Meeting needs and reducing distress is the title of recently-released guidance for the prevention and management of clinically related challenging behaviour in NHS hospitals.
It’s from NHS Protect which incorporates some functions of the former NHS Security Management Service (NHS SMS). It covers how to prevent and manage challenging behaviour related to a patient’s clinical condition. A related website also covers physical intervention (which includes assessing mental capacity according to the Mental Capacity Act 2005), training and information sharing.
The guidance is for the use of clinical and non-clinical NHS staff and managers. As the NHS security body says, clinically related challenging behaviour by patients and service users makes it difficult for staff to deliver good care safely. It can range from mildly uncooperative to highly disruptive and potentially dangerous behaviours. Such behaviour is often related to a clinical condition or treatment and is a sign of distress and unmet needs rather than any intent.
The guidance was developed by an expert group of doctors, nurses and training and security specialists, led by NHS Protect. Security people included Adrian Clarkson – Area Security Management Specialist, South West, NHS Protect; Bill Fox of trainers Maybo; Peter Lester, Trust Security Advisor, Cambridge University Hospitals NHS Foundation Trust; and Simon Whitehorn, Security Operations Manager, Brighton and Sussex University Hospitals NHS Trust.
For the 78-page guidance in full visit – http://www.reducingdistress.co.uk/reducingdistress/wp-content/uploads/2013/12/Meeting_needs_and_reducing_distress.pdf
It is supported and endorsed by organisations, including NHS England and the Royal College of Nursing. Their aim is to help staff prevent and manage clinically related challenging behaviour by minimising a patient’s distress, meeting their needs and delivering personalised care, safe for staff, patients and visitors. It underscores the importance of staff employing good communication skills and being compassionate to build trust with patients and service users and better understand what leads to distress.
Practical strategies are provided for staff to dynamically assess the situation when things go wrong, minimise the risks and respond to an individual’s anxiety and distress calmly, by non-confrontation and de-escalation.
The guide authors add that senior managers have a key role to play in making available sufficient resources to support a culture which puts the patient first. In particular, staff should have access to bespoke training to ensure their own safety and that of the people they care for. The guidance provides examples of how challenging behaviour awareness training can be incorporated in existing conflict resolution training or dementia or learning disability awareness training.
The full package includes:
Guidance document – outlining practical approaches for clinical and non-clinical staff and organisational responsibilities to deliver high quality, personalised care that meets all the needs of patients and minimises their distress.
Dedicated website – single point of access to the guidance, as well as case studies, learning outcomes, clinical guidelines, tools and templates available at www.nhsprotect.nhs.uk/reducingdistress
Scenario-based videos – outlining prevention and management strategies that can be incorporated into staff inductions and challenging behaviour awareness training or used as a separate learning resource for staff.
Andrew Masterman, Policy Lead, Violence Strategy, at NHS Protect, one of the expert group behind the guidance, said: “The aim of this important new guidance is to assist staff in preventing clinically related challenging behaviour by anticipating an individual’s needs, reducing their distress and delivering the highest quality care. It provides a practical approach on how to prevent challenging behaviour and where it occurs to manage it safely. It also provides staff with a consistent approach, so that anyone can adopt it in any NHS setting. That is its real strength.”
And Dr Mike Durkin, Director of Patient Safety, NHS England said: “The challenge of keeping patients safe at times when they are outwardly exhibiting challenging behaviour has been increasingly recognised over the last few years. “Meeting needs and reducing distress” provides a welcome focus on an area of healthcare that can cause high levels of anxiety for patients, their families and healthcare professionals.
“This is part of a wide and far-reaching programme of work being developed on the avoidance and safe management of restraint, to ensure every step is taken to keep risk to a minimum and that safety is paramount.”
More endorsements from stakeholder organisations are available at www.nhsprotect.nhs.uk/reducingdistress/background/endorsements
