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PARIHS: Restraint Intervention in Health & Social Care

Promoting Action on Research Implementation in Health Services (PARIHS) is one concept of health & social care (HSC) that is highly regarded methodological model. Various changes to United Kingdom (UK) legislation, regulations and, the recent catalogue of abuse cases and negligence, where restraint intervention (RI) has been used; it is inevitable that such practices are measured, in practice and policy. Therefore, strong and coherent research by practitioners inform ‘good practice’ which is a necessary process, and one that is collaborative, to ensure best practice.

The reasoning for a process of decision making for RI, is predominately based loosely on a scenario of ‘what evidence is deemed necessary’ to enable the use of restraint in challenging behaviours, for the good of the service user. The recent spate in poor judgement in RI practices that have lead regulators to ensure strong and robust procedures is ambiguous. Those that are, engaged daily in frontline evidence base practice (EBP), will always seek more precise evidence from numerous resources, before policy becomes procedure. Therefore, the research base is brimming over with evidence and case studies that add to the many theories that restraint is a method of control that ensures an optimum outcome for both the service user and the practitioner.

Health and social care takes place in numerous settings, and therefore, there cannot be a one model fits all strategy; although, a strategy needs to be fluid enough to designate the context for RI. Therefore, any research, planning and process, should be comprehensive, in each care assessment for RI. In doing so, the situation for RI, can be managed successfully and in keeping with the desired outcome for all involved.

Evidence informs practice, and practice informs research evidence; therefore, what is noted in recent reported events in the media, note that there is a complete ‘variance’ between the practices in care settings and in the level and means of service user welfare, dignity and safety; which has been a significant problem noted in many recent case studies. ‘PARIHS’, therefore, should require a strong basis for engaging practice, consequently, the need for, strong leadership, safe environment, linear collaborative culture and consistent evaluation, to be a successfully and inform practice.

–  Stephen Cunningham-Collins (Tutor and IV at Oxford Learning College)