What Is Physical Intervention? A Complete Carer Guide.

Physical Intervention

Working in healthcare brings rewards but also challenges. Patients sometimes act aggressively or display behaviour that risks their own safety or that of others nearby. In these scenarios, staff may feel physical intervention is necessary to prevent harm.

However, manual restraint often escalates crises and inflicts trauma. This article explores evidence-based techniques to defuse tensions without force, upholding dignity and human rights.

What we covered

• What is Physical Intervention?
• What is Physical Intervention training?
• What Does UK Law Say About Physical Intervention?
• What Are Specific Needs of Physical Intervention?
• What are the main types of physical intervention techniques?
• What are risk factor that increase likelihood of physical intervention?
• Physical Intervention training best practices
• Step to follow during and after physical restraint
• Alternatives to minimise need for physical intervention
• Frequently Asked Question on Physical Intervention

What Is Physical Intervention?

Physical intervention means any direct physical contact a staff member makes with a patient to restrict or control their movement.

This includes manual restraint like holding someone by the arms or shoulders, dragging them away from danger, pinning them to the floor, or forcing injection of medications.

It also includes use of wrist or ankle cuffs and clothing that constricts free movement. Any action that interferes with a person’s ability to move of their own free will qualifies as physical intervention.

What is Physical Intervention Training?

Physical Intervention Training is a specialised course that equips individuals with the skills to safely manage and de-escalate challenging or potentially violent situations using physical techniques, ensuring the safety of all involved parties.

The keyword here is safely managing the situation by applying applying best method to difficult situations using physical methods, with a focus on ensuring safety for everyone involved.

This type of training is often provided to professionals in various fields, including healthcare, security, law enforcement, and social services, who may encounter situations where physical intervention is required to ensure safety and prevent harm.

You can book a group training on physical intervention training here.

Here are the main physical intervention training types:

1. Breakaway Techniques: These teach you how to safely break away from someone’s grasp or control without causing harm.
2. Restraint Techniques: These focus on restraining a person’s movements when it’s necessary for safety, using minimal force.
3. De-escalation Techniques: You’ll learn how to calm down tense situations and prevent them from escalating into physical confrontations.
4. Self-Defence Techniques: These methods help you protect yourself if there’s no other option, emphasizing non-aggressive responses.
5. Control and Hold Techniques: You’ll learn to safely control a person’s movements without causing injury, useful in situations requiring restraint.
6. Conflict Resolution: This involves communication skills to peacefully resolve conflicts and avoid physical intervention.

What Does UK Law Say About Physical Intervention?

Laws like the Mental Health Act 1983, Mental Capacity Act 2005, Human Rights Act 1998, and relevant NICE guidelines aim to protect patient rights and restrict use of force. Key principles include:

– Force should only be used as an absolute last resort when risks are grave and imminent. All other options must be attempted first.

– Any force applied must be reasonable and proportionate to the risks involved, using minimum strength for the shortest time.

– Intervention should never be used to inflict pain, punishment or force compliance.

– Patients should give informed consent when possible. If they lack mental capacity, decisions must follow best interest principles.

– Manual restraint procedures should be officially documented, time-limited, and subject to rigorous oversight.

Staff have a legal duty of care but physical force often violates patient rights. Organisations must provide proper training in de-escalation approaches to avoid the need for restraint altogether.

We provide meticulously tailored Breakaway Training to effectively address the unique challenges faced by individuals in your care and nursing homes. To explore our expert guidance and discover customised solutions, reach out to our course advisors at enquiries@caringforcare.co.uk or give us a call at 01782 563333.

What Are Specific Risks of Physical Intervention?

While intended to ensure safety, physical restraints pose many risks including:

1.    Injury and Distress 

Restraint use can result in bruises, cuts, broken bones, and other injuries as patients resist or staff handle them forcefully. There is also immense psychological trauma and re-triggering of past abuse when physically forced against one’s will. These effects create lasting damage.

2.    Loss of Trust

Relationships and treatment progress get severely impacted when patients feel violated or neglected. Force destroys therapeutic alliances needed for care.

3.    Deprivation of Rights

Manual restraint contradicts basic human rights principles like autonomy, dignity, and freedom from harm that organisations must uphold.

4.    Legal Problems

Injuries or unneeded use of force make facilities liable to lawsuits or sanctions for violating laws and patient protections.

What are the main types of physical intervention techniques?

Physical intervention encompasses actions that employ physical contact to curtail an individual’s freedom of movement. It is a measure of last resort, used to prevent harm to individuals or others.

It involves both restrictive, non-restrictive, and hybrid techniques. Caution must be exercised to ensure safety and respect for the individual’s rights.

