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Staff experiences and understandings of the RE s TRAIN Yourself initiative to minimize the use of physical restraint on mental health wards
Author(s) -
Duxbury Joy,
Thomson Gill,
Scholes Amy,
Jones Fiona,
Baker John,
Downe Soo,
Greenwood Paul,
Price Owen,
Whittington Richard,
McKeown Mick
Publication year - 2019
Publication title -
international journal of mental health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.911
H-Index - 54
eISSN - 1447-0349
pISSN - 1445-8330
DOI - 10.1111/inm.12577
Subject(s) - context (archaeology) , thematic analysis , mental health , psychology , nursing , service (business) , qualitative research , medicine , applied psychology , medical education , psychiatry , business , sociology , paleontology , social science , marketing , biology
International efforts to minimize coercive practices include the US Six Core Strategies© (6 CS ). This innovative approach has limited evidence of its effectiveness, with few robustly designed studies, and has not been formally implemented or evaluated in the UK . An adapted version of the 6 CS , which we called ‘ RE s TRAIN Yourself’ ( RY ), was devised to suit the UK context and evaluated using mixed methods. RY aimed to reduce the use of physical restraint in mental health inpatient ward settings through training and practice development with whole teams, directly in the ward settings where change was to be implemented and barriers to change overcome. In this paper, we present qualitative findings that report on staff perspectives of the impact and value of RY following its implementation. Thirty‐six staff participated in semi‐structured interviews with data subject to thematic analysis. Eight themes are reported that highlight perceived improvements in every domain of the 6 CS after RY had been introduced. Staff reported more positively on their relationships with service users and felt their attitudes towards the use of coercive practices such as restraint were changed; the service as a whole shifted in terms of restraint awareness and reduction; and new policies, procedures, and language were introduced despite certain barriers. These findings need to be appreciated in a context wherein substantial reductions in the use of physical restraint were proven possible, largely due to building upon empathic and relational alternatives. However, yet more could be achieved with greater resourcing of inpatient care.