Event Title
Improving Nurse Safety in Behavioral Health Emergency Department
Faculty Mentor
Susan Marks
Major/Area of Research
FNP
Description
Mental health emergencies represent a growing number of emergency department visits. Emergency departments must safely manage patients with a variety of illnesses that are often accompanied by agitation or outbursts. As the volume of patients increased, the number of assaults on staff was rising.The design of the study was structured around changes that could be made to improve safety in the emergency department for staff as well as for patients and families by minimizing the frequency of assaults.The PDSA (plando- study-act) method was used to create the plan of action for change and determine the efficacy of the interventions. The data was tracked and placed into the equation used to determine if there was a decrease in the # of assaults ( # of assaults / patient visits x 1000). Many interventions were included in the original plan, from increasing staffing as well as improving the efficacy of the triage and workflow process. As this is a continuous process, new interventions are currently being added, which include better staff training, utilization of new acuity scale as well as utilizing resources available that can minimize anxiety in the emergency department.The study showed a decrease in nurse assaults by 80%. The pre-intervention assault rate was 0.44 and post-intervention was 0.05. This drastic change shows that the interventions are effective. The goal is to eliminate all assaults and therefore additional interventions are being added to the project.The study showed that minimizing assaults on staff has a direct correlation to the staffing present as well as the environment and workplace flow. Separating patients by acuity, as well as determining the risk for agitation/aggression early, can help the staff take appropriate actions to minimize the risk and ensure a safe environment. Ensuring the appropriate staff is available to care for patients at risk in a quick and efficient manner will decrease patient time in the emergency department, thereby reducing aggressive tendencies and anxiety. Having appropriately trained staff monitor the patients from the moment they enter the emergency department, and are flagged as a high risk patient, will allow for early interventions including verbal de-escalation, redirection and diversional activities to reduce the risk of escalating the patient to a point of violence.
Improving Nurse Safety in Behavioral Health Emergency Department
Mental health emergencies represent a growing number of emergency department visits. Emergency departments must safely manage patients with a variety of illnesses that are often accompanied by agitation or outbursts. As the volume of patients increased, the number of assaults on staff was rising.The design of the study was structured around changes that could be made to improve safety in the emergency department for staff as well as for patients and families by minimizing the frequency of assaults.The PDSA (plando- study-act) method was used to create the plan of action for change and determine the efficacy of the interventions. The data was tracked and placed into the equation used to determine if there was a decrease in the # of assaults ( # of assaults / patient visits x 1000). Many interventions were included in the original plan, from increasing staffing as well as improving the efficacy of the triage and workflow process. As this is a continuous process, new interventions are currently being added, which include better staff training, utilization of new acuity scale as well as utilizing resources available that can minimize anxiety in the emergency department.The study showed a decrease in nurse assaults by 80%. The pre-intervention assault rate was 0.44 and post-intervention was 0.05. This drastic change shows that the interventions are effective. The goal is to eliminate all assaults and therefore additional interventions are being added to the project.The study showed that minimizing assaults on staff has a direct correlation to the staffing present as well as the environment and workplace flow. Separating patients by acuity, as well as determining the risk for agitation/aggression early, can help the staff take appropriate actions to minimize the risk and ensure a safe environment. Ensuring the appropriate staff is available to care for patients at risk in a quick and efficient manner will decrease patient time in the emergency department, thereby reducing aggressive tendencies and anxiety. Having appropriately trained staff monitor the patients from the moment they enter the emergency department, and are flagged as a high risk patient, will allow for early interventions including verbal de-escalation, redirection and diversional activities to reduce the risk of escalating the patient to a point of violence.