Staff injuries as a result of physical interventions in forensic learning disabilities services analysed


Earlier this week we have looked at the reports into the Winterbourne View scandal, which identified some appalling practice by staff at the home.

Today, we are looking at some research that focuses on the potential for injury of staff who are involved in physical interventions.

Physical interventions are defined as responses to challenging behaviour involving some degree of direct physical force to limit or restrict movement or mobility. They are still widely used in services that support people with learning disabilities and challenging behaviour (see posting June 19). We have posted before about the impact of their use on people with disabilitles, but the researchers in this study were interested to explore the impact on staff, and in particular on staff injury.

The researchers were looking in particular at staff injuries that occurred in a forensic learning disability hospital that arose directly from incidents that involved physical intervention with service users.

To look at this, they went through patient records for a period of nine months, to identify and review all incidents in which staff reported injuries.

They found that the Injury rates for staff were consistently higher than those for service users over the period. The reports showed that most staff injuries were happening as a result of an assault on staff by the service user.

They found that injury occurred just before physical intervention was used in 36.3% of incidents and during the process of carrying out the intervention for 47.6%.  For the remaining incidents, injuries occurred as a result of accidents during the physical intervention (16.1%) or as a result of a re-escalation of aggression (3.2%)

However, they found that a very small number (4.8%) of staff injuries were reported as serious. Where there were serious injuries reported, they occurred as a result of staff being kicked by service users.

They suggest that their findings highlight points at which staff injuries may occur during physical interventions and that that this information could be used to support the development of training aimed at reducing the rate and seriousness of staff injury.

Staff injury arising from the use of physical intervention, Johnson P, in Journal of Learning Disabilities and Offending Behaviour, 3 ,1, 35–43

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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