Angry Patient Case Study

Kelly et al. (2015) continued with the statement that staff who are insulted tend to be younger, less experienced or educated, provide more direct care and spend more time with patients, receive lower pay, and possess low levels of qualifications (Kelly et al., 2015). The most common injuries on psychiatric units are kicking, hitting, shoving, and beating (Occupational Safety and Health Administration, 2015). The most common health complaints reported by staff that were involved in a physical assault are headaches, muscle soreness, and headaches; other complaints that are more serious include dizziness, shortness of breath, and numbness and tingling of the extremities (Kelly et al., 2015). These aggressive behaviors of patients are preceded by many things. Patients may be upset about being admitted to the unit or feel as if their control has been taken away. Literature suggested that poor medication compliance, positive symptoms (such as command hallucinations), and substance misuse makes act of violence (Graham, 2012). Graham (2012) stated that it should not be assumed that there is a direct relationship between a specific disease (or symptoms) and acts of violence. The reason for patient violence is varying and sometimes unknown. It was reported

There is a copy of the document ‘The short-term management of disturbed/violent behaviour in psychiatric in-patient settings and emergency departments’ on Miplace. You need to write a summary of this in a booklet which covers four areas of dealing with violence in A&E:

A lot of aggression is created by anxiety, regularly in light of the fact that individuals feel powerless and out of control. Aggression here and there results from frustration. To overcome defusing aggression as a barrier of communication, health and social care expert ought to stay calm and breath typically at all times, this will demonstrate that they are not going to become aggressive. Another methodologies is, health and social care expert ought to utilize listening skills to demonstrate that they are using so as to consider the other individual important non-verbal aptitudes to convey regard. In particular, as a care worker they ought to dependably attempt to meet the other individual's self-regard needs, this is by attempting to make

In health and social care settings, aggression could often be the result of fear, frustration or stress; consequently resulting in barriers to effective communication. Therefore care practitioners should device strategies to overcome this barrier by dealing with aggressive behaviour appropriately. For example:

According to Purpora and Blegen, approximately 60% of actual errors in patient care result from poor and ineffective communication (para. 3). Horizontal violence causes a decrease in effective communication between caregivers which places the patient’s safety in jeopardy. Horizontal violence decreases staff morale which leaves room for error in the workplace (Longo & Smith, 2011).

In this task I will be describing how health and safety legislation, policies and procedures promotes the safety of individuals in a Hospital. Quality care is an important issue for both health care workers and their partners. Government continue to work on implementing staffing law that will upgrade the medical systems. Hospitals are required to provide security for patients and staff. Mechanical equipment, housekeeping, administrative and food staff play important roles in preventing all environmental hazards. Safety concerns surrounding these hazards include injury, illness, disease exposure, disaster

A practice that has been put in place is the use of call buttons that are installed and easily available for the staff to use when dealing with escalating patients. Within this Veterans Affairs Hospital, the inpatient geriatric unit has at least 2-3 cases of patient-on-patient assault each month. For those that are very aggressive, this is currently being addressed by the use of one-on-one staff and antipsychotic medications. Clinicians are expected to be able to assess whether intervention is needed to protect other patients and staff from patients’ violence, to assess when patients pose a sufficient level of risk, and to assess when patients who have been hospitalized can be safely discharged to the community. However, surveys of practitioners suggest that many receive little formal training in violence risk assessment. (McNeil, et al. 2009) The limitations of formal training in risk assessment for violence suggested by such surveys underscore the need for education in this topic, hence the relevance of this educational training. Nurses on the front lines of care are ill-prepared to deal with this, hence the need for training. (Peek-Asa, et al.

Patients that we received often wants to either harm themselves or others, and these patients are also considered violent which lead to the frequent use of restraints and seclusion. Using these methods represent a danger to not only staff but also for the patients. Many injuries occur during these confrontations. The need to minimize the use of restraints and seclusion on the unit is necessary for patients and staff safety.

Violence in health care is an intriguing subject. Understanding and coping with threatening and violent behavior in mental health settings can be challenging and is a necessary part of being a health care provider (Berring, Pedersen, & Buus, 2016). If the situation is not handled well, patient and staff injuries can occur. A well thought out de-escalation plan and having a process in place is valuable. Having a range of psychosocial interventions that are focused on redirecting patients can help calm them down. The important aspects of de-escalating are being familiar with the patient, understanding the situation, knowing yourself, and having the knowledge of how to communicate in such a situation. Unfortunately, there are not many studies that have explored how staff and patients experience de-escalation methods and further research is needed in this very relevant area of health care.

Horizontal violence is a hidden pattern of individual behavior in controlling other individual that risk health and safety (Hinchberger, 2009). According to Roche, Duffield and Catling-Paull, violence can be describe as emotional abuse, threat, or actual violence in any health care setting. Although the definition varies according to situations and practice settings, there is agreement that workplace violence has a negative impact on the health and wellbeing of nurses and the delivery of quality nursing care (Hinchberger, 2009). Violence mostly occur in any health care setting, However, it mostly occur in emergency department, waiting room, psychiatric ward and geriatric unit on which people involved psychological situations.

The intimidation factor claims that patients must subdue themselves the policies in place or face the consequences. Ruling the ward is the Big Nurse, who regulates any unacceptable behavior by reminding them to "... cooperate with the staff policy which is engineered for your cure, or you'll end up on that side"(19). This threatening tone reflect the trained, skilled, and constructed ideology the staff condones all patients to follow. By leaving out any specifc

Further, there are many aspects of improvement and quality care that go with safety. I will discuss with consumers and providers then analyze how to create safer and healthier environment work place. The clinic has different departments that provide various services, and culture of safety is crucial. For instance, in stand of employee reporting incident and wait for feedback as

Horizontal violence is not a topic that medical faculties discuss on a day-to-day basis, but it is an enormous problem within the health care system. In this research the author looks at bulling from a registered nurse (r.n.) aspect .The effects on patient centered care can be detrimental for patients and r.n.’s. The work place needs to be a safe place for not only the patients but also the employees. With the rise of new graduate nurses who are employed by the medical facilities, they too are starting to face horizontal violence within the first year on the job, which leads to retention of nurses in the medical field. Horizontal violence will continue to arise if nurses do not stand up to bullying and empower victims to speak up on

P: Timothy will learn and implement anger management skills that reduce irritability, anger, and aggressive behavior as evidenced by demonstrating appropriate behavior at home and school.

Taking its name from an aviation rule stating that pilots must refrain from distracting behavior during critical stages of flight, such as takeoff and landing, the healthcare “sterile cockpit” states that all non-essential activities and communication is to be ceased when preparing and administering medications. In one study, a pulmonary unit at an academic research hospital implemented the use of such signs. The results were a nearly 50% decrease in medication errors for that unit over the course of a year (Federwisch, Ramos, & Adams, 2014). This is a simple and low cost way to help decrease errors in medication distribution.