Restrictive Physical Intervention Techniques (Exercise Caution):

Physical Restraint Techniques:

1. Prone Restraint: Restraining an individual face-down on the ground. This technique is considered risky and controversial and should be used with extreme caution and only when absolutely necessary.
2. Supine Restraint: Restraining an individual face-up. Like prone restraint, it is considered high-risk and should be used sparingly, if at all.
3. Lateral Restraint: Restraining an individual on their side. This is considered a less risky alternative to prone or supine restraint.
4. Two-Person Holds: In some situations, two trained staff members may work together to control an individual safely. Examples include:
   • Two-Person Supine Control Hold: Restraining an individual face-up with two staff members.
   • Two-Person Prone Control Hold: Restraining an individual face-down with two staff members.
5. Manual or Physical Restraint Devices: These are specialized devices designed to limit an individual’s ability to move. They should be used with caution and as a last resort.
   • Limb Restraints: Used to immobilize arms or legs.
   • Belts and Body Restraints: Used to limit overall body movement.
   • Blanket Wraps: Used to immobilize the entire body by wrapping the individual in a blanket.
6. Seclusion Rooms: A designated room or area where an individual can be placed temporarily to prevent harm to themselves or others. Use the room with caution, and ensure that you comply with safety guidelines when using it.

Non-Restrictive Physical Intervention Techniques (Can Be Used with Caution):

De-Escalation Techniques: While not physical interventions in the traditional sense, these techniques aim to verbally and behaviorally de-escalate a situation. They can be used with caution and are generally considered safer alternatives to physical restraint.

1. Active Listening: Giving the individual your full attention and showing empathy.
2. Verbal Communication: Using calm and non-confrontational language.
3. Distraction Techniques: Redirecting the individual’s attention away from the source of distress.
4. Time-Outs: Allowing the individual a brief break from the situation to regain control.
5. Medication: In some cases, prescribed medication may be used to manage extreme agitation, aggression, or psychotic symptoms. This should be administered by a qualified healthcare professional.

Hybrid Physical Intervention Techniques (Use with Caution):

Physical Prompts and Guidance: Used primarily in educational or therapeutic settings, these techniques involve gently guiding an individual’s movements or providing physical prompts to help them complete a task. They can be used with caution and should prioritize the individual’s safety and comfort.

Preventative Physical Intervention Techniques (Use with Caution):

Emergency Physical Intervention Plans: Professionals develop these individualized plans for specific individuals who may require physical intervention in emergencies.

The plans outline the least restrictive methods for intervention and specify when and how you should use physical intervention.

You should use these plans with caution and only when necessary to prevent harm to the individual or others.

We provide meticulously tailored Breakaway Training to effectively address the unique challenges faced by individuals in your care and nursing homes. To explore our expert guidance and discover customised solutions, reach out to our course advisors at enquiries@caringforcare.co.uk or give us a call at 01782 563333.

What Are Risk Factors That Increase Likelihood of Physical Intervention?

Certain factors correlate with higher use of restraint on vulnerable individuals:

– Staff shortages increase caregiver stress and limit time for de-escalation.

– Lack of staff training in non-physical crisis response methods.

– Poor ward design with limited personal space.

– Underlying medical issues like dementia or mental illness.

– Communication barriers impeding needs being met.

– Disruption from changes like construction or staff turnover.

– Previous trauma leading to aggressive responses when feeling threatened.

Organisations must examine their own practices to address potential risks and replace force with care.

Physical Intervention Training Best Practices 

While training to use physical restraint could seem to promote its practice, proper education focuses on holistic prevention. Effective programs teach:

– Legal, ethical and human rights concerns regarding use of force.

– Risks and potential harm associated with physical intervention.

– Verbal and non-physical de-escalation strategies. 

– Avoiding manual restraint except as an absolute last resort.

– Using least restrictive options to minimize harm when needed.

– Meeting patient needs holistically to preempt crises.

– Tracking data to monitor and reduce use of restraint.

With emphasis on restraint as a never first option, training promotes a culture of care over control.

Alternatives to Minimise Need for Physical Intervention

Before considering restraint, organisations and staff must first exhaust all evidence-based options:

1.    Understand Triggers

Look beyond behaviour to identify unmet needs like pain, hunger, distress over changes, lack of control, miscommunication and more. Address the causes, not just the symptoms.

2.    Communicate with Compassion

Practice active listening, ask open questions, reflect feelings, and validate emotions without judgement. Ensure directions are given simply, slowly and patiently. Kindness calms distress. 

3.    Provide Physical & Emotional Space

Offer options to walk, move freely, spend time alone and disengage from stressors or overstimulation. Distance and autonomy restore a sense of control.

4.    Employ De-escalation Techniques

Strategies like distraction, humour, validation, relating, flexibility, compromise, praise, or suggestions of alternatives redirect behaviour. Defuse anger and confusion before it intensifies.

