Shared learning database

Type and Title of Submission


Improving managing violence training - combining managing violence and life support


Combining Managing Violence and Life Support training has created a safer response to violence by highlighting the importance of life support during restraint. Including the service user's views into the training has increased the staff understanding of the impact of restraint on the individual. We emphasise the importance of early intervention to prevent violence.



Does the submission relate to the general implementation of all NICE guidance?


Does the submission relate to the implementation of a specific piece of NICE guidance?


Full title of NICE guidance:

CG25 - Violence: The short-term management of disturbed/violent behaviour in in-patient psychiatric settings and emergency departments

Category(s) that most closely reflects the nature of the submission:

Training format

Is the submission industry-sponsored in any way?


Description of submission


We wanted to create a managing violence and life support course which would emphasise the importance of physical monitoring and life support during and after restraint and/or rapid tranquilisation. We also felt that the views of the service user, particularly concerning the impact of restraint, were important.


1. Incorporate life support and physical monitoring into the managing violence training to create a holistic approach to restraint. 2. Include the service user viewpoint to improve staff awareness 3. Highlight the dangers of restraint to encourage earlier intervention, and include the need for life support in some of the scenarios used for training.


The trust has had separate managing violence training and life support training programs for a number of years. Each one mentioning the importance of the other. However, being taught in isolation, the instructors felt that the staff were not fully appreciating the importance of physical monitoring, and possible life support, during restraint and rapid tranquilisation. Also, the viewpoint of the service user was not included within the training, and so the staff were not considering the impact of the restraint on the service user. With the David Bennett enquiry, and the release of CG25, the instructors felt that these created a good opportunity to examine the training program and see if improvements could be made.


1. A 5 day course was created which incorporates life support and managing violence. The combination has allowed the use of scenario's to include the collapsed patient as well as the normal restraint. The course is open to all levels of staff within the in-patient area. 2. We have a small number of service users who attend on day two of the course and present their views and lead a discussion on the impact of restraint on the service user. This is being well received by the staff, with positive feedback. 3. By combining the life support and managing violence, the staff are made aware of the importance of physical observations during and after restraint and rapid tranquilisation. They benefit from the combined approach, especially the combined scenarios during which patient collapses and requires life support.

Results and evaluation

Each course has an evaluation form for attendees to complete. Violent incidents and medical emergencies are monitored. However, it is too soon to see if this training will have any impact on these statistics.

Key learning points

Life support training must be included within managing violence training. Using scenarios which include physical monitoring and collapse are very useful. The service user viewpoint positively affects the staff.

View the supporting material

Contact Details

Name:Nicola Woodhall
Job Title:Resuscitation Officer
Organisation:Rotherham Doncaster and South Humber Mental Health NHS Foundation Trust
Address:St Catherine's, Tickhill Road
County:South Yorkshire
Postcode:DN4 8QN
Phone:01302 796911
Fax:01302 798343


NICE handles personal information provided to the Institute in accordance with the Data Protection Act 1998. Find further details in our data protection policy.

This page was last updated: 29 September 2008

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.

Selected, reliable information for health and social care in one place

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.