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/clinical/nursing-hub/npg/quick-help/resources/Nursing-Quick-Help-Aggression-Precautions.pdf

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Aggression Precautions - Nursing Quick Help

Aggression Precautions - Nursing Quick Help - Clinical Hub, Nursing Hub, Nursing Practice Guidelines, Quick Help for Nurses, Resources


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Hello Nurses. We are DJ Niemuth and Rachel
Edwards. We are part of the team that helps
with aggressive patients and are here to help
keep you safe. To your left you will find some
quick topics to help you.
Just click on the pictures to the left to
learn more.
Quick Help for Nurses:
Aggression Precautions
Nursing Practice Innovation, 2017

Quick Help for Nurses:
Aggression Precautions

Help for PSAs/PSOs/RCTs:
Recognize behaviors early to prevent escalation

When should I notify the RN?
HOME
Watch for a change in behaviors. Are they
acting differently? Notify RN
Increased anxiety, fidgeting, restlessness,
increased verbalizations or stress. Notify RN
Paranoia, seeing or hearing things and fear
can all increase risk. Notify RN
Confusion, increased confusion or paranoia
with confusion. Notify RN
Wanting to leave or talking about leaving,
address it immediately with RN.
Nursing Practice Innovation, 2017

HOME
Signs of Escalating Behaviors:
Common Triggers that can lead to aggression
• Providing cares (peri care) or touching a patient, telling a patient
“No”, patients who want to leave, staff getting in a patient’s way
who is trying to leave.

Non-Verbal
Escalation:
changes in body
language, pacing,
agitation,
restlessness
Give space, ask
if the patient
needs
something
Ask if
something is
wrong or if you
can help
Get help early:
RN, Team, think
PRNs
Verbal
Escalation:
increased tone,
volume, yelling,
cursing, sudden
silences
Get in a safe
position (near
door, get help)
Act early, get
assistance:
“something is
wrong”
Do not ignore
early warning
signs-consider
medications
Threatening or
becoming
violent: making
fists, verbal
threats, looking
agitated
Call for help,
remove
yourself to a
safe distance
Call Behavioral
Response,
security, use
panic button if
needed
Don't get close,
attempt to
listen to the
patient
Medications
The Acute
Agitation Order
Set can be used
in dangerous
situations
Medications
need to be
given early
Goal is to
prevent
escalation of
behaviors
Nursing Practice Innovation, 2017
Watch for changes in behaviors: if they are acting differently, do something.

Environment:
Keeping Everyone Safe
HOME
Always scan
the room for
safety every
time you
enter
Two care
providers with
all cares. Do not
be alone with
the patient
Weapons,
remove things
that could be
used as
weapons, call
lights, scissors
etc.
Never try to
physically stop a
patient from
leaving- call for
help
If you need to
be without an
easy exit, get
assistance, don’t
go alone
Always maintain
an easy exit, sit
between the
patient and the
door, the door
should be open
Nursing Practice Innovation, 2017

HOME
How to
Prevent
Aggression
Monitor
yourself, be
calm and non-
judgmental, be
aware and
actively listen
Recognize
stress, anxiety,
pain early and
ask what helps
the patient to
reduce it
Don’t give
advice , just
take time to
actively listen
and provide
support
Offer
distractions:
music, deep
breathing ,TV,
walking, talking
to anxiety

Consider
medications
early

Get others
involved early
when you see
escalating
behaviors

How to Prevent Aggression: Always
Think Prevention
Nursing Practice Innovation, 2017