One to One Nursing

---

It should be recognised that all behaviour has a meaning and often the behaviour can be interpreted as communicating a need or a feeling.

Behaviour may indicate several things, for example:

• Being in pain
• Being afraid
• Feeling lost
• Being overwhelmed by noise or activity on the ward
• Not having enough activity to stimulate
• Trying to express a need ie. hunger, thirst, the need to use the bathroom
• Effects of medication
• Trying to find someone or something familiar

The use of restrictions or restraints can take away a person's freedom and so deprive them of their liberty. These include:

• The use of some medication, for example, to calm a person
• One to one supervision
• Physically stopping a person from doing something which could cause them or others harm
• Removing items from a person which could cause them harm
• Holding a person so that they can be given care, support or treatment
• Bedrails or wheelchair straps

If a patient has been identified as high risk using the Risk Assessment tool, staff can consider the use of assistive technology such as;

• Pressure and pad alarm sensors
• Electronic location devices

Assistive technology where available for use, should only be used in a therapeutic manner in extraordinary circumstances in order to maintain patient safety and promote safer wandering. Where possible, that patient's consent must be sought for the use of these devices. If a person lacks capacity to make a decision, the practitioner must take into account the views of anyone named by the person as someone to be consulted in caring for the person.

In extreme cases, it may be appropriate for a patient to have additional staffing to keep them safe. In order for this decision to be made, a One to One Supervision Risk Assessment and Decision Record should be completed and reviewed daily (currently being developed).