Shared learning database

Rotherham Doncaster and South Humber Mental Health NHS Foundation Trust
Published date:
September 2008

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.

This example was originally submitted to demonstrate implementation of NICE CG25. It has been reviewed by the team and continues to align with the updated guideline NG10.

Does the example relate to a general implementation of all NICE guidance?
Does the example relate to a specific implementation of a specific piece of NICE guidance?


Aims and objectives

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.

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

Reasons for implementing your project

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 the NICE guideline, the instructors felt that these created a good opportunity to examine the training program and see if improvements could be made.

How did you implement the project

  • 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.
  • 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.
  • 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.

Key findings

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.

Contact details

Nicola Woodhall
Resuscitation Officer
Rotherham Doncaster and South Humber Mental Health NHS Foundation Trust

Primary care
Is the example industry-sponsored in any way?