Understand that violence happens in Health Care We can do things to help prevent these incidents through Professionalism and Preparation Learn to Identify various factors as to why the violent behaviour is occurring ID: 1034816
Download Presentation The PPT/PDF document "Housekeeping Details Course Objectives" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
1.
2. Housekeeping Details
3. Course ObjectivesUnderstand that violence happens in Health Care.We can do things to help prevent these incidents through Professionalism and Preparation.Learn to Identify various factors as to why the violent behaviour is occurring.Learn appropriate responses to the Respondent and Operant behaviour.Review the basic aspects of Recording a violent incident.
4. Staff members who have developed a systematic approach to the treatment of assaultive behavior are less likely to injure or be injured during an assaultive incident than those who haven’t.
5. Description of TermsApproach – principles not specific interventions.Problem-solving – asking the right questionsEmergency response – primary plan, then secondary, then PART.Gender neutral – don’t need to be strong or male to use PART.Teamwork – “no heroes please”.Rights – Client and worker, both kept safe.Acceptance – has been accepted in many places for years.
6. PART InterventionsUsed when:the primary treatment plan doesn’t work;the primary back up plan doesn’t work;you are facing an immediate threat of injury.It is important that you stick to theprimary plan for each individual.
7. Course BackgroundAs agencies assume responsibilityfor the treatment of peoplewith assaultive behavior,they face a clear pattern of risks.
8. What are the risks?That the individual will be successful in injuring themselves or othersThat the staff could be seriously injured during the incidentStaff members could contribute to the injuryLack of teamwork could contribute to the injuryManagers could contribute to the injuryPublic censureFormal penalties from court or legislation
9. DisclaimerThe techniques taught in the PART workshop have proven safe and effective.Their proper application is the responsibility of all staff involved.Instruction cannot be a substitute for professional judgment.
10. Course OutlinePurpose – What would we like to see as outcome?Professionalism – Why do I do what I do?Preparation – How have I prepared myself for this job/today?Identification – Can I identify why it’s happening?Response – Can we approach appropriately?Recording/Reporting – How do I share this?Follow-up/plan – Can we work together to not have it reoccur?
11. PurposeUnderstanding of treatment plan outcomes. What do we want to have happen?If you know what’s supposed to happen, you know how to help.If there is no plan, PART, working in crisis mode, may become the primary plan…not it’s intent.
12. ProfessionalismSelf as a toolProfessionalism and safety – Do we pose a threat to ourselves and others?Features of professionalismMood – What causes your moods?Attitude – Cynicism, pessimism, others.Motivation – What brought me to this job and what keeps me here.
13. ProfessionalismTaking responsibility for the disciplined management of mood, attitude and motivation in the service of the client.
14. PreparationAttire – right clothes for the job.Mobility – ready to move.Observation – “Do I sense everything?”Self-control – Don’t lose your cool.self-assessmentknow your limitsregaining self-controlrestoration and healingWhat are things that make you lose self control?
15. Self-controlSelf-assessmentKnow your limitsRegaining self-controlRestoration and healingWhat are things that make you lose self control?
16. What Do I Bring?Our attitude (and prejudices)Our self-control (or not)Our mobility (or not)Our observation (or not)Our past experiences (whatever they may be)
17. IdentificationLegal ModelStress ModelDevelopmental ModelCommunication ModelInteractive ModelEnvironmental Model Basic Needs ModelSocio-cultural ModelCommon knowledge Model
18. Legal Modelcommon assaultassault causing bodily harmaggravated assaultThis is not intended as legal advice
19. Stress ModelAssault cycleI. Triggering – self controlII. Escalation – crisis interventionIII. Crisis – crisis interventionIV. De-escalation – self controlV. Post-Crisis Depression – unconditional positive regard
20. Developmental Modelpreschool age childrenearly elementary age childrenlate elementary age childrenearly adolescentslate adolescentsyoung adultsmiddle aged adultselderly
