Disruptive Behaviors, Aggression, Violence for Progressive Care Certified Nurse (PCCN)
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Outline
Disruptive Behaviors, Aggression, Violence
Definition/Etiology:
- Call to action!
- Lack of reporting
- See something
- Say something
- Do something
Pathophysiology:
- Identify
- Person at risk for aggression/violence
- Verbal aggression
- Attempts to elope
- Self-harm
- Refusing to eat/drink
- Aggressive towards objects/people
- Hallucinations
Noticing: Assessment & Recognizing Cues:
- Report (awareness and policy)
- Supervisor
- Coworkers
- Security
- Risk management
Interpreting: Analyzing & Planning:
- De-escalation Techniques
- Verbal communication =clear and calm
- Non-threatening body language
- Respectful
- Clear limits for patient/family
- Environmental stimulation (lighting, loud noises/conversations)
Responding: Patient Interventions & Taking Action:
- Education: Safety first!
- Training on violence awareness and prevention
- Facility’s safety policy/procedures
- Report accordingly
- Press charges if assaulted
- Support coworkers
- Team-focused solutions
Reflecting: Evaluating Patient Outcomes:
- Effects on nurses
- Mental health concerns
- Psychological distress
- PTSD
- Anxiety
- Depression
- Burnout
- Mental health concerns
- Physical injuries
- Long-term effects
- Decreased quality of patient care
- Decreased engagement
- Increased intention to leave
- Long-term effects
Linchpins (Key Points):
- Identify, Report, Deescalate
- Identify = patients/families with potential for aggression/violence
- Report suspicions accordingly
- Deescalate= utilize de-escalation techniques.
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Transcript
References
- Bellizzi, S. Pichierri, G., Farina, G., Cegolon, & Abdelbaki, W. (2022). Violence against healthcare: A public health issue beyond conflict settings. American Journal of Tropical Medicine and Hygiene, 106(1), 15-16. doi: 10.4269/ajtmh.21-0979.
- Pariona-Cabrera, P., Cavanagh, J., & Bartram, T. (2020). Workplace violence against nurses in health care and the role of human resource management: A systematic review of the literature. Journal of Advanced Nursing, 76, 1581-1593. doi: 10.1111/jan.14352.
- The Joint Commission. (2019). De-escalation in health care. Quick Safety 47, 1-5.
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Progressive Care Certified Nurse (PCCN)
Course Lessons
Cardiovascular
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Ventricular Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Acute Coronary Syndromes (MI-ST and Non ST, Unstable Angina) for Progressive Care Certified Nurse (PCCN)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Aneurysm (Dissecting, Repair) for Progressive Care Certified Nurse (PCCN)
Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)
Cardiac Tamponade for Progressive Care Certified Nurse (PCCN)
Cardiac/Vascular Catheterization (Diagnostic, Interventional) for Progressive Care Certified Nurse (PCCN)
Cardiogenic Shock For PCCN for Progressive Care Certified Nurse (PCCN)
Cardiomyopathies (Dilated, Hypertrophic, Restrictive) for Progressive Care Certified Nurse (PCCN)
AV Blocks Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Heart Failure (Acute Exacerbations, Chronic) for Progressive Care Certified Nurse (PCCN)
Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)
Minimally-Invasive Cardiac Surgery (Non-Sternal Approach) for Progressive Care Certified Nurse (PCCN)
Valvular Heart Disease for Progressive Care Certified Nurse (PCCN)
Vascular Disease for Progressive Care Certified Nurse (PCCN)
Pulmonary
Acute Respiratory Distress Syndrome (ARDS) for Progressive Care Certified Nurse (PCCN)
Asthma (Severe) for Progressive Care Certified Nurse (PCCN)
COPD Exacerbation for Progressive Care Certified Nurse (PCCN)
Minimally-Invasive Thoracic Surgery (VATS) for Progressive Care Certified Nurse (PCCN)
Obstructive Sleep Apnea for Progressive Care Certified Nurse (PCCN)
Pleural Space Complications (Pneumothorax, Hemothorax, Pleural Effusion, Empyema, Chylothorax) for Progressive Care Certified Nurse (PCCN)
Pulmonary Embolism for Progressive Care Certified Nurse (PCCN)
Pulmonary Hypertension for Progressive Care Certified Nurse (PCCN)
Respiratory Depression (Medication-Induced, Decreased-LOC-Induced) for Progressive Care Certified Nurse (PCCN)
