在精神病急诊室的一个病房里,隔离率和工作场所暴力
Joshua D Moran Jimenez1, Christa Walden2, Alexa Carey3
1Joshua D. Moran Jimenez, DNP, PMHNP-BC, CPHQ, CPAHA, CARN, NE-BC, Medical University of South Carolina, Charleston, SC, USA.
概括
在精神病急诊室实施暴力风险协议显著降低了隔离率和工作场所暴力事件. 这种方法通过早期识别风险和个性化降级策略来提高患者安全和员工福祉.
科学领域:
- 医疗保健管理的管理
- 患者安全 患者安全
- 精神病学护理 精神病学护理
背景情况:
- 工作场所暴力和高隔离率是精神病急诊室 (ED) 的重要问题.
- 精神科ED病房的预防干预隔离率为5.57/1,000个患者护理小时,远远超过州 (0.26) 和全国 (0.35) 的平均水平.
- 现有的隔离率需要进行干预,以提高安全性并减少患者的克制.
研究的目的:
- 通过新的暴力风险识别和管理协议,降低隔离率.
- 通过主动管理患者的攻击性来提高精神病诊所的安全性.
- 通过有针对性的干预措施,建立一个可接受的隔离率的基准.
主要方法:
- 实施使用暴力评估工具 (VAT) 的暴力风险协议.
- 强制性员工培训关于增值税和隔离报告程序.
- 在从精神科ED到住院病房的患者移交过程中沟通增值税组件.
主要成果:
- 工作场所暴力报告在精神科ED下降了25%,在成人住院病房下降了17%.
- 在成年精神病医院住院病人的单位观察到,隔离率累计下降了5%.
- 该协议证明了对减少不良事件和隔离的可测量影响.
结论:
- 早期识别暴力风险因素和患者特定的降级偏好可以提高安全性.
- 暴力评估工具 (VAT) 显示了减少孤立和工作场所暴力的潜力.
- 建议进一步研究患者对增值税的看法,以优化其作为以患者为中心的工具的使用.
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