Minimising Restrictive Practices
Research type
Research Study
Full title
Improving patient experience of mental healthcare by minimising restrictive practices: a mixed methods study.
IRAS ID
224007
Contact name
Elizabeth Barley
Contact email
Sponsor organisation
University of West London
Duration of Study in the UK
0 years, 11 months, 28 days
Research summary
Background: ‘Restrictive practices’ are over-used in mental healthcare; this leads to physical harm and mental distress in patients and their families. Restrictive practices are “Making someone do something they don’t want to do or stopping someone doing something they want to do.” This includes interventions such as physical restraint or seclusion, but also simple acts such as only allowing cups of tea at certain times or restrictions regarding leave. Positive Behaviour Support Plans (PBSPs) may help reduce restrictive practices by helping nurses to identify how and when to intervene to prevent challenging behaviour and to promote wellbeing. The proposed research will examine, from patient and staff perspectives and from clinical records, how PBSPs are currently being used in one mental health Trust.
Methods: Qualitative interview study of carers of people admitted to a psychiatric intensive care unit or one of two acute wards who have experience of having a PBSP and of mental health nurses working in the same areas. All eligible carers will be invited to take part; purposive sampling will be used to select nurse participants by gender, experience and NHS band. Interviews will be digitally recorded and transcribed. Data will be analysed using a six-step thematic analysis process. Data analysis and collection will be iterative. A ‘triangulation protocol’ will be used to combine themes from nurse and carer interviews. Data will also be gathered from patient records to understand their use.
Findings: Aspects of the PBSP essential for behaviour change and testable improvements to its implementation will be identified. The findings will inform the development of a standardised intervention (which will include PBSPs) to reduce restrictive practices which is implementable in and suitable for large scale roll-out and testing.REC name
South West - Cornwall & Plymouth Research Ethics Committee
REC reference
17/SW/0074
Date of REC Opinion
20 Mar 2017
REC opinion
Favourable Opinion