Clinical holding with children who display behaviours that challenge

Abstract

Nurses hold children to administer treatment, prevent treatment interference and undertake clinical assessments, which can sometimes be invasive, as part of their regular duties. Clinical holding ensures this treatment or assessment is carried out safely, however, it has been reported that there is little training available in this area. This article explores the prevalent clinical holding techniques used by nursing staff when caring for children with behaviours that challenge. As an initial insight into what the researchers hope will become a more in-depth 2-year study, this investigation looks to explore current practice when holding children and the factors influencing this. It is hoped that this will inform the development of a training package offered to nurses when caring for these children. Thirteen semi-structured interviews took place with a small group of nurses, which were given thematic analysis. The overarching themes influencing holding practice were the nursing role itself along with intrinsic and external factors.

Specialist hospital treatment and care as reported by children with intellectual disabilities and a cleft lip and/or palate, their parents and healthcare professionals

“…Using physical restraint to anaesthetize older children with intellectual disabilities was alarming and contrasts with the apparent non‐holding approach taken with their neurotypical peers. Page et al () questioned whether restraining older children is appropriate or even safe to use. Available literature suggests restraint is reserved for young children and that occurrence largely decreases with age (Bray, Snodin, & Carter, ).…”

Determining the sensory needs of children with Hunter and Sanfilippo syndromes who need hospital treatment

“…Behaviours of concern may prove difficult for nurses to manage a child's quality of care and the intensity of such behaviours can put parents, carers and nurses at risk of injury (Page and McDonnell, 2013;Chan et al, 2011;McDonnell, 2010). Many children diagnosed with life limiting conditions may display behaviours of concern when receiving medical care from healthcare professionals (Page et al, 2015).…”

“…In supporting clinical research the NIHR/CRF aims to improve clinical care and the lives of children, young people and their families. Many of the children and young people undertaking such clinical research are doing so because they have a life limiting medical condition which often includes conditions and syndromes which gives rise to conditions and syndromes which challenge healthcare practitioners when they are administering medical care (Page et al, 2015). Some of the children and young people visiting the NIHR/CRF have disabilities and traits of autism as part of their condition, for example those with Hunters Syndrome or Sanfilipo Syndrome.…”