Project Background


As part of a research project of student nurses and healthcare staff (nursing, radiography, theatre, phlebotomy, play specialists, neuro scientists, lecture practitioners, education/learning team and medical staff) were interviewed to identify what their teaching and learning needs are regarding the application of therapeutic holding techniques.

We know that healthcare staff, student nurses and parents:

  • Want to be shown how to hold the child effectively
  • Find it difficult to interpret existing photographs as guidelines or as posters.

We hope that you will find the 3D images a useful reference to aid learning, memory and retention of skill.


Within clinical practice it may be necessary in some circumstances to use physical or mechanical techniques (therapeutic holding, also known as clinical holding techniques) in order to help a child or young person stay still for a medical procedure or examination, keeping them safe and ensuring that they receive appropriate care. The context may be that the infant, toddler, child or young person lacks capacity and the ability to understand and co-operate with the specific procedure or examination; this could be due to medical condition, medication, or because of their age.

Other context may be that the child or young person does not understand the need to remain still during the procedure or examination; the child or young person has involuntary movements or an inability to control their movement and needs help to remain still; the child or young person may have asked for help to remain still.

Project Funding

The Department of Health introduced a new structure for reviewing Health Service commissioned Health Care programmes during 2009. The process is called Education Commissioning for Quality (ECQ). At the time our local Strategic Health Authority indicated that HEIs achieving targets would be rewarded with a quality payment. Birmingham City University uniquely used some of this quality reward to fund projects in partnership with our placement provider partners. Partners were invited to bid for funding for projects which met the principles of ECQ. The proposed projects had to demonstrate how they were addressing aspects of the Faculty action plan; enhancing quality and the student experience of the programme before funding was agreed. Additionally funding was also preferentially directed towards those projects that indicated an Interprofessional slant. Funding was dependent on partners providing a report at the end of the project.

Dr Andrea Page, Associate Professor
PhD; MSc; PG Cert (Education); PG Cert (autism studies); RNLD; RT; SFHEA; SEDA Recognised Supervisor
Birmingham City University

Andrea is a module leader and lecturer on foundation nursing skills and issues relating to the care of people with a learning disability for level 4, 5 , 6 and 7 undergraduate students within the Faculty of Health, Education and Life sciences.

She works collaboratively with colleagues in the Faculty of Health, Education and Life sciences, Birmingham Women’s and Children’s Hospital, Studio 3 (which promote the ideals, philosophies and benefits of non-aversive behaviour management when working with people with challenging behaviours) and Posturalcare. CIC/Simple Stuff Works (a Community Interest Company working to protect pody shape for people with movement difficulties).

Andrea completed her academic studies part time studies to gain a PhD; her research looked at developing evidence based practice relating to holding children and young people for clinical procedures.

Nicola Vanes
EN(G), RGN (Adult), Prince 2 MSC (Dip) PGMCE
Senior Programme Partner Quality Improvement

Nicola has 36 years' experience working within clinical and corporate roles in adult, paediatric and community settings, across the Midlands.

She is passionate about the provision of safe, high-quality care.

Nicola is delighted to work in partnership with Birmingham City University on this project to improve patients experience, and staff delivery, using research-based techniques. She has previously published in Nursing Times and The Association of Anaesthetic Nurses Journal.

Her work around patients' privacy and dignity and design of new patients' DG suits covered by Local, National, and international press and nominated for a Nursing Times Award.

Nicola also works in partnership with local schools to support students wishing to commence a health-related profession and providing regular presentations to local secondary schools related to nursing and the wider NHS

Alison Warren
Master of Education (Candidate) PG Cert (HE)
RGN, RSCN, ENB 415/998, APLS, EPLS, PHPLS and GIC Instructor

Alison Warren joined Birmingham City University as a Senior Lecturer July 2019 following a career in nursing spanning 38 years. She has both Child and Adult nursing qualifications. Prior to joining BCU she was the Clinical Matron for Children and Young People's Services at The Royal Orthopaedic Hospital NHS Foundation Trust (ROHNHSFT). As well as management and leadership of Children's Services within the Trust Alison also participated in the more strategic elements of the NHS. During this role Alison was recruited as a Health Education England Education Fellow and worked alongside the Emergency Department (ED) staff in Lincolnshire, to promote the safe care of infants, children, and young people, following two ‘Inadequate’ Care Quality Commission (CQC) ratings. Her previous posts also include being a senior nurse at Birmingham Women's and Children's Hospital where she worked for 29 years. She has a clinical background in Paediatric Intensive Care, Neurosciences, Hepatology and Liver Transplantation, Resuscitation services and working within the Education and Learning team.

In 2014-15 Alison worked with a small project team for Health Education West Midlands on the “Every Student Counts” project and is a co-author of the “Mind the Gap - Exploring the needs of early career nurses and midwives in the workplace” report. She has also been involved in research into coma evaluation in children.

Alison is the founder member and Chair of the West Midlands Regional Preceptorship Group and has participated in the development of the new National Preceptorship Framework (2022). She is also the Chair of the Partners in Paediatrics (PiP) Senior Nurse Forum.

During her nursing career she has published a number of articles and contributed to a chapter in a book. She is also actively involved in the simulation agenda and was a Student Nursing Times Finalist for an online simulation model developed during the pandemic. Alison has actively been involved in Clinical Holding research and teaching innovation and has been a member of the collaborative project team since 2010.


  • Page, A., & McDonnell, A, A., (2015) Holding children and young people: identifying a theory practice gap British Journal of Nursing 24(8): 378-382
  • Page, A.; McDonnell, A, A.; Gayson, C.; Moss, F.; Mohammed, N.; Smith, C and Vanes, N., (2015) Clinical holding with children who display behaviours that challenge British Journal of Nursing 24(21):1004-1009
  • Page, A., (2015) Holding children and young people for clinical procedures: moving towards an evidence-based practice. PhD dissertation, Birmingham City University
  • Page, A., Warren, A., and Vanes, N., (2017) Clinical holding an evaluation of a website developed through a collaboration between Birmingham City University and Birmingham Children’s Hospital NHSFT Nursing Children and Young People, 29(2); 20-24
  • Page, A., Gayson, C., Vanes, N., Ashmore, P and McDonnell, A, A (2017) Determining the sensory needs of children with Hunter and Sanfilippo syndromes who need hospital treatment. Learning Disability Practice, 20(2); 17-21
  • Page, A., & Wakeman, M., (2017) Considerations nurses caring for people with a learning disability should think about when undertaking nursing observations - a framework. Learning Disability Practice
  • McDonnell, A, A., Milton, D., Page, A., Kendall, S., Johal, T, K., O’Connell, A (2018) The Low Arousal Approach: a Practitioners Guide Special Report September 2018, Sussex, Pavilion Publishing and Media ltd
  • Page, A., Elven, B., Seabra, S., Warren, A., McDonnell, A, A., Mortiboys, I, L. and Vanes, N., (2019) Holding children and young people for procedures: ethical guidance for children’ nurses working in the United Kingdom. 31(4);28-33

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