Violence Prevention Act, De-Escalation Resources

March 7, 2019

MEMORANDUM

Violence Prevention Act, De-Escalation Resources

Enhancing workplace safety has taken on increasing significance with recent, high-profile attacks involving frontline hospital employees. As a reminder, PA 100-1051, that went into effect earlier this year, amended the Nurse Practice Act, the Hospital Licensing Act and other statutes to address workplace violence through mandatory prevention training, required signage and whistleblower protections to safeguard nurses from retaliatory actions. Additionally, the legislation adds provisions to the Unified Code of Corrections mandating provider notice and protections when committed persons are transferred to facilities for medical care and treatment.

To assist hospitals with their implementation efforts, IHA is providing a list of resources recently published by the Joint Commission. Resources include an advisory that summarizes several de-escalation models and provides guidance and resources for managing aggressive or agitated patients in the emergency department (ED) and inpatient settings.

The advisory (click here) recommends the following actions for healthcare organizations:

  • Committing resources and time for senior management to educate staff on de-escalation and to ensure time is provided to audit interventions and environmental changes necessary to create the most therapeutic unit possible;
  • Using audits to inform practice;
  • Implementing workforce training on new techniques and interventions;
  • Incorporating use of assessment tools;
  • Involving patients; and
  • Implementing debriefing techniques.

There are a number of assessment tools available to help healthcare professionals recognize an aggressive patient, including:

  • Staring, Tone and volume of voice, Anxiety, Mumbling, and Pacing (STAMP) is a validated tool for use in the ED.
  • Overt Aggression Scale (OAS) is a reliable tool for use in the inpatient setting for children and adults.
  • Broset Violence Checklist (BVC) has been validated for use in the adult inpatient psychiatric unit.
  • Brief Rating of Aggression by Children and Adolescents (BRACHA) has been found to be a valid tool for use in the ED to determine the best placement on an inpatient psychiatric unit.

Positive consequences of de-escalation include:

  • Preventing violent behavior;
  • Avoiding the use of restraint;
  • Reducing patient anger and frustration;
  • Maintaining the safety of staff and patients;
  • Improving staff-patient connections;
  • Enabling patients to manage their own emotions and to regain personal control; and
  • Helping patients to develop feelings of hope, security and self-acceptance.

If you have questions, please contact Keneatha Johnson.