Policies and guidelines
As discussed previously in this resource, there's a wide range of policies and guidelines that have a direct bearing on managing challenging behaviour. Here are some that are relevant to the scenarios we've presented to you.
Select each to learn a little more about how they might relate to managing challenging behaviour.
Care Pathways for Autism
Evidence-based statements on diagnosing and managing autism spectrum disorder (ASD) in adults and on the delivery of quality improvements in care for children, young people and adults with autism
Challenging behaviour and Learning Disabilities
Evidence-based recommendations on prevention and interventions for people with learning disabilities whose behaviour challenges. It advocates using Positive Behavioural Support (PBS) and does not advocate the use of restraint.
Clinical Record Keeping
Comprehensive and accurate clinical record is mandatory for all client interactions undertaken by healthcare professionals. This BASRAT guideline delineates the expectations of a Sport Rehabilitator. Guidance for other professions is included in the resources page.
When faced with challenging situations in practice, it is important to take time to reflect, and receive support where needed. One way to do this is via clinical supervision which can give an opportunity to discuss sometimes difficult circumstances, receive advice, and ultimately improve patient care.
Good communication is an essential aspect of avoiding and managing challenging behaviour.
Dealing with complaints
Patients Association Good practice standards for NHS ... 7 Good practice standards for handling NHS complaints 1.7 Where the complainant is communicating through a third party (e.g. an independent advocacy service provider
NICE guidelines cover the prevention, diagnosis and management of delirium. Delirium increases agitation, can cause delusions and hallucinations and may be a cause of violence and aggression.
These detail guidance on lone working and the Midwifery guidance on making unaccompanied visits in the final year of a midwifery programme. They also include a comprehensive risk assessment form.
This report looks at the evidence base of antipsychotic prescribing and recommends reducing the use of antipsychotic drugs for people with dementia and that non-pharmacological treatment of behaviour disorders in dementia should be used before using antipsychotic drugs.
"I am concerned about failing – I don't want to have to repeat the placement"
It is understandable that students fear failing their clinical placement. If you are finding the placement difficult, the clinical and academic staff will work closely with you to set an improvement action plan. Don't let the stress of anticipated failing sabotage your thinking. Take each challenge at a time and listen to understand constructive criticism…..rather than hearing it as personal criticism
Patient experience in adult NHS services
Patient experience in adult NHS services Quality standard Published: 17 February 2012 nice.org.uk/guidance/qs15 © NICE 2012. All rights reserved.
There are various initiatives examining reducing restrictive or coercive practices in care settings, and research summaries that highlight principles relevant to areas like Mental Health. There is furthermore ongoing reviews relating to mental capacity law, also relevant to restrictive practices
- Department of Health: Positive and Proactive Care: reducing the need for restrictive interventions
- The Eileen Skellern Lecture 2014: physical restraint: in defence of the indefensible?
- HOUSE OF LORDS Select Committee on the Mental Capacity Act 2005: post-legislative scrutiny
- Restraint Reduction Network Website