5.    Individualise Responses

Note successful techniques in care plans. Identify motivators, triggers, abilities and background to customise support. Universal approaches rarely work. Know each person at their level.

6.    Review Medications

Assess side effects that may increase agitation like pain or confusion. Adjust dosages timing and combinations carefully in collaboration with the care team and patient consent.

7.    Make the Environment Safe

Remove nearby objects that could cause injury. Use minimal, non-restrictive safety measures like cushioning or sensor mats. Ensure adequate lighting, space and familiar surroundings to prevent disorientation.

8.    Adjust Communication Methods

Use drawings, gestures, boards and other adaptive ways to connect with those unable to speak or understand traditionally. Identify nonverbal cues and preferred options.

When healthcare providers make physically restraining patients the exception rather than the norm, they protect their rights and wellbeing. But organisations must devote resources and training to make this culture shift possible.

Key Steps to Follow During and After Physical Restraint

In crisis scenarios, staff should remember: 

1.    Exhaust all alternatives first

Only utilise physical intervention when risks are immediate and grave with no other options. Start with de-escalation and addressing unmet needs.

2.    Use least restrictive means briefly

If you absolutely need to use restraint, you should choose the least intrusive technique, such as guiding, to apply minimal force for the shortest time until you resolve the risk.

3.    Avoid pain or punishment

Restraint should never be used to cause pain or penalise behaviour. The motive must be preventing harm, not enforcing compliance.

4.    Ensure safety 

Frequently reassess patient condition including circulation, breathing, distress levels and immediate needs like medication or bathroom. Discontinue at the first safe chance. Monitor for injury after.

5.    Debrief respectfully 

Discuss the incident, offer genuine apology, validate feelings, explain necessity, thank them for trying alternatives, and clarify how to prevent recurrence. Reaffirm dignity.

6.    Follow reporting procedures

Promptly complete required documentation like incident reports detailing justification, duration, observations and follow up plans to address gaps. Ensure oversight.

With commitment to care and accountability, physical intervention becomes obsolete, replaced by understanding, empathy and prevention. When organisations value patience over power, helping hands replace hands of force. And when care guides over control, trust endures.

Why Choose Breakaway Training Over Other Options?

In the realm of physical intervention and training, making the right choice is paramount. When it comes to ensuring the safety, well-being, and dignity of residents in care and nursing homes, Breakaway Training stands out as the preferred option.

Unlike generic physical intervention courses, Breakaway Training from Caring for Care offers meticulously tailored solutions that empower your staff with effective techniques.

Our training prioritizes safety, compliance with UK regulations, and is adaptable to your unique care environment. Elevate your care standards by choosing Breakaway Training from Caring for Care – where safety meets compassion through our personalised approach.

Please do not hesitate to get in touch with our dedicated team to discuss the unique challenges faced by individuals within your organisation.

By understanding your specific needs, we can craft a Breakaway Training programme tailored precisely to address these situations effectively and safely.

Your safety and the well-being of those under your care are our top priorities, and our commitment to providing personalised solutions ensures that you receive the training that best suits your circumstances. You can reach out to our course advisors at enquiries@caringforcare.co.uk or call us at 01782 563333 to get started.

Frequently Asked Questions

Below are answers to some common queries about physical intervention:

Why does intervention sometimes increase after training?

After learning techniques, staff may rely on them before trying alternatives. But quality training stresses it as a last resort. Culture change takes time but data should show reduction.

What determines use of force was justified?

You only need to justify the use of restraints in documented high-risk imminent situations like significant self-harm or harm to others that you could not prevent by any other safe means in that moment. You do not need to routinely justify restraint use.

How long can manual restraint be applied?

No legal limit but restraint should be brief as possible – just long enough to mitigate immediate danger, usually minutes. Prolonged restraint increases severe harm risk.

What role can families play?

They can share insights on patient triggers, de-escalation approaches, culture, past trauma, and ways to rebuild trust after incidents. Including families reduces use of force.

When should you involve the police?

As an absolute last option if all other attempts fail and waiting poses risks of death or destruction that staff are unqualified to handle. Most situations can resolve without law enforcement.

What reduces need for restraint facility-wide? 

Leadership commitment to culture change, investing in staff training, adequate staffing ratios, reduced stimulatory environments, rigorous data monitoring, and transparency around use of force.

What replaces restraint?

Prevention through addressing unmet needs, therapeutic communication, de-escalation techniques, tailored support, calming spaces, sensory tools, flexibility and unconditional positive regard. Physical restraint, even when legally defensible, inflicts lasting damage.

But when healthcare centres value patience over power, empathy over enforcement, prevention over reaction, possibility over protocol, and care over control, mechanical bonds transform into human bonds. With compassion, crises give way to healing.

Change requires commitment but is possible when we recognise force fractures trust – and true safety