The Effects of an Action Plan, Staff Training, Management Support and Monitoring on Restraint Use and Costs of Work‐Related Injuries

Abstract

Background Dignity and respect are at the foundation of good care and effective treatment planning and are guiding service principles. The use of physical restraints is contrary to treatment with dignity and respect. Because of the numerous risks to clients and employees associated with the use of physical restraints, an innovative plan was implemented to minimize the use. Method Information was gathered to obtain a clear understanding of the employees' feelings about the initiative to minimize physical restraint. Training was provided regarding philosophical issues as well as how to utilize a new tool ⁄ procedure to keep everyone safe during aggressive outbursts. Presence by the management team was increased to support employees and encourage newly trained techniques. Finally, a formal system of processing was put in place to learn from each restraint in order to prevent the situation in the future. Results The Winchester Region reduced the use of physical restraint by 99.4% and client-induced employee injuries by 37.7%. Conclusions We drastically reduced physical restraints, staff injuries and created a safer place to work.

Descriptive Analysis of a Staff Injury-Reduction Intervention in a Human Services Setting for Children and Youth With Intellectual and Developmental Disabilities

“…The components outlined in this article, in light of other similar projects (Sanders, 2009), demonstrate the utility of behavior incident analysis for designing comprehensive clinical safety programs, reducing injuries to staff, and creating safer habilitation and living environments. Clearly, more research in this area is needed to identify effective procedures that can be adopted by HSOs.…”

Evaluation of a Program Model for Minimizing Restraint and Seclusion

“…The change process helped Grafton leadership manage organizational behaviors through a clearly defined intervention that has been fine tuned up to and beyond the initial results provided by Sanders (2009). The ability to change a culture with so many unknowns and with the potential for dangerous outcomes shows that this method of change can work in extreme situations.…”

“…In the original study, Sanders (2009) reported results from a region of Grafton which included children (average census of 75 between the ages of 6 and 22) and adults (average census of 43 at ages 22 and older) with Bvarying levels of autism and/or intellectual disabilities along with concurrent psychiatric conditions and significant behavioral challenges^(p. 216). This represented outcomes for one of Grafton's regional operations.…”

“…Data were collected through existing data collection systems including client, regional, and corporate data which were entered into a quality assurance database that was distributed across the programs monthly. As an update to the first initiative reported by Sanders (2009), Grafton Integrated Health Network (Unpublished) further defined its model of minimization of restraint and seclusion as a multi-component treatment package that provided strong leadership and the use of communication, training, measurement, debriefing, alternative solutions, and therapeutic treatment planning. The combination of these integrated parts as a transformational change model that can help to establish sustainable outcomes is the basis of this evaluation.…”

“…Within this model (Sanders 2009) which contained communication, training, support, and debriefing, information was gathered through employee feedback that to obtain a pulse for how employees felt about the change. The feedback was transformed into an action plan that maintained safety as a top priority.…”