{"id":431,"date":"2024-11-06T19:55:39","date_gmt":"2024-11-06T19:55:39","guid":{"rendered":"https:\/\/iims.uthscsa.edu\/isrn\/?page_id=431"},"modified":"2024-11-06T19:55:39","modified_gmt":"2024-11-06T19:55:39","slug":"improving-safety-through-early-identification-of-anxiety-and-agitation","status":"publish","type":"page","link":"https:\/\/iims.uthscsa.edu\/isrn\/resources\/ereading-room\/abstracts\/improving-safety-through-early-identification-of-anxiety-and-agitation\/","title":{"rendered":"Improving Safety Through Early Identification of Anxiety and Agitation"},"content":{"rendered":"

[vc_row][vc_column width=”2\/3″][vc_column_text css=””]<\/p>\n\n\n\n\n\n
Principal Investigator:<\/td>\nPatricia A. Allen, RN, BSN, CARN<\/td>\n<\/tr>\n
Co-Principal Investigators\/Collaborators:<\/td>\nRolaine Weeks, Shanna Cullums<\/td>\n<\/tr>\n
Organization:<\/td>\nRiverside Methodist Hospital Behavioral Health<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Abstract<\/h2>\n

Problem<\/h3>\n

Individuals can commit suicide anywhere and anytime. Healthcare organizations are not immune to this tragedy; in fact, 5-6% of suicides are committed in hospitals.<\/p>\n

Evidence<\/h3>\n

According to JCAHO the most frequently occurring sentinel event is inpatient suicide. Current research suggests that aggressive treatment of severe anxiety\/agitation may reduce acute suicidal risk and violent outbursts and that the use of a tool to monitor behaviors and affect leads to earlier intervention (Temkin & Crotty, 2004).<\/p>\n

Strategy<\/h3>\n

Clinical practice was reviewed and revised on the behavioral health unit as we sought to more readily recognize escalation and intervene more quickly through systematic monitoring for behaviors associated with increased risk of severe anxiety and\/or agitation.<\/p>\n

Practice Change<\/h3>\n

A modified precaution monitoring tool was developed and implemented following a review of the literature and input from the entire staff. The tool uses terminology that creates a common language to describe behaviors and affect. All staff received education on the terminology and documentation codes as well as signs and symptoms of anxiety and agitation. The monitoring of risk becomes a shared responsibility of the multidisciplinary team.<\/p>\n

Evaluation<\/h3>\n

Since implementation of the tool, episodes of seclusion\/restraint have been reduced on average by 75% as well as the rate of assaults and self harm incidents by 13.4% as compared to the previous 12 months.<\/p>\n

Results<\/h3>\n

The safety of the environment has improved. The new monitoring process provides clinicians the opportunity to use early intervention techniques such as verbal de-escalation, administration of medications, etc. to help reduce the number of restraint episodes, violent outbursts and parasuicidal behaviors.<\/p>\n

Recommendations<\/h3>\n

The tool has potential application on non-behavioral health units when combined with staff education in the recognition of risk behaviors and use of common terms to describe affect and behavior.<\/p>\n

Bibliography<\/h3>\n