It is always better to avoid using a restrictive skill; however, care employees often face a dilemma of deciding whether to provide care against resistance, or delay care and risk being deemed neglectful.
When care employees have identified that they need to perform an essential care “now’, they are taught to follow the Essential Care Holding Timeline, a sequence of 10 steps that provides structure for a best practice response.
The first step is to identify if the care need is essential “now” using the Essential Care Box tool.They will gauge the level of resistance using the Pressure Gauge tool. They will use the Look, Listen and Test sequence to establish if they can gain cooperation of if there is a level of resistance. Training strongly advocates the need for three attempts to avoid using 3 attempts to try and avoid using a restrictive hold.
Note: If your organisation is inspected by CQC or receives NHS funding, and you use Clinical Holding or any form of restrictive practice, then you then you will need to consider the implications of the Restraint Reduction Network Training Standard. See link.
Examples of Clinical Holding:
- Administration of medications
- Intravenous access
- Recording of vital signs
- Wound care
If you have a Clinical Holding need please call and discuss it with one of our team.