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Practice Guidelines for the Assessment of Risk for Violent Behaviors during the Psychiatric Evaluation
Published in Kunsook S. Bernstein, Robert Kaplan, Psychiatric Mental Health Assessment and Diagnosis of Adults for Advanced Practice Mental Health Nurses, 2023
Kunsook S. Bernstein, Robert Kaplan
The initial psychiatric evaluation of a client includes assessing:Current and prior aggressive or psychotic ideas, including thoughts of physical or sexual aggression or homicide (e.g., command hallucinations).Past aggressive/violent behaviors (e.g., homicide, domestic or workplace violence, other physically or sexually aggressive threats or acts), as this is the most robust statistical indicator of further violence.Consequences of past aggressive behaviors leading to legal or disciplinary actions, psychiatric hospitalization, and/or ED visits.History of violent behaviors in biological relatives.Current or recent substance use disorder or change in use of alcohol or other substances.Presence of psychosocial stressors.Exposure to violence or aggressive behavior, including combat exposure or childhood abuse.Past or current neurological or neurocognitive disorders or symptoms.
Self-Care, Including the History of the Nurses' Code
Published in Gia Merlo, Kathy Berra, Lifestyle Nursing, 2023
Elizabeth Simkus, Deborah Chielli, Gia Merlo
Institutions could utilize survey tools to help identify potential burnout. One such tool is the Professional Quality of Life (ProQOL). This is a tool that measures both compassion satisfaction stemming from the positive feelings associated with providing care and compassion fatigue (CF) stemming from the negative feelings. CF results from burnout and secondary traumatic stress (Steinheiser, 2021). Tools such as this would allow institutions to monitor the level of CF and put in place interventions to help counteract it and thus hopefully retain their nursing staff. HNHN (2020) recommends supervisors and employers offer mental health screening, evidence-based programs for prevention and alleviation of anxiety and depression, mental health and resilience interventions, and caregiver response teams with emotional first-aid providers. They should also celebrate victories and appreciate nurses. Policies and procedures are needed to reduce the risk for occupational health hazards, workplace violence, bullying, and incivility. Nurses’ health and well-being make an impact on the quality, cost, and safety of the care provided (NASEM, 2021). System-level supports were created out of the identified need to address clinician well-being and prevent burnout. Self-care and system-level programs can assist in building resilience, processing grief, managing stress, and retaining the nursing workforce.
Preventing and Managing Patient-Initiated Violence
Published in Leanne Rowe, Michael Kidd, Every Doctor, 2018
Patient-initiated violence is increasingly common in medical practice and is a reflection of increasing community violence. While zero tolerance is a superficially attractive proposition, most doctors find it ineffective in practice as it usually only deflects violent behaviour onto other colleagues or to the wider community. Patients who display violent behaviours usually have an underlying disorder which requires assertive clinical management. Unfortunately, medical workplace violence is often tolerated because of duty of care issues, and tends to be underreported to the police.
Caring Knowledge as a Strategy to Mitigate Violence against Nurses: A Discussion Paper
Published in Issues in Mental Health Nursing, 2023
Sara Brune, Laura Killam, Pilar Camargo-Plazas
Physical consequences of workplace violence incidents against nurses range from minor consequences such as bites, scrapes, scratches, and bruises to more serious injuries that can result in permanent disability, life threating injuries, and even death (Alameddine et al., 2011; Hahn et al., 2012; Ünsal et al., 2013). Up to 60% of violent incidents against healthcare workers require medical treatment (Gates et al., 2006; Hahn et al., 2012) with 4.5% of these workers receiving life-threatening injuries (Erkol et al., 2007). In terms of psychological impacts, post-traumatic stress disorder (PTSD) is perhaps the most prevalent psychological outcome from workplace violence with 32% of victims meeting the diagnostic criteria for PTSD (Gates et al., 2011; Richter & Berger, 2006). Other mental health disturbances attributed to exposure to workplace violence include sleep disturbances, anxiety, depressive symptoms, hypervigilance in the workplace, and burnout (Alameddine et al., 2011; Mckenna et al., 2003; Talas et al., 2011; Ünsal et al., 2013). A recent survey of nearly 3000 nurses in British Columbia reported that even indirect exposure to workplace violence results in psychological disturbances for nursing staff; 17.3% of nurses who experienced only indirect violence met the criteria for PTSD (Havaei, 2021).
Nurses and midwives reporting of workplace violence and aggression: an integrative review
Published in Contemporary Nurse, 2022
Vanessa Tyler, Christina Aggar, Sandra Grace, Frances Doran
Workplace violence and aggression includes physical, verbal, sexual, and economic forms of aggression and can range from intimidation and armed threats to personal and property (Hyland et al., 2016; Kvas & Seljak, 2014; Pekurinen et al., 2019). Verbal and physical aggression are the most common forms of violence and aggression reported in hospital inpatient settings (Liu et al., 2019). Physical abuse can include slapping, kicking, hitting, using fists as weapons, throwing equipment, retrieving syringes and needles from the sharps bins to use as threats or weapons (Partridge & Affleck, 2017). Verbal abuse encompasses threats of violence, harsh tone of voice, insulting language and harassment (Hyland et al., 2016; Liu et al., 2019; Partridge & Affleck, 2017). Verbal abuse also includes hostility, gendered themes, and sexual overtones (Liu et al., 2019).
Examining physical therapists’ training and intervention needs around workplace violence
Published in International Journal of Healthcare Management, 2019
Juliya Golubovich, Stanton Mak, Chu-Hsiang (Daisy) Chang
Thematically, recommendations could be grouped as touching on organizational support, strategies/skills/attitudes, or coping with incidents that have happened. For at least half of the PTs, recommendations pertained to avoiding or diffusing incidents, the need for training or educational opportunities, desire for organizational support in the form of programs, policies, and personnel, and practical and emotional support from coworkers. Although we tried to identify distinct themes in participants’ responses, there is naturally some overlap and interdependence between them. For example, some ideas that were mentioned as strategies to avoid incidents (e.g. taking a team-based approach to treatment) requires coworker support (a separate theme) and strategies for diffusing incidents can be taught during training (also a separate theme). The variety of themes that emerged, and the interconnections between them, help to highlight the fact that there is more to prevention of workplace violence than just training; employees must also have adequate administrative and environmental support [27].