21. Communication Model Withdrawal Passivity Assertion Aggression Assault
22. Interactive ModelEnvironmentalIndividualStaffPhysicalPsychologicalSpiritual
23. Environmental Modelphysical conditionsstaff performance problemsscheduling problems
24. A Basic Needs Model
25. Socio-cultural ModelAggression is a result of:social trainingExamples?social settingsGangs, fight clubs, etc.
26. Common Knowledge ModelFearFrustrationManipulationIntimidation
27. FrustrationFearRespondent Behavior
28. Operant BehaviorManipulationIntimidation
29. Fear - RespondentMotive: irrational need to escape, defend against or eliminate a perceived threat.Signs of impending aggression:visualauditoryhistory
30. Visual SignalsPosturetense, prepared to defend, hide or runSkin Colourpale or ashen (depending upon natural skin tone)Facial Expressionwide-eyed or fearful
31. Auditory SignalsVoice qualitywhining, pleadingBreathingrapid, shallow, irregular
32. Confirming HistoryWithdrawal and victimizationAggressive outbursts
33. Crisis Intervention for FearGoal: threat reduction Posture – relaxed, open, hands in full view Gestures – slow, palms up Position – off to one side, 8-10 feet away Voice quality – firm, reassuring, confident Speech content – logical, encouraging calm reflection, promise to help if possible Eye contact – if sought but do not force Physical contact – light, if any
34. Frustration – RespondentMotive: irrational need to express frustration in a physically destructive mannerSigns of Impending Aggression:visualauditoryhistory
35. Visual SignalsPosturetense and prepared to assaultSkin Colourtones of purple, red or red blotches (depending upon natural skin tone)Facial Expressiontense, focused and angry
36. Auditory SignalsVoice qualitymenacing, aggressive, loudBreathingloud, deep, long and heavy
37. Confirming HistoryLow frustration tolerance coupled with impulsiveness
38. Crisis Intervention forFrustrationGoal: Control Posture – self-confident, commanding, firm, in control Gestures – firm, commanding, palms out or down Position – directly in front but out of striking range Voice quality – quiet, firm, commanding but use a low tone Speech content – repetitive, confident commands without threat Eye contact – direct and expressive Physical contact – firm, without excessive movement or pain
39. Manipulation - OperantMotive: impulsive attempt to obtain something in exchange for not losing emotional control and doing something dangerousSigns of Impending Aggression:visualauditoryhistory
40. Visualdifficult to interpret
41. Auditory Signalswhiny voice with “gimmie” words of “poor me” (pitiable) victimaccusations, comparisons and trivia in more aggressive tonesthreats and actions against propertyassault is attempted
42. Confirming Historylosing controlassaulting physically when feeling deprived or oppressed
43. Crisis Intervention forManipulationGoal: detachment Posture – closed, relaxed Gestures – disapproval and mild irritation Position – 4-5 feet away, close enough to intervene but far enough away to show non-involvement Voice quality – detached, mechanical, slightly bored Speech content – quiet, repetitive, “broken record” Eye contact – avoid – look at forehead or chin Physical contact – quick and unemotional – make contact with clothing, not skin
44. IntimidationMotive: calculated attempt to obtain something in exchange for physical safety or freedom from threat of injurySigns of Impending Aggression:visualauditoryhistory
45. Visualbasically neutral or unremarkablethreatening posture
46. Auditory Signalsmenacing voice quality and threatening wordsrecognizable pattern:clear, strong demandsbelievable threatrefusal to comply followed by attempt to injure through assault
47. Confirming Historybullyingextortionother criminal assault
48. Crisis Intervention forIntimidationGoal: clear consequences of action(s) Posture – poised and ready to move Gestures – few and far between Position – greatest relative defensive advantage Voice quality – matter of fact, monotone, emotionless; avoid screaming, shouting or threatening Speech content – clear and direct statement of consequences Eye contact – sparingly to emphasize a statement Physical contact – if necessary, quick and smooth and as matter of fact as possible
49. Identification - summaryassaultive incidents can be categorized into levels of dangerousnessincidents progress through a 5-phase cycleassaultive incidents are signaled by, and grow from patterns of unbalanced, and assertive communicationfunction of developmental age
50. Identification - summaryenvironmental irritants often contributea perceived threat to deprive a person of basic needs may lead to assaultoften related to social or cultural pressuresassaultive incidents develop from patterns of behaviour
51. ResponseCrisis InterventionReacting appropriately to the phase of the violent incident.Rule of fiveEvasionGetting out of the wayRestraintHolding a person in placeLess AggressiveMost Aggressive
