1. New Zealand Standard Health and Disability Services (Restraint Minimisation and Safe Practice) Standards Foreward –Least restrictive environment Legal and Ethical Considerations –Beneficence –Non-maleficence –Avoiding harm to self and others –Respecting dignity and human rights –Promote the interests, safety and well-being of all involved –Should not be used for punitive reasons 1

2. New Zealand Standard Restraint is the implementation of any forcible control by a service provider that: –limits the action of a consumer in circumstance which the consumer is at risk of injury or injuring another person –the intentional removal of their right to freedom 2

3. New Zealand Standard Categories of Restraint –Personal Restraint – service providers physically holding a consumer to prevent them harming themselves or others –Physical Restraint – the use of equipment and furniture to limit actions or normal rights to freedom of a consumer –Environmental Restraint – this can range from a contained environment to planned interventions that reduce level of social contacts and/or environmental stimulation –Enablers – the voluntary use of equipment to assist in maintaining independence 3

4. New Zealand Standard Restraint Minimisation and Safe Practice –Used only after less restrictive interventions have been attempted –Proactive approaches should be used at all times –When reactive, de-escalation techniques should be used first 4

5. New Zealand Standard Policy and procedures should ensure adequate and appropriate : –Observation –Care –Dignity –Respect –On-going assessment In order to minimise the risk of harm to consumers – frequency and level of observation should be appropriate to level of risk 5

6. New Zealand Standard Outcomes –Consumers receive and experience services in the least restrictive manner Standard 1 – Services demonstrate that the use of restraint is actively minimised –Consumers receive services in a safe manner Standard 2.1 - Services maintain a process for determining approval of all types of restraint used, restraint processes, duration of restraint, and on- going education on restraint use and this process us made known to service providers and others 6

7. New Zealand Standard –Consumers receive services in a safe manner Standard 2.2 – Services shall ensure rigorous assessment of consumers is undertaken, where indicated, in relation to use of restraint Standard 2.3 – Services use restraint safely –Minimum time –Last resort –Documentation 7

8. New Zealand Standard –Guidance »New Staff receive training before using restraints »Use of effective de-briefing strategies following a restraint episode Standard 2.4 – Services evaluate all episodes of restraint Standard 2.5 – Services demonstrate the monitoring and quality review of their use of restraint 8