The Hidden Risks of Physical Intervention in Healthcare

James Hourihan, Author

In as caring a profession as healthcare, our inherent actions are motivated by a desire to do no harm. Yet, sometimes we are faced with moments where physical intervention becomes a necessary measure to protect our patients and ourselves. While these interventions are taken with the best intentions, they carry potential risks that we must tenderly acknowledge and manage. This article explores the risks associated with physical interventions and offers guidance on minimising harm.

The Nature of Physical Interventions

Restrictive interventions are practices employed to manage vulnerable people who pose an immediate risk to themselves or others. They may range from something as simple as a supportive hand to more restrictive measures like holds or restraints. Healthcare providers must approach these interventions with a deep sense of responsibility and a clear understanding of their serious implications, the decision to use physical intervention is often fraught with urgency and complexity, underscoring the importance of comprehensive training and processes. 

Understanding the Risks

For the patient, the act of restraint may lead to physical injuries like bruises or fractures, particularly in those with existing vulnerabilities such as osteoporosis or cardiovascular issues. The psychological aftermath shouldn’t be overlooked: the experience can be traumatic for all involved, potentially leading to anxiety, distress, and in some cases, post-traumatic stress disorder. Interventions can sow lasting seeds of fear, anger, and mistrust in patients, potentially worsening mental health symptoms and damaging relationships.

Healthcare staff face a similar threat, with the possibility of being hurt in the process of applying an intervention. These interventions often leave healthcare providers grappling with feelings of guilt and anxiety over the necessity and appropriateness of their actions. The effects can extend beyond the immediate encounter, potentially altering the patient-carer dynamic and hindering ongoing communication.

Minimising the Risks

Minimising the risks associated with physical intervention involves a comprehensive approach that integrates organisational processes and policies, with effective communication channels. Policies should emphasise compassion over compulsion, fostering a culture where restrictive intervention is the exception, not the norm.

Establishing a clear set of operating procedures ensures that staff understand when and how to implement physical intervention as a last resort. This organisational clarity, supported by robust communication channels, allows for swift and effective coordination and support during high-pressure situations like restrictive interventions, reducing the likelihood of physical injury or psychological trauma.

Organisational commitment to continuous learning and development reinforces a culture of safety across the board. Routine positive behaviour management training equips healthcare professionals with the skills and self-confidence to recognise and respond to early signs of patient distress, defuse potential confrontations in their early stages, and apply de-escalation techniques as a last resort.

Additionally, fostering an environment of open communication where staff can freely report and discuss instances of physical intervention promotes transparency and shared learning, which contributes to systemic improvements. By discussing these incidents freely, carers can better understand patterns and triggers, leading to tailored adjustments in the day-to-day care of individuals.

The Role of Communication

Skilled communication can de-escalate tense situations at their root, reinforcing a culture of safety and respect over restraint. In essence, good communication reinforces a more harmonious care setting, minimising the circumstances where physical intervention might otherwise be considered necessary. Looking behind the behaviour, listening, and establishing empathetic dialogue can often prevent and avoid escalating situations.

An investment in communication can equip us to navigate complex emotions, traumas, and behaviours with efficiency and care. Through clear and calm communication, patients have permission to feel understood and valued, reducing symptoms of anxiety and aggression.

It also enables carers to assess the situation more accurately, respond to cues, and tailor their approach to individual patient needs, fostering a trusting and person-centred environment. We’ve recently published an article discussing the importance of empathic communication in healthcare, to read more visit here.

Alternatives to Restrictive Intervention

The decision to use physical intervention is fraught with urgency and complexity, and rarely taken lightly. Recognising and mitigating the risks involved is not just a professional obligation; it is a moral one. We must continue to educate ourselves, refine our approach, and above all, maintain our dedication to the compassion that defines our work.

By embracing empathy, strengthening our relationships, and exploring alternatives, we can ensure that our care environments are places of safety and trust. Thankfully, the toolbox is rich with alternatives to restrictive intervention. Our Timian Physical Intervention Training is designed for staff to safely and confidently support people in crisis and promote positive behaviour.

At Timian, our comprehensive training is designed for staff to safely and confidently support people in crisis and promote positive behaviour. Our approach provides a deeper understanding of trauma informed behaviour, teaching how to promote positive behaviour within your organisation, alongside developing individual support strategies. For more information, please fill out our enquiry form here and we will be in touch.

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