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代码降级:在社区医院急诊室的激动管理过程中减少克制的使用

Dana D Im¹, Alice K Bukhman¹, Josh W Joseph¹

¹Department of Emergency Medicine, Brigham and Women's Faulkner Hospital, Boston, MA, 1153 Centre Street, Boston, MA 02130, USA; Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 75 Francis Street, NH-2, Boston, MA 02115, USA.

The American journal of emergency medicine

|December 13, 2023

概括

代码降级,一种以团队为基础的方法,在精神病患者的急诊室 (ED) 显著减少了身体克制的使用. 这种标准化的方法也帮助管理威胁行为,提高了患者和工作人员的安全.

科学领域:

紧急医疗紧急医疗
精神病学是一个精神病学.
医疗保健管理的管理

背景情况:

在急诊室 (ED) 中使用身体束对患者和医护人员构成重大风险.
对精神病患者威胁行为进行有效的管理策略对于ED安全至关重要.

研究的目的:

评估代码降级的有效性,一个标准化的,以团队为基础的方法,在减少身体克制的使用.
评估代码降级对社区ED环境中的工作场所暴力的影响.
为了比较干预之前和之后的限制使用率,以及与邻近的医院相比.

主要方法:

追溯性观察性研究分析了非自愿精神病关押患者的身体克制使用情况.
途径实施包括系统评估患者和工作人员所感知的威胁.
通过比较10个月的干预前后期间的克制使用率和工作场所暴力率来衡量结果.

主要成果:

观察到身体克制使用的显著下降,从7.4%降至3.7% (ARR为0.028,p<0.05).
限制使用的减少是干预地点的特点,而不是在对照医院观察到的.
该研究包括434次干预前和535次干预后的ED遭遇,涉及精神病患者.

结论:

一个标准化的降级算法,如代码降级,有效地减少了身体限制的使用.
这种方法有助于在ED环境中管理激动的精神病患者.
实施可以带来更好的安全性和减少与限制使用相关的不良事件.

关键词:

剧烈的激动是急性激动.煽动管理煽动管理身体上的克制.限制束器的使用方法工作场所暴力工作场所暴力

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