Disruptive Behaviors, Aggression, Violence for Progressive Care Certified Nurse (PCCN)

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
• Physical injuries
  • Long-term effects
    • Decreased quality of patient care
    • Decreased engagement
    • Increased intention to leave

Linchpins (Key Points):

• Identify, Report, Deescalate
  • Identify = patients/families with potential for aggression/violence
  • Report suspicions accordingly
  • Deescalate= utilize de-escalation techniques.