Increased Feelings Of Safety Research Articles

Screening and Intervention to Prevent Violence Against Health Professionals from Hospitalized Patients: A Pilot Study

Health care providers, particularly nursing staff, are at risk of physical or emotional abuse from patients. This abuse has been associated with increased use of physical and pharmacological restraints on patients, poor patient outcomes, high staff turnover, and reduced job satisfaction. In this study, a multidisciplinary team at Tufts Medical Center implemented the Brøset Violence Checklist (BVC), a screening tool administered by nurses to identify patients displaying agitated behavior. Patients who scored high on the BVC received a psychiatry consultation, followed by assessments and recommendations. This tool was implemented in an inpatient medical setting in conjunction with a one-hour de-escalation training led by nursing and Public Safety. The intervention design was executed through a series of three distinct Plan-Do-Study-Act cycles. This study measured the number of BVCs completed and their scores, the number of psychiatric consults placed, the number of calls to Public Safety, the number of staff assaults, nursing restraint use, and staff satisfaction. During the study period, restraint use decreased 17.6% from baseline mean and calls to Public Safety decreased 60.0% from baseline mean. In the staff survey, nursing staff reported feeling safer at work and feeling better equipped to care for agitated patients. The BVC is an effective, low-cost tool to proactively identify patients displaying agitated or aggressive behavior. Simple algorithms for next steps in interventions and training help to mitigate risk and increase feelings of safety among staff. Regular psychiatric rounding and the identification of champions were key components in a successful implementation.

A Communication Complex Approach to Autism Awareness Training Within First Response Systems in Indiana

Providing Autism and communication training to facilitate better interactions in emergency situations between first responders and individuals with Autism is a critical need. Although trainings exist for first responders, “typical training already being provided on the job is not sufficient” (IBCCES). In addition, while resources—such as YouTube videos—are available, the process for viewing, discussing, and debriefing over the material along with the development of more effective conversational practices is an unexplored space. This case study describes the use of the Communication Complex (CC) perspective for training Volunteer Firefighters in Indiana, emphasizing the development of knowledge and skills necessary for effectively managing this often challenging context. It extends the body of CC research that relates to first responders and other health care providers. An elaboration of the theoretical framing is provided, followed by a brief introduction to Autism and a discussion of safety concerns in the community. Finally, a detailed analysis of the case study is presented. Reports from the participants indicate that Autism awareness training through a CC approach can enable more desirable interaction patterns in emergency situations involving first responders and those with Autism. The findings suggest that the CC approach is effective for enhancing understanding, which can positively impact future scenarios involving individuals with Autism and their families and increase feelings of safety.

Evaluation of the Positive Behavioural Support (PBS) model with female forensic inpatients

BackgroundThe Positive Behaviour Support (PBS) is a multidimensional framework which aims to increase understanding of the function of a person’s behaviour. PBS consequently helps to develop effective support strategies (Allen et al., 2012; Carr et al., 1999). The PBS model was introduced in a low secure mental health hospital for females in order to maximise the support offered, increase feelings of safety, and reduce secondary gains from enhanced observations.MethodStaff views on the implementation and effectiveness of the PBS model were evaluated using qualitative and quantitative analysis. The evaluation was based upon responses from 20 participants, who were regular Care Assistants and Nurses working on admission wards within the aforementioned clinical setting. Semi-structured interviews and short questionnaires were completed anonymously by participants.ResultsOverall, staff reported that the PBS model had a positive impact on the day-to-day running of the wards. The PBS model was identified as an effective tool to address challenging behaviour. Staff reported that PBS is a useful approach when working with patients with learning disabilities and personality disorders.ConclusionIt has been suggested that further training and development of PBS strategies (e.g. functional analysis) would be beneficial.