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The Resident-intruder Paradigm: A Standardized Test for Aggression, Violence and Social Stress
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Developing entrustable professional activities to enhance application of an aggression prevention protocol.

Tessa Maguire1, Georgina Willetts2, Brian McKenna3

  • 1Centre for Forensic Behavioural Science, Swinburne University of Technology, Australia; The Victorian Institute of Forensic Mental Health (Forensicare), Australia.

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Experts found Entrustable Professional Activities (EPAs) suitable for assessing aggression prevention interventions. This framework aids in reducing restrictive practices and promoting self-reflection in mental health nursing.

Keywords:
EntrustmentInterventionMental health nursingPsychiatric nursingRestrictive practicesRisk assessment

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Area of Science:

  • Forensic mental health nursing
  • Clinical assessment frameworks
  • Healthcare quality improvement

Background:

  • Reducing restrictive practices is a priority in inpatient mental health.
  • Competence frameworks have limitations for complex interventions like aggression prevention.
  • Entrustable Professional Activities (EPAs) offer a potential solution for assessing complex clinical skills.

Purpose of the Study:

  • To evaluate the suitability of EPAs for assessing the Aggression Prevention Protocol (APP).
  • To gather expert opinions on using EPAs in forensic mental health nursing.
  • To explore the utility of EPAs in structuring aggression prevention interventions.

Main Methods:

  • Focus groups conducted with 11 aggression prevention experts from Australia and New Zealand.
  • Thematic analysis, comparative analysis, and SWOT analysis were employed.
  • Expert feedback was collected on the application of EPAs within the APP.

Main Results:

  • Experts identified the need for frameworks like the APP to eliminate restrictive practices.
  • APP-EPAs present an opportunity to standardize best practices in aggression prevention.
  • Experts provided insights for enhancing EPAs before implementation, including 'who watches the watchers'.

Conclusions:

  • EPAs address a practice gap in aggression prevention.
  • EPAs provide a framework to reduce restrictive practices and promote self-reflection.
  • The study highlights EPAs' potential for guiding best practice and continuous improvement in mental health care.