52. Principles of Crisis InterventionSelf-controlIdentificationCommunicationTimingPatienceSpontaneity
53. Reasonable ForceObserved Behaviorcommon assaultassault causing bodily harmaggravated assaultReasonable Forcenilcrisis interventioncommunicationevasive techniquescontrolling techniques or manual restraint
54. STOP Strategy Slow down Think about what is happening Options Plan to have time for you
55. Stress ModelI. Triggering – self controlII. Escalation – crisis interventionIII. Crisis – crisis interventionIV. De-escalation – self controlV. Post-Crisis Depression – unconditional positive regard
56. RecordingWho?Where?When?What?How?Why?InjuriesNotificationFollow-up
57. Dementia Enhancement
58. Learning OutcomesUnderstand dementiaIdentification of potentially violent situationsSafe work practices to minimize or eliminate riskAppropriate response
59. What is Dementia?Dementia is an overall term for a set of symptoms that are caused by disorders affecting the brainSymptoms may include memory loss, difficulties with thinking, problem-solving, or languageMay also include changes in mood and behavior
60. Dementia Bill of RightsTo be informed of one’s diagnosisTo have appropriate, ongoing medical careTo be treated as an adult, listened to, and afforded respect for one’s feelings and point of viewTo be with individuals who know one’s life story, including cultural and spiritual traditionsTo experience meaningful engagement throughout the dayTo live in a safe and stimulating environment
61. Dementia Bill of RightsTo be outdoors on a regular basis To be free from psychotropic medications whenever possibleTo have welcomed physical contact, including hugging, caressing, and hand holding To be an advocate for oneself and othersTo be part of a local, global, or online communityTo have care partners well trained in dementia care
62. Person-centred careThe person-centred philosophy focuses on the individual rather than on the condition, and on the person’s strengths and abilities rather than losses
63. Care PlanIs there a care plan in place for each client?What is in the care plan?Do you follow the care plan?Can/do you recommend changes to the care plan?Should indicate the needs of the client – likes and dislikes. Knowing this could prevent an incident; not knowing may cause an incident.
64. Stress ModelBe aware of client’s trigger(s)Eliminate or manage the triggersTriggers may be real or imagined (real to them) When you are faced with a negative or challenging response from a client, it is YOU who will make a change – change your attitude, approach, body language/non-verbal communication
65. Communication ModelUse the STOP strategy:Slow downThink about what is happening OptionsPlan
66. Common Knowledge ModelValidate their feelings and emotionsAllow a person with dementia to believe what he or she believes is realRedirect/distract when necessary
67. Processing InformationOur brain is continuously processing information – consciously or unconsciouslySome behaviours of a person with dementia may be seen as inappropriate to us; while to them it is appropriate because of the way their brain is processing the information
68. Brain Health
69. Seven A’s of DementiaAnosognosia AgnosiaAphasiaApraxiaAltered perceptionAmnesiaApathy
70. Validation Therapy/RedirectionRedirection – diverting individuals’ attention from the stressful event to something that is more pleasantValidation Therapy – validating feelings and emotions while integrating redirection techniques
71. Ten Tips for Communicating with a Person with DementiaSet a positive mood for interactionGet the person’s attentionState your message clearlyAsk simple, answerable questionsListen with your ears, eyes, and heart
72. Ten Tips for Communicating with a Person with DementiaBreak down activities into a series of stepsWhen the going gets tough, distract and redirectRespond with affection and reassuranceRemember the good old daysMaintain your sense of humor
73. When working with individuals with dementia remember to be patient, use your self-control plan. Don’t take it personally – be empathetic. The person with dementia is not doing “things” on purpose – it is not their choice but rather the illness taking over.
74. Intermediate Program*A contract must be signed *Skills must be practiced slowly
75. Principles of Evasionkeep talkingstay out of the wayget out of the waycover updeflect blows and kickscall for HELP!be patientcontrol yourselfroll with the punchescape holding assaults
76. CapturesAlways move toward the Point of CapturePoint of Capture
77. Mobility and Warm-upstancebreathingneck mobility/shoulder rollstoe/heel liftsbalancecrouchside and back steppivotkneelteam steps
78. Evasionstalk and evadetalk, crouch, cover and rolltalk, crouch, cover roll and close assaulttalk and evadeescapeuse a shield