Prevention Measures to Reduce Workplace Violence in the Acute Care Setting
Mitchell, Kelsey A.
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Abstract
Problem: On an adult medical surgical unit in a mid-sized, community hospital in Maryland there has been an increase in Workplace violence (WPV) that has led to unfortunate injuries to staff providing care. Based on the event reporting system, there have been seven events where staff members were physically assaulted and six events involving nonphysical violence in the last year. Purpose: The purpose of this quality improvement project is to decrease WPV from patients against staff by implementing a clinical practice guideline, defining the use of 3 evidence-based tools: Broset Violence Checklist (BVC), Patient Treatment Agreements, and Behavioral Emergency Response Team (BERT) activation. A decrease in WPV will benefit the staff, the patients, and the organization. Methods: In the months preceding project implementation, the Quality Improvement Project Lead (QI-PL) assembled a team of invested stakeholders. The QI-PL developed a clinical practice guideline, gained stakeholder approval and provided education to all nurses. The guideline outlined that every patient admitted should be screened with the BVC to assess for potential violence. If a patient displays behavior that indicates potential violence, a patient treatment agreement should be completed. If a patient begins to escalate in behavior, a BERT should be activated to deescalate the situation, prior to a violent event occurring. Results: During the 15 weeks of project implementation, 100% of patients on the unit were screened with the BVC, no patient treatment agreements were completed, two BERTs were activated, and two WPV events were reported. Conclusions: Findings suggest high adherence with the clinical practice guideline despite limitations identified. Continued utilization of these evidence-based prevention measures is recommended because it has the potential to decrease the overall number of WPV events.