Respiratory Failure (Acute, Chronic, Failure to Wean) for Progressive Care Certified Nurse (PCCN)
Respiratory Infections (Pneumonia) for Progressive Care Certified Nurse (PCCN)
Thoracic Surgery (Lobectomy, Pneumonectomy) for Progressive Care Certified Nurse (PCCN)
Endocrine/Hematology/Neurology/Gastrointestinal/Renal
Diabetes Mellitus for Progressive Care Certified Nurse (PCCN)
Diabetic Ketoacidosis for Progressive Care Certified Nurse (PCCN)
Hyperglycemia for Progressive Care Certified Nurse (PCCN)
Hypoglycemia for Progressive Care Certified Nurse (PCCN)
Anemia for Progressive Care Certified Nurse (PCCN)
Coagulopathies, Medication-Induced (Coumadin, Platelet Inhibitors, Heparin, HIT) for Progressive Care Certified Nurse (PCCN)
Encephalopathy (Hypoxic-ischemic, Metabolic, Infectious, Hepatic) for Progressive Care Certified Nurse (PCCN)
Seizure Disorder for Progressive Care Certified Nurse (PCCN)
Stroke for Progressive Care Certified Nurse (PCCN)
Functional GI Disorders (Obstruction, Ileus, Diabetic Gastroparesis, Gastroesophageal Reflux, Irritable Bowel Syndrome) for Progressive Care Certified Nurse (PCCN)
GI Bleed (Upper, Lower) for Progressive Care Certified Nurse (PCCN)
GI Infections (C. difficile) for Progressive Care Certified Nurse (PCCN)
GI Surgeries (Resections, Esophagogastrectomy, Bariatric) for Progressive Care Certified Nurse (PCCN)
Hepatic Disorders (Cirrhosis, Hepatitis, Portal Hypertension) for Progressive Care Certified Nurse (PCCN)
Ischemic Bowel for Progressive Care Certified Nurse (PCCN)
Malnutrition (Failure to Thrive, Malabsorption Disorders) for Progressive Care Certified Nurse (PCCN)
Pancreatitis For PCCN for Progressive Care Certified Nurse (PCCN)
Renal Failure- Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD) for Progressive Care Certified Nurse (PCCN)
Electrolyte Imbalances for Progressive Care Certified Nurse (PCCN)
End-Stage Renal Disease (ESRD) for Progressive Care Certified Nurse (PCCN)
Musculoskeletal/Multisystem/Psychosocial
Functional Issues (Immobility, Falls, Gait Disorders) for Progressive Care Certified Nurse (PCCN)
End of Life for Progressive Care Certified Nurse (PCCN)
Healthcare-Acquired Infections: Catheter-Associated Bloodstream Infections (CAUTI) for Progressive Care Certified Nurse (PCCN)
Healthcare-Acquired Infections: Central-Line-Associated Infections (CLABSI) for Progressive Care Certified Nurse (PCCN)
Healthcare-Acquired Infections: Surgical Site Infections (SSI) for Progressive Care Certified Nurse (PCCN)
Infectious Diseases: Influenza for Progressive Care Certified Nurse (PCCN)
Infectious Diseases: Multidrug-Resistant Organisms (MRSA, VRE, CRE, ESBL) for Progressive Care Certified Nurse (PCCN)
Pain (Acute, Chronic) for Progressive Care Certified Nurse (PCCN)
Palliative Care for Progressive Care Certified Nurse (PCCN)
Pressure Injuries (Ulcers) for Progressive Care Certified Nurse (PCCN)
Rhabdomyolysis for Progressive Care Certified Nurse (PCCN)
Sepsis for Progressive Care Certified Nurse (PCCN)
Shock States (Anaphylactic, Hypovolemic) For PCCN for Progressive Care Certified Nurse (PCCN)
Toxic Ingestion, Inhalation, Overdose for Progressive Care Certified Nurse (PCCN)
Wounds (Infectious, Surgical, Trauma) for Progressive Care Certified Nurse (PCCN)
Altered Mental Status- Delirium and Dementia for Progressive Care Certified Nurse (PCCN)
Disruptive Behaviors, Aggression, Violence for Progressive Care Certified Nurse (PCCN)
Psychological Disorders (Anxiety, Depression) for Progressive Care Certified Nurse (PCCN)
Substance Abuse (Alcohol, Drug Withdrawal) for Progressive Care Certified Nurse (PCCN)
Substance Abuse (Chronic Alcohol Abuse, Chronic Drug Abuse) for Progressive Care Certified Nurse (PCCN)
Substance Abuse (Drug-Seeking Behavior) for Progressive Care Certified Nurse (PCCN)
Professional Caring and Ethical Practice
Advocacy & Moral Judgement for Progressive Care Certified Nurse (PCCN)
Caring Practices for Progressive Care Certified Nurse (PCCN)
Response to Diversity for Progressive Care Certified Nurse (PCCN)
Facilitation of Learning for Progressive Care Certified Nurse (PCCN)
Collaboration for Progressive Care Certified Nurse (PCCN)
Systems Thinking for Progressive Care Certified Nurse (PCCN)
Clinical Inquiry for Progressive Care Certified Nurse (PCCN)
