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Practical experiences of forward thinking in restraint as a consultant

Dr Arokia Antonysamy Consultant Psychiatrist at Oxleas NHS Foundation Trust takes part in a panel session on the National Objective to end on Prone/face down Restraint in the NHS a year on and implementing the 2015 NICE Guidance in Practice at today's Prone/Face Down Restraint conference.

Dr Arokia Antonysamy’s presentation discusses the practical experiences of forward thinking in restraint as a consultant. 

Dr Arokia Antonysamy's full presentation is available for download at the end of this page.

Dr Arokia Antonysamy's presentation covered 

How restraint has reduced by more than 50%.  Treat patients with respect and dignity, hope and optimism.  Reduce stigma of PICU.  Take accountability for actions – review film of incidents from CCTV as in hindsight/calm you learn so much about any problems with techniques being used.  Must have excellent standards.

Average length of stay, seclusions, staff sickness – all reduced by introducing better practice on the ward.

Process more important in some ways than outcomes – patient and carer involvement, staff empowerment, positive risk taking (this is unusual in NHS), support people to better manage their own care.

MaZon recovery tool – categorizes patients into red/amber/green, this is a tool developed by Dr Samy with the patients to help with recovery.  Radical thinking – leave activites for patients, e.g. gardening, cookery, golf, zoo trip.  Feedback from patients was amazing, positive.  Boredom (and smoking ban!) is commonest cause of aggression – kill the boredom, no aggression!  Interaction with animals also had fascinating positive effects.

Building a ‘Tree of Hope’ where every time a service user leaves the ward they leave a message of hope for new users coming in, on a ‘leaf’ on the tree, which is a big wall display in the ward.

Published findings in BMJ Quality Improvement report 13th May 2013.

Forthcoming events of interest:

Improving Mental Health Crisis Care
Thursday 15 October 2015
Hallam Conference Centre, London
Positive and Proactive Care Meeting the New National Guidance on Reducing Seclusion
Tuesday 20 October 2015
Hallam Conference Centre, London
Smoking Cessation in Mental Health
Tuesday 20 October 2015
Hallam Conference Centre, London
Masterclass: Deprivation of Liberty Safeguards
Friday 13 November 2015
Hallam Conference Centre, London
Safe Staffing for Nursing in Mental Health Inpatient Units
Monday 16 November 2015
Hallam Conference Centre, London

Download: an-end-to-restraint-dr-samy_1174.pdf

22 September 2015


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