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Mental Health Nursing (Doc)

   

Added on  2020-02-24

9 Pages2037 Words46 Views
Running head: MENTAL HEALTH NURSINGMental health nursingName of the StudentName of the UniversityAuthor note

1MENTAL HEALTH NURSINGWhat strategies do nurses in an adult mental health inpatient unit use to deescalate aggression displayed bypatients? Are these strategies best practice?The rationale for choosing aggression as issue because I have observed patients being non-compliant when they areaggressive and they refuse to comply with everything or it may trigger their illness, if proper interventions are not inplaced. During my exploration of issue, I had talk with different staff about the particular issue in inpatient unit. Everyanswer revolved around aggression and how stressful for staff on certain occasion when it is not managed in certaintime and risk to staff from aggression. Every staff had different approach in order to manage aggressive patient andmake them comply with PRN medication in safe possible environment. During my placement I witnessed few differentstrategies to manage aggressive patient, some of them escalated the situation, and some of them were able to calmthe patient, resulting in-patient taking PRN medication and sharing concern with staff. By choosing this as my projectquestion, I would investigate more about techniques used by mental health staff in managing aggression in inpatientunit. Violent and aggressive behaviors are common among the mental health patients andnurses and medical staffs employ various approaches to manage the aggressive and violentpatients. The technique like de-escalation approach is a therapeutic intervention that is frequentlyused to prevent aggression and violence in mental health services. A thematic literature reviewconducted by Price & Baker, (2012) depicted that skilled staffs are required to perform thesetechniques. They need to be de-escalators who maintain personal control and have effective non-verbal and verbal skills. They employ the technique of engaging with the patient to ensure safede-escalation approach that confirm autonomy and is considered it a complex interventionprocess. It consists of psychological techniques that are aimed at reducing the violent oraggressive behaviour. The nurses use non-verbal and verbal communication skills to controlaggressive behaviour in patients. These de-escalators are honest, open, self-aware, confident andnon-judgmental without being arrogant to the mental health patients. The strength of the study isthat it elucidates the current and best practices in de-escalation techniques. However, the

2MENTAL HEALTH NURSINGlimitation of this research is that there is no randomized controlled trials (RCTs) performed inthis thematic literature review.In another study conducted by Dickens, Piccirillo & Alderman, (2013) demonstrated thatprevention and management of aggressive behaviour could be done through training of nursingand medical staffs. For this research, confirmatory factor analysis was done to study theunderlying factors to manage violent behaviour. The attitude of the nurses plays an importantrole in managing aggressive behaviour in mental health settings. The data was collected inmedium and low secure adult mental health wards at St Andrew’s Healthcare in May and June2011 through MAVAS Scale. The nurses’ perceptions depicted that restrictive environmentscontribute to the aggressive behavior. To manage violence and aggression, they use medicationthat is considered a valuable approach for treating violent behavior. They also use seclusion andphysical restraint under necessary conditions. The alternatives to this are use of sedation andcontainment to manage physical violence. However, the sample size for the study is too smalland requires further trials for exploring the attitudes and perceptions of nurses. A study conducted by Richmond et al., (2012) has demonstrated the verbal de-escalationtechnique that uses engagement of patient to help them become active partner in the evaluationand treatment process to de-escalate agitation. Environmental planning and voluntary medicationare also important for dealing with aggression in mental health patients. They have lessened thecoercive interventions where staff members manage behavior by calming down the patient.According to Spencer & Johnson, (2016) de-escalation technique arrests the progress of theagitation in mental health patients. The technique involves the use of effective attitude andlanguage to deal with aggression along with confrontation avoidance and posture. This studyevaluated the effectiveness of de-escalation techniques to establish a positive relationship and

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