[The latest best practice guidelines relating to seclusion and restraint]. / Les dernières recommandations de bonnes pratiques sur l'isolement et la contention.

Several measures relating to seclusion and restraint are included in the French public health code. The best practice guidelines of the French National Health Authority, published in 2017, define these two notions and advise on the behaviour to adopt with regard to their implementation and monitoring. Likewise, informing and supporting the patient when these measures are lifted are critical moments which the teams must also be able to manage correctly.

['Zero isolation', a care practice oriented towards recovery]. / "Zéro isolement", une pratique de soins orientée vers le rétablissement.

Some institutions do not have an isolation room. Agitation is managed otherwise, with the idea that restraint or isolation can only be a terrible experience. The care pathway is therefore designed to favour autonomy and to limit restrictions of freedom. In this context, professionals are in constant contact with the user. Example of a unit which advocates this concept of rehabilitation.

British Association of Critical Care Nurses position statement on the use of restraint in adult critical care units.

Critical care nurses in the United Kingdom have become increasingly concerned about the use, potential abuse and risks associated with physical restraint of patients. Restraint in critical care is not only confined to physical restraint but can also encompass chemical and psychological methods. There are concerns regarding the legal and ethical issues relating to the (ab)use of physical restraint techniques in critical care. The aim of this article was to present the British Association of Critical Care Nurses (BACCN) position statement on the use of restraint in adult critical care units and to provide supporting evidence to assist clinical staff in managing this process.

Natural therapeutic holding: a non-aversive alternative to the use of control and restraint in the management of violence for people with learning disabilities.

For at least the last 10 years, control and restraint (C&R) has gained increased popularity amongst nurses as a safe, professional and legal means to manage violence in health care settings. However, during this period there has been an increased momentum to find non-aversive management strategies for people with learning disabilities and there has been frequent debate on the abolition of practices which do not achieve this. More recently, the main criticisms of C&R have been the professional and ethical objections that the techniques used inflict some degree of pain or discomfort to the client, and the fact that it remains a reactive strategy with no theoretical framework for professional practice. On this basis, alternatives should be sought which seek to address these issues. This paper outlines the development of natural therapeutic holding, an approach which is non-aversive and which provides a theoretical structure for professionals to base their practice on in order to develop clear therapeutic goals for the client. Initial findings within a small community residential service for people with learning disabilities indicate that natural therapeutic holding was a preferred method of intervention strategy by staff, proving as effective as C&R in the management of violent incidents, with interventions being much shorter in duration and non-aversive in nature.

Uses of and alternatives to restraints in pediatric settings.

Restraints are a common component of pediatric nursing practice that currently have no empirical base. This article provides background information concerning the use of restraints with the pediatric population, the impact these devices have on children, and the possible alternatives that have been identified. It is hoped that by providing acute care nurses with recommendations concerning changes in this area of practice, the care that children receive in the inpatient setting may be improved.