There is no standard definition of physical restraint. While it is difficult to address the myriad of dangerous situations and behaviors that confront residential group care residents and workers, a clear definition of physical restraint is necessary. An emergency situation must be defined to ensure not only the physical safety of the patient but the physical safety of others. Education and training The standard should go beyond requiring ongoing education and training for all staff who have direct patient contact to stipulate that the staff receive education and training prior to any direct contact with patients. In addition, the staff should receive annual, if not more frequent, training in the areas of behavior management, de-escalation, and the use of seclusion and restraints.
Many issues concerning effective and safe behavioral interventions remain unclear.
There is a critical need for the development of standards related to the quality, quantity, and frequency of orientation and training of those staff responsible for the implementation of behavioral intervention concepts and techniques. The lives of vulnerable children, youths and families are too important to entrust to the hands of people who, while usually well-intended, are also unskilled. The direct care worker is an important, and perhaps for many children the most important, person in changing their lives. The development of high professional standards, along with a system for imparting these standards and skills, guaranteeing consistency in qualifications, and evaluating the results, is long overdue. The Child Welfare League of America looks forward to working with the Department of Health and Human Services and others toward these critical goals.