Introduction The prevention of patient-to-patient assault in an inpatient psychiatric unit is essential for the safety of patients and staff (Perez, 2014). The aim of this quantitative pilot study is to decrease patient-on-patient assaults which, in the long run, may improve patient safety during hospitalization (Staggs, 2015). This chapter discusses the study design and population plan and describes procedures for implementing the project, data collection, data analysis, the institutional review board (IRB) process, and challenges that may occur with initiating the quality improvement project. Design The design of this project is a quasi-experimental pre- and post-test quantitative pilot quality improvement project. Participants if this …show more content…
Organizational readiness for improvement or change in health care settings is vital for the successful implementation of new programs and health care practices (Hall & Roussell, 2014). After detailed conversations with the unit manager and registered nurses, it is clear there is a need for interventions targeted toward patient-to-patient assaults, as safety is a top priority for the patients in the unit. In addition, staff members state that there has been an increase in the number of patient-to-patient assaults in the inpatient psychiatric unit (2–3 incidents per month), and this poses a threat to staff and patient safety. In Hall and Roussel (2014), states that healthcare facilities must be viewed as a high-risk environment and available financial and human resources must be available to address safety issues and concerns (Wieczorek, Marent, Osrecki, Dorner, & Dür, 2015). The unit manager volunteered to provide assistance for the implementation of the program and worked with the doctoral student on scheduling a presentation of education/teaching interventions for staff members. Lastly, the unit manager provided a large conference room within the unit to use for teaching the registered …show more content…
Prior to implementation of the quality project, a signed consent will be obtained from the registered nurses, and then a 10-point questionnaire will be utilized to assess knowledge pre the education and post-education, with additional questions to assess knowledge gained. To protect confidentiality, no personal identifier will be used for any of the participants. All completed questionnaires will be stored in a locked cabinet in my office and data will be recorded on my personal computer with security access ensured. Data will be kept for three years after
Police and prosecutors tend to downplay the violent assaults on health care workers unless someone is severely injured, even though 30 states have felony laws against it (Jacobson, 2014, p. 4). According to a descriptive study conducted by Lisa Wolf there were many instances in, which the legal, judicial system was unwilling to pursue charges against patients, or family members who assaulted nurses. Thus the focus on legislation to make an assault on health care workers a felony crime may have limited efficacy unless efforts are made to address society’s complacency toward violence against nurses (Wolf et al., 2014, p. 3). In Pennsylvania two house bill’s were introduced one in 2011 House Bill 1992.
Ms. Augustin Doreus has also been very active in the following hospital committees such as: Restraint, Safety, Fall, ConED, and Performance Improvement. Furthermore, she has been a voice for the veterans focusing on changing the culture of how restraints are being used in the organization. She advocates on focusing more on alternative measures such as, de-escalation techniques, therapeutic communication, recognized early sing of agitation, and intervene on a timely manner, and so on. Outcome: As a member of the Hospital Restraint Committee and the leader of the Sub-restraint committee, Mrs. Augustin Doreus proposition to the Restraint Committee was to change the philosophy of our current restraint practice to focus more on finding alternative ways to keep our veterans safe during behavioral outburst.
The QSEN was developed in order to improve the quality, safety, and education of individuals in the nursing field. My QSEN competency is related to the quality improvement initiative. We have recognized that the quality of students that were previously admitted to the nursing program are proving to be less successful in the classroom, clinical setting, and on their NCLEX. My initiative is to develop and implement a screening tool in order to select a higher quality students prior to admission, that will prove to be successful in both the program and on their NCLEX, (QSEN,
The display of lateral violence in nursing is an issue that is hurting the profession as a whole. Lateral violence is an unprofessional display of behavior from one nurse to another that is meant to intimidate. According to Tina Dimarino “researchers have found that the most common forms of lateral violence in nursing include nonverbal innuendo, verbal insults, gossiping, undermining, withholding information, sabotage, infighting, scapegoating, backstabbing, failure to respect privacy, and broken confidences.” This type of behavior is also termed horizontal violence, nurse to nurse, incivility or bullying (Dimarino, 2011).
When it comes to abuse and neglect, we automatically think of children. Children are not the only ones who deal with being abused. In fact, this happens to the elderly as well. While some elderly may be productive enough to care for themselves, others are not.
There is an opportunity at the Alvin C. York VA Medical Center to improve the safety of patients and staff during the administration of medications on the acute psychiatric units. Currently, all inpatient units at the Alvin C. York VA Medical Center utilize a Pyxis medication station to store patient medications. The current physical location of the medication room and Pyxis stations are not ideal. The Pyxis machine that stores the medications is placed against the back wall close to the nursing station. The location of the Pyxis is next to the medication room where the nursing medication administration cart and scanning system is located.
