Patient Aggression Causes Nurse Injuries: The Need for Nurse Education on Patient Aggression Predictor Tools for the Medical-Surgical Unit Defining the Teaching/Learning Need

Patient Aggression Causes Nurse Injuries: The Need for Nurse Education on
Patient Aggression Predictor Tools for the Medical-Surgical Unit
Defining the Teaching/Learning Need

According to Kim Ideker and Tocheeney-Mannes (2011) nurses are subject to patient violence in all units of the hospital. However until fairly recently patient violence predictor tools have been developed only for psychiatric units and emergency departments which may not be valid for use in other areas of the hospital (Calow et al 2015). A review of current literature reveals that a need exists for a specific tool tailored to patient risk factors for aggressive behaviors on medical-surgical units (Ideker Toldecheeney-Mannes & Kim 2011). The literature reveals that many general hospitals do not currently use a violence risk assessment tool (Calow et al 2015). Therefore nurses on medical-surgical units have a need to be educated about the availability and use of such predictor tools to assess the potential for patient aggression while hospitalized: the following teaching/learning/analysis project attempts to fill this gap in nursing education in an effort to protect nurses from injury on the job.
Identification Process of the Learning Need
Inspira Hospital in Vineland NJ is a general hospital that does not currently employ an assessment tool for predicting the risk of patient violence yet the patient population is such that many risk factors for patient aggression exist: some of these factors include patients with delirium dementia alcohol abuse and drug abuse (Williamson et al 2013). If Inspira decided to adopt a tool such as the Aggressive Behavior Risk Assessment Tool (ABRAT) nurses would be empowered to assess the risk of patient aggression which might in turn allow nurses to plan interventions to help prevent or de-escalate aggressive patient behavior towards nurses and other staff (Kim Ideker & Tocheeney-Mannes 2011).
At a nursing staff meeting in October 2015 one of the nurses mentioned the increase in Code Grey alerts over the last several months and asked the nurse manager and the group about what might be done to prevent harm to staff related to aggressive patient behaviors on the medical-surgical unit. At the time I was researching for this project and found out that assessment tools exist that help nurses to predict potential risk for patient violence which could help reduce Code Grey incidents and possible nurse injuries. The nurse manager decided investigation of such tools might be of benefit to her nurses and she agreed to look into existing tools. I offered to get the ball rolling with my teaching/learning/analysis project and the nurse manager Patty Sanchez MSN-RN gave me a green light to report back to her and to share my findings with the staff on the third floor.
My preceptor Ellen Reeves RN also agreed that the nurses might benefit from learning about patient aggression predictor tools because of the particular patient population served at Inspira Hospital; patients often include drug and alcohol abusers patients with delirium/dementia and other cognitive impairment who are often at a high risk for aggressive behavior (Williamson et al 2013). From my experience at Inspira Hospital I can say with certainty that about 40% of the patients I have served fit into the aforementioned categories and I was present for 3 Code Grey events while attending clinical this semester. I completed a review of several existing tools and I decided to teach the nurses on the third floor medical-surgical unit about the benefits of using the ABRAT (Kim Ideker & Tolcheeny-Mannes 2011) to assess patients for a risk of aggressive behavior while hospitalized.
Teaching/Learning Tool Development

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