studies are required to determine the relative risks of the range of interventions in use such that practice is informed by evidence rather than opinion.

Keywords
psychotropic agent; aggression; Europe; exercise; human; legal aspect; mental health service; methodology; organization and management; patient care; patient right; practice guideline; psychiatric nursing; review; risk assessment; standard; violence; Humans; Mental Health Services; Patient Isolation; Patient Rights; Practice Guidelines; Psychotropic Drugs; Restraint, Physical

Journal
British Journal of Nursing: Volume 15, Issue 22