Course Content

• Influences on PMVA
• Current Guidance and Legalisation
• What is self-defence?
• Hierarchy of Responses
• De-escalation
• Principles of Observation & Communication
• Legal & Ethical Issues
• Risks in Restraint
• Blood-born infections
• Substance Misuse and Associated Behaviours
• Positional Asphyxiation
• Excited Delirium
• Compartment Syndrome
• Sickle cell anaemia
• Best Practice Guidance
• Health & Safety Act 1974
• The Mental Capacity Act 2005
• The Mental Health Act 1983 (Amended 2007)
• Deprivation of Liberty Safeguards
• Cheshire West Supreme Court Ruling
• Human Rights Act 1998
• What is torture?
• What is inhumane treatment?
• What is SIRI?
• What is Post Incident Review?
• Review Stages
• Post Incident Support
• Staff Perception
• Impact of Violence and Aggression
• Interventions in Dementia Settings
• Interventions in Children's Services
• Interventions in Secure Services
• Interventions in Acquired Brain Injury Services
• Interventions with Personality Disorder Patients
• Interventions with Eating Disorder Patients
• Trauma in Mental Healthcare
• Mental Health First Aid Model
• Consequences of non-compliance
• References
• Case Studies
• Current Issues related to PMVA in the Media
• Video

Learning Outcomes

By the end of the course, participants will be able to:

• Identify possible causes of violence and aggression in mental healthcare settings
• Recognise the importance of implementation of early intervention strategies in reducing the occurrence of violence and aggression
• Demonstrate the ability to communicate effectively with colleagues and patients
• Identify legal and ethical implications of utilising physical intervention strategies
• Demonstrate the ability to select and utilise appropriate physical and non-physical strategies to manage an aggressive individual
• Understand the need to continually assess and evaluate the levels of risk posed by difficult and challenging individuals.
• Demonstrate how to escape safely from a variety of grabs and holds
• Candidates will be able to define the role of NHS Protect, LSMS, and SMD.
• Be able to give explanations for aggression – particularly in MH/LD settings
• Know the stages of the assault cycle, and what each stage means
• Be able to identify signs of escalation of aggression
• Understand Strategies to de-escalate
• Understand the legal issues around reasonable force in line with MHA, MCA and best practice guidance
• The importance of conducting post incident reviews
• The negative impact to staff and organisations of non-compliance to the completion of post-incident review.
• The essential elements of conducting a post incident review.
• How staff and patients can be psychologically affected by incidents.
• Good and bad practice in post-incident review.

Assessment

• Group Participation - Physical and Theoretical
• Scenario Based Candidate Assessment
• Teamwork Physical Intervention Skills
• Safety Stance
• Fighting Arc

Standing and Relocation Holds

• Non-contact Guiding
• Stage 1
• Stage 2
• Stage 3
• Figure of Four
• Thumb in Palm
• Finger & Thumb
• Seated De-escalation
• Rationale
• Purpose
• Environment
• Approach
• Trouble Drills

Re-location to the Floor Supine

• Relocation to the floor and back to standing.
• Upper rest positions and reinforced holds
• Securing the legs
• Lost Holds
• De-Escalation

Relocation to the floor prone Last Result or Patient led

• Principles and Current guidance relating to prone restraint
• Relocation to the floor and back to standing
• Lower rest positions and reinforced holds
• Safe/secure holds for medication administration.
• Securing the legs
• Lost Holds
• De-Escalation
• Stop and Rest
• Modified Recovery
• Turning Patients:
  • Prone to Supine
  • Supine to Prone
• Doorways
• Stairs

Relief/Changing Options

• Floor
• Seated
• Standing

Seclusion Techniques

• Floor Option – Exiting via the head
• Exiting from the side
• Kneeling Option
• Human Factors