Successful "3S" Strategies to Translate and Implement Evidence on the Management of Disturbed, Aggressive and Violent Patients (DAV) in a Mental Health Hospital

10.50
Hdl Handle:
http://hdl.handle.net/10755/152914
Type:
Presentation
Title:
Successful "3S" Strategies to Translate and Implement Evidence on the Management of Disturbed, Aggressive and Violent Patients (DAV) in a Mental Health Hospital
Abstract:
Successful "3S" Strategies to Translate and Implement Evidence on the Management of Disturbed, Aggressive and Violent Patients (DAV) in a Mental Health Hospital
Conference Sponsor:Sigma Theta Tau International
Conference Year:2010
Author:Kannusamy, Premarani, PhD, RN
P.I. Institution Name:Institute of Mental Health
Title:Deputy Director, Nursing
21st INRC [Evidence-Based Practice Presentation] Search for the Clinical Problem: Using the PICO format, the clinical problem was will the use of clinical practice guidelines on the management of DAV patients (I) versus traditional methods of management of DAV patients (C) , reduce the number of patient to patient and patient to staff assaults and restraints per month (O) at the mental health hospital. Search for the Evidence: A systematic review was done, which resulted in the development of Clinical Practice Guidelines for management of DAV patients. Strategies to translate and implement EBP: The author and a team comprising APN and nurses implemented the following to manage DAV patients: Conducted hands-on-workshop and lunch time road shows on implementation of EBP; Designed a one page algorithm with 3 protocols merged into one evidenced based nursing protocol; Used the Fremantle Acute Arousal Scale for assessment Implemented evidence based interventions de-escalation, ventilation, redirection, time-out and a PRN regime of rapid tranquilization and physical restraints aimed to prevent disturbed behaviors and reduce the risk of violence. Results: There was a significant reduction in the number of assaults from 8.9 per 10,000 patient days to 3.5 per 10,000 patient days. The use of restraints also decreased from 35 to 15 per month and the duration decreased from 8 to 4 hours. Conclusion: The outcome of using an Evidence-Based approach to change current practice in the management of DAV patients has been positive. Roger's (1995) theory on the diffusion of innovations was used to achieve outcomes.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleSuccessful "3S" Strategies to Translate and Implement Evidence on the Management of Disturbed, Aggressive and Violent Patients (DAV) in a Mental Health Hospitalen_GB
dc.identifier.urihttp://hdl.handle.net/10755/152914-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Successful &quot;3S&quot; Strategies to Translate and Implement Evidence on the Management of Disturbed, Aggressive and Violent Patients (DAV) in a Mental Health Hospital</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Kannusamy, Premarani, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Institute of Mental Health</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Deputy Director, Nursing</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">prema_k@imh.com.sg</td></tr><tr><td colspan="2" class="item-abstract">21st INRC [Evidence-Based Practice Presentation] Search for the Clinical Problem: Using the PICO format, the clinical problem was will the use of clinical practice guidelines on the management of DAV patients (I) versus traditional methods of management of DAV patients (C) , reduce the number of patient to patient and patient to staff assaults and restraints per month (O) at the mental health hospital. Search for the Evidence: A systematic review was done, which resulted in the development of Clinical Practice Guidelines for management of DAV patients. Strategies to translate and implement EBP: The author and a team comprising APN and nurses implemented the following to manage DAV patients: Conducted hands-on-workshop and lunch time road shows on implementation of EBP; Designed a one page algorithm with 3 protocols merged into one evidenced based nursing protocol; Used the Fremantle Acute Arousal Scale for assessment Implemented evidence based interventions de-escalation, ventilation, redirection, time-out and a PRN regime of rapid tranquilization and physical restraints aimed to prevent disturbed behaviors and reduce the risk of violence. Results: There was a significant reduction in the number of assaults from 8.9 per 10,000 patient days to 3.5 per 10,000 patient days. The use of restraints also decreased from 35 to 15 per month and the duration decreased from 8 to 4 hours. Conclusion: The outcome of using an Evidence-Based approach to change current practice in the management of DAV patients has been positive. Roger's (1995) theory on the diffusion of innovations was used to achieve outcomes.</td></tr></table>en_GB
dc.date.available2011-10-26T11:54:55Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T11:54:55Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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