A report on how to manage aggression and violence within inpatient services by using the safeward model to decrease the use of containment and restraint Evidenced based practice (EBP) has become a dominant approach in healthcare, providing a framework for professionals to apply their art in a systematic fashion (Golec, 2009). EBP is supported by a clear, up to date rationale which takes into account the patients preferences and using clinical judgements. The NMC (2015) dictate that professionals should work to an evidence based approach, but there is also a moral necessity, as healthcare practitioners are accountable for the care they deliver and must be able to safeguard patients from harm and minimise risk by doing so (Ross, 2012). Structures of evidence have been established to grade evidence according to its methodological quality of their design, validity, and applicability to patient care. This hierarchy of evidence is …show more content…
Evidence papers were evaluated by using the CASP tool, which systematically evaluates clinical research papers (Stevens, …show more content…
A study was conducted using semi-structured interviews to gain the views from service users and staff on a male unit. The unit was chosen at random, however this was limited as there are only 3 high secure units within England. The aim of the research was to compare attitudes between nursing staff and patients surrounding violence and aggression, and to utilise the results to develop future training for staff. The findings of the study demonstrated that because this patient group have tendencies to express themselves through aggression, it is imperative that patient’s voices are heard in a respectful manner (Wright et al.,
Evidence based practice, “involves integrating the best available research evidence with professional expertise while also taking account of patient preferences the patients state setting and circumstance and health care resources” (Gerrish, K. Lathlean, J, 2015). As the health care profession constantly changes, then it is vital that all evidence based practice is kept up to date with current information and research, relating to nursing practice. Always assuring that the patients need are taken into consideration (Sackett et al, 1996).
Evaluating the eight papers for quality evidence was critical when selecting the two papers to utilise. The evidence hierarchy was considered, aiming to use the highest evidence possible, such as systematic reviews and meta-analyses; and randomized, controlled, double-blind studies, to ensure the most accurate evidence informed the clinical decision for the patient (Bloom, Olinzock, Radjenoic & Trice, 2013). When sorting the results, other various factors were also taken into consideration; credibility, reputability, reasonability and support. With these factors taken into account, the two papers selected are highly esteemed in regards to evidence, and are most relevant to the patient (Stichler, 2010).
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:
Evidence-based practice is an approach used by health care professionals to continually use current best evidence-based research to make ethical and reliable decisions regarding patient care. “Research to promote evidence-based practice is becoming more and more a part of the regular work of health care leaders” (Grand Canyon University, 2015, p. 1). However, it is important to determine the difference between solid research and flawed research that provides unreliable inferences. Evidence-based research includes focusing on a clinical question; and includes the review and incorporation of several studies to strengthen the results of the new study (Grand Canyon University, 2015). Roddy et al. and Ganz et al. articles will be assessed to determine if the recommended changes were backed by solid research that warrants changes in a hospital.
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:
Evidence-Base practice (EBP) is defined as: “based on problem identified from the practitioner’s area of practice; a combining of best evidence and professional expertise and an integration of this into current practice; about ensuring patients receive quality care, being part of quality improvement processes; about collaboration and requiring a team approach” (French, 1999). Scott and Mcsherry (2008) supported the French’s assertion, proposing the key elements of EBP are that it is a theory-driven process, which involves the use, evaluation and application of research; identification of best evidence; evaluation of care; problem solving; decision-making; clinical expertise; and requires patient involvement. Evidence-based practice is made of evidence, clinical expertise, patient preference, the context of care (Barker, 2013). In brief, evidence-based practice is the parameter in the nursing practice that it requires that the nurses gather and use clinical evidence to make decision for the patients so that in the nursing process they can deliver the quality of care for the patients (Ellis, 2013). In the other words, in the nursing practice all the nursing procedures performed by the clinical evidence supported.
Nurses are responsible in providing holistic, quality care to their clients. In order to effectively provide such care Boswell and Cannon (2009, p. 2 & 7) states that nurses must base their provision of care on the most current, up-to-date health information available and sound nursing knowledge. This is where evidence-based practice (EBP) comes in. Polit and Beck (2010, p. 4) defined EBP as "the use of the best clinical evidence in making patient care desicions". This usually comes from research conducted by nurses and other healthcare professionals. Thus it is pertinent that research reports are critically analyzed.
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
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.
The evidence hierarchy is a ranking that distinguish the types of research evidence based on the strength of the evidence itself (Polit & Beck, 2012). It is mostly applicable to the research questions regarding the effects of clinical interventions. The evidence that are ranked based on the evidence that uses appropriate research methods, rigorously reviewed with minimized biases and has great clinical implications. The strongest evidence based on the evidence hierarchy is systematic reviews, which draws conclusions from many randomized controlled trails (Polit & Beck, 2012).
Evidence-based practice is an approach in the decision making of using the best evidence about the care of a patient.it is an integration of clinical expertise, patient values and the available evidence from ongoing research .taking into consideration internal and external influences, it promotes critical thinking in the application of the evidence in patient care. The impact of EBP has been echoed in the optimal health care, quality of life and clinical outcomes (Mabbott, 2011). Application of EBP in the plan of care has resulted in benefits such as reduced costs, decreased variation in care and nurse satisfaction. The EBP movement is one component essential aimed at transforming the current knowledge into a plan of care decisions to improve
Evidence based practice is the incorporation of individual clinical expertise with best research evidence and patient values and expectations. Health care decision of individual patients should be based on best available research evidence. A health decision made from a sound research evidence has the potential to ensure best practice and reduce variations in health care delivery. In health science, an ever increasing plethora of studies being published and is challenging for clinicians to keep up with the literature. Integrating research into practice is time consuming and need methods for easy access to such evidences for busy clinicians. Indeed, clinical decision should be based on the latest research evidence. Systematic reviews and meta-analyses summarize the research evidence, which is generally the best form of evidence, thereby making the available evidence more accessible to decision makers and are positioned
As every patient is unique and has his/her own condition, nurses and other health care providers need a source to follow as a guideline. Evidence based practice can be used as good guideline for health care provider, and it also can show different ways of care and their results. Evidence based practice has a huge role in the world of nursing profession. One of the biggest goals of nurses is to apply the evidence into their practice in a right way, even though a lot of nurses could not apply the evidence into their practice in the right way. ((Schmidt & Brown, 2015). Role of a professional nurse is to implement the evidence into practice in a right way, and create the right result from it. There are a lot aspects involved in evidence based practice
ARTICLE 8: “Patient and visitor violence in the general hospital, occurrence, staff interventions, and consequences: a cross-sectional survey.” (8)
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.