Reduction on physical restraint for patients with challenging behaviours in Siu Lam Hospital

Abstract Description

Authors (including presenting author) :

N/A

Affiliation :

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Introduction :

1. Community Services and Health Industries Skills Council (2015) Positive behaviour support: Facilitator guide, Australia. http://www.cshisc.com.au/media/141601/CHC08 Disability Behaviour Support Facilitator Guide.pdf 2. HA Guidelines on Use of Physical Restraint 2016 3. SLH Guidelines on Physical Restraint & Seclusion 2018 4. CPH Guidelines on Physical Restraint & Seclusion 2018 5. SLH Guideline on Protective Apparel 2018

Objectives :

1. To reduce and minimize the use of physical restraint to manage patients with challenging behaviours in Siu Lam Hospital 2. To employ least restrcitive measures in intervention process 3. To encourage the engagement of meaningful activities/ training for the patients

Methodology :

1. Enhancement of daytime activities & training - increase training sessions in Severe Intellectual Disabilities of Activity Centre of Excellence, Occupational Therapy Department & Physiotherapy Department 2. Medication adjustment 3. Use of least restrictive device - adopt appropriate protective apparel provided by Occupational Therapy Department 4. Implement "Positive Behaviour Support" (PBS) for designated patients with intellectual disability and challenging behaviours 5. Enhancement of staff training - equip the necessary communication skill and BPS training 6. Modification of ward environment - re-arrange bed assignment of the target patients for easy observation and management

Result & Outcome :

1. Total restraint hours decreased from 152 hours to 68 hours or by 55% 2. Number of patients with standing physical restreaint order reduced from 20 to 6 or by 70% 1. Monthly reporting on restraint statistical figures 2. Monitor, analyze and evaluate the trend of physical restraint 3. Recommend and monitor least restrictive measures in a multi-disciplinary approach