Aggression management in a children's hospital setting.

Area of Science:

• Healthcare Management
• Patient Safety
• Clinical Psychology

Background:

• Aggression in healthcare settings poses risks to staff and patients.
• Formalized systems are needed to manage aggressive incidents effectively.
• Children's hospitals require tailored approaches to aggression management.

Purpose of the Study:

• To detail the development, structure, and implementation of a formal aggression management system.
• To evaluate the utilization of this system during its first year of operation.
• To assess the impact of the aggression management team on staff safety and patient care.

Main Methods:

• Prospective audit conducted at a major children's hospital.
• Analysis of 14 months of utilization data, including prospective forms, security logs, and medical records.
• Rostered multidisciplinary team comprising emergency consultants, hospital administrators, and clinical staff.

Main Results:

• 104 incidents were managed by the aggression management team over 14 months.
• Incidents involved patients (75 cases) and visitors (29 cases), occurring equally on wards and in the emergency department.
• Patient aggression stemmed from mental disorders, frustration, or developmental disabilities; visitor aggression was mainly due to frustration or drugs. Interventions included verbal de-escalation, physical, and mechanical restraint, with documented injuries.

Conclusions:

• A formal aggression management team can be successfully established in a children's hospital.
• This team structure effectively addresses concerns regarding staff safety.
• The implemented system provides a valuable response for ensuring optimal patient care in aggressive situations.