Aggressive behavior poses a significant risk to patients and staff in the healthcare setting. At YNHHS, staff have tools and strategies for managing aggressive patient behavior in a safe and therapeutic manner, including new options presented at the Workplace Violence Prevention webinar June 24.
“As a system, we have been able to take best practices and bring them all together,” said April Alfano, RN, DNP, director of Nursing at Bridgeport Hospital Emergency Services and of System Emergency Management.
The tools, along with training, will be implemented this summer. They include the Brøset Violence Checklist (BVC), Behavioral Intervention Response, YNHHS Patient Code of Conduct, and Patient and Visitor Conduct Agreements.
The BVC, which assesses short-term violence risk, is a proactive safety approach. Webinar panelist Amanda Jagodzinski, RN, nurse manager, Greenwich Hospital Emergency Department, shared how the BVC recently proved helpful.
After about 45 minutes, a patient began pacing in his patient care room; he had also left his room several times. Recognizing a change in behavior the nurse decided to update his Brøset screening assessment. Upon arrival, his score was 0 (low risk of aggressive behavior); upon reevaluation, he scored a 2 (moderate risk of aggressive behavior). The nurse implemented safety interventions, asking Security staff to perform additional rounding in the ED pod. The nurse also alerted her care team, the charge nurse and the provider. The team later learned the patient had a psychiatric diagnosis and had displayed aggressive behavior in the past at other institutions.
“The nurse really used her intuition to recognize that something else was going on with this patient,” Jagodzinski said. “The interventions she put into place kept the patient and staff safe.”
“That’s the goal of the Brøset Violence Checklist – to raise awareness,” said panel member Laura Jansen, RN, clinical program director, Central Staffing Office Administration. “It was chosen from a wide selection of assessment tools to help nurses identify or predict the potential for the patient to become physically aggressive within the next 24 hours.”
Nurses are expected to complete a Brøset score upon admission and every shift after; if the patient’s behavior changes, they would do another assessment.
BVC procedure training is expected of every YNHHS nurse upon hire.
To learn more about the BVC, Behavioral Intervention Response and YNHHS Code of Conduct agreements, view a recording of the webinar and find tip sheets on the Workplace Violence Prevention intranet page. From the employee intranet landing page, click “Departments and Communities” and choose “Workplace Violence.”
