There is a significant shortfall in suitably powered studies to provide sufficient evidence for safe prescribing of AEDs to people with ID.

PurposeThe practice of restraint is controversial as deaths in care or custody have been a consequence of restraint. The purpose of this paper is to clarify research from national and international literature to ascertain any common findings in order to provide guidance for staff on safe and effective restraint techniques where there is no other resort in the management of violent and aggressive individuals.Design/methodology/approachThe researchers undertook a review of the literature on the medical theories relating to restraint‐related deaths and an analysis of deaths in custody in the UK for the time period 1 Jan 1999 to 1 Jan 2010.FindingsFindings showed that certain groups are particularly vulnerable to risks while being restrained. There are also biophysiological mechanisms which staff need to be aware of when restraining an aggressive or violent individual.Originality/valueIt is evident that those in vulnerable groups when restrained in a prone position, or in a basket hold, for a prolonged period and who are agitated and resistive, are most at risk of death in custody. Consistency in reporting relevant deaths locally and nationally is necessary to facilitate analysis of key information and prevent deaths in custody in the future. Staff training and awareness are also key factors.

This paper describes a survey of the educational preparation of nurses working in high, medium and low security mental health settings. Data from focus groups and interviews were also content-analysed to yield a theory of nursing in secure environments comprising of statements of competency. The competences were translated into a questionnaire and distributed to nurses working in high, medium and low security mental health settings. Respondents stated whether individual competences were part of their current practice or supervisory involvement, and the degree of importance they accorded to each competency. The competence framework received widespread support from nurses at all levels of security in relation to their role description and level of importance. Results identified issues in relation to security and how procedures in parts of the system (notably in high security) militate against therapeutic care. Noticeable differences emerged between respondents working in high and medium secure environments in relation to involvement of the patient's family and preparation for discharge. Issues of concern common to all levels of security included teamwork, balancing security and therapy, boundaries of professional practice, and clinical supervision.

No abstract

No abstract