• Led by the University of Central Lancashire (UCLan).
  • Supported by the universities of Liverpool and Manchester and the Advancing Quality Alliance (AQuA).
  • Working in eight mental health trusts in the northwest of England.
  • Aims to improve mental health patient safety by reducing the level of unnecessary restraint.
  • Uses the 6CS-UK approach, to provide a framework to promote safety at an organisational, service and team level.
  • Running from early 2014 to mid 2016.

Physical restraint is used to prevent individuals in mental health services from harming themselves or others. It continues to be used routinely despite adverse effects reported from both patients and staff.

This project’s key aim is to reduce the incidence of harm caused to patients and staff as the result of a 40% reduction in physical restraint by June 2016.

The results of using restraint range from patient and staff discomfort to injuries leading to death. The cost to mental health services in terms of staff turnover, burnout and litigation is also significant.

Evidence shows that many restraint episodes may be preventable if certain contextual factors are addressed. These include unclear policy and guidelines, environmental quality, staff inexperience or unavailability, and poor ward design. Contributing staff characteristics include negative interactional styles, provocative or authoritarian behaviour, and poor communication skills.

The project uses a restraint-related patient safety initiative called 6CS-UK. The team will measure the harm caused by restraint, and other outcomes such as patient and staff relationships.

The project’s key components are:

  • training the trainers – developing an improvement toolkit
  • rolling out training across participating teams
  • improvement collaborative to support learning, sharing and adoption
  • evaluation.

6CS-UK is an adaptation of the Six Core Strategies (6CS) – an evidence-based patient safety programme used in the US to reduce seclusion and restraint in mental health settings by promoting therapeutic relationships.

Benefits

  • Reducing incidence of harm for service users and staff.
  • Involving service users in their own care.
  • Understanding methods for improving patient safety, which can be applied to other areas.