Restrictive practices in health care
Restrictive practices are potentially harmful non-therapeutic interventions, and their use can be avoided by positive changes to the provision of assessment, treatment, care and support.
The use of restrictive practices must therefore be a last resort, and only used after alternative strategies have failed or there is imminent or actual health or safety risk. In these situations workers with expertise will apply and monitor, and support recovery afterwards, in order to reduce harm.
A flowchart (PDF 85KB) will assist clinicians to minimise the use of restrictive practices.
SA Health Resources
Minimising Restrictive Practice Policy Framework
SA Health has developed a policy directive (PDF 555KB) which outlines the requirements to act in:
- minimising or eliminating where possible, the use of restrictive practice
- practicing safely and lawfully if restraint or seclusion are applied during a period of health care.
Minimising Restrictive Practice Toolkit
Tool 1 - What are restrictive practices, and what types are there?
What are restrictive practices, and what types are there? (PDF 107KB) provides assistance for clinical staff in deciding whether their actions constitute a restrictive practice.
Tool 2 - Reporting and review of incidents – restrictive practices
Reporting and review of incidents – restrictive practices (PDF 108KB) provides an overview of the requirements for reporting and review of incidents where restrictive practices have been used.
Tool 3 - Clinical strategies to minimise the use of restrictive practices
Clinical strategies to minimise the use of restrictive practices (PDF 111KB) is a summary of restraint minimisation strategies and a list of current guidance, for reference by clinicians and clinical educators.
Tool 4 - Safe application of restrictive practices, and recovery
Safe application of restrictive practices, and recovery (PDF 115KB) outlines actions, strategies and considerations to achieve the safest possible outcome for all people, if restraint or seclusion are applied.
Tool 5 - Legal information about restrictive practices
Legal information about restrictive practices (PDF 110KB) provides additional information for clinicians and managers about legal requirements and the guidance that is provided in relevant Acts.
5.35 Where restraint is clinically necessary to prevent harm, the health service organisation has systems that:
- minimise and, where possible, eliminate the use of restraint
- govern the use of restraint in accordance with legislation
- report use of restraint to the governing body
5.36 Where seclusion is clinically necessary to prevent harm and is permitted under legislation, the health service organisation has systems that:
- minimise and, where possible, eliminate the use of seclusion
- govern the use of seclusion in accordance with legislation
- report use of seclusion to the governing body
The SA Health Accreditation Resource Standard 5: Comprehensive Care identifies the resources that are available to support each action.
Education and training
Introduction to minimising restrictive practice (eLearning)
This eLearning course is for all SA Health employees who may be required to apply restrictive practices. See the eLearning fact sheet (PDF 121KB) for information.
The course will take approximately 90 minutes to complete.
Access to the course is through the Safety and Quality section of the SA Health intranet.
Safety and Quality Unit
Telephone: (08) 8226 9599