Hospital largest human resource cost is nursing staff. Hospital allocate most of their personnel budget to nurse recruit and replacing staff. There is no secret that a nursing shortage exist, but nursing have a dirty little secret, which is, “nurses eat their young” (Sincox, 2010, p.8) or the more formal term lateral violence. Lateral violence is a nurse intentionally withholding pertinent patient information, assigning workload of total care and pain seeking patient, turning a blind eye or just plain sabotaging ones’ efforts (Thompson, 2013). One of the reason “new nurses leave their first staff job within the first six months due to some form of lateral violence” (Sincox, 2010, p.8).
If they cannot protect themselves from violent visitors, hospital administrators need to step in and rectify the problem. Patient-centered care is all about prioritizing patients and families, but we need care nurses and healthcare professionals to be prioritized as well so their work is not affected by violence. Even though nurses and healthcare professionals are faced with these challenges, they still continue to want families and others to have the right to visit patients and I agree with them. Families and friends deserve to see their loved ones especially in the conditions that they are in. They can provide a sense of love and support and that can help patients get better in a way that nurses and healthcare professionals cannot.
Lateral violence is very prevalent in the nursing profession. Lateral violence is defined by the American Nurses Association (2018) as “repeated, unwanted, harmful actions intended to humiliate, offend, and cause distress in the recipient”. Lateral violence or bullying of any kind can have negative impacts on healthcare workers health, decreased productivity, job satisfaction, quality of care, patient safety, and outcomes (Berry, Gillespie, Gates, & Schafer, 2012). The purpose of this paper is to bring light to this critical issue nurses face.
The findings reveal that over the last one year of the study, 20% of nurses had been assaulted at least once while on job, 12% of nurses had been assaulted at least once a week, and 3% experienced assault on a daily basis. Just under half of the respondents included in the survey (49%) had been harassed and assaulted 2–6 times in the previous year. A statistical report compiled by Poster and Ryan (1993) exhibits in great detail that physical assault is worryingly high In the healthcare settings. Sofield and Salmond (2003) and O’Connell et al.
Violence against healthcare providers is a significant problem that has been receiving growing attention. Incidents of workplace violence are experienced by nurses and physicians on a day-to-day basis, especially in emergency departments. The corollary of this phenomenon has become a significant matter due to the psychological stress it is placing on healthcare providers, hence affecting their efficiency and productivity. We may often undermine the consequences of workplace violence, but studies show that it may cause distress, apathy, rage, disappointment, helplessness, anxiety, self-doubt, and insecurity of healthcare workers. (Öztunç 360-365)Hence, their entire job performance is decreased and absenteeism is increased.
The purpose of this discussion post is to describe patient/inmate experience within the medical unit of the prison system of my employer. Furthermore, explain the nurse’s role, along with the inmate experience. In addition, explain this nurse’s understanding of customer service satisfaction in correlation to reimbursement rates from insurance companies. SCI Retreat prison has established an internal method to communicate with inmates regarding their psychological and medical needs to the correctional healthcare team. These forms of communication are sick call slips and grievance forms.
When looking at the function of professional nursing, the attitude, experiences, as well as factors such as demographics, social class, education, and values, can determine how the nurse will view violence in the workplace. These factors that have contributed to the development of the professional nurse can also determine how the nurse views and even reacts to workplace violence and aggression towards them. The qualities of the professional nurse and their background can determine how the human behavior from the patient is viewed and can lead to de-escalation or escalation of violent situations. The behavior of the patient can include cooperation, calmness, anxiety, aggression, or anger. Behaviors of aggression, anger, frustration, and acts of intimidation when patients are experiencing an illness can exacerbate stressful situations which can turn violent.
McMillan explains that the value of qualitative research is derived from the postulation “that multiple realities are represented in participant perspectives, and that context is critical in exploring and understanding the phenomenon being investigated” (McMillan, 2015, p. 304). Additional to this position, the interdependence of factors and influences lend to the holistic perspective of research; thereby emphasizing the interconnectedness of all the parts of a study rather than variables to reach conclusions, or develop frameworks. Integral to qualitative research are the insights, interactions and induction by which researchers analyze and interpret data. McMillan characterizes this is a “bottom-up” approach to research design, and allows
Prisons, penitentiaries, correctional facilities and psychiatric forensic hospitals are in place to provide rehabilitation and treatment to offenders who have mental illnesses. Correctional facilities are high stress areas where many offenders may have conditions consequent on trauma and they could have labile emotions that may predispose to violence against other individuals and caregivers. Within the field of forensic nursing there is considerable debate about the significant aspects of the forensic nurse’s role. An imperative task for the forensic nurse is to complete an assessment of the offenders’ violence risk. The purpose of this paper is to critically review a journal article titled ‘Risk Assessment of Forensic Patients Nurses’ Role’