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Alert system may prevent incidents of patient violence

An Epic flag and door sign alerts staff members of a potentially harmful patient.

The recently admitted patient is belligerent. Right now his weapons are words, which are bad enough. What happens, though, if his anger snaps into physical violence?

A new warning system created by the Workplace Violence Prevention Program aims to protect staff from such scenarios. If a patient exhibits or has a history of violent or harmful behavior, he or she is “flagged” in Epic and a sign placed on the door.

To preserve the patient’s dignity and privacy, the sign bears only the Workplace Violence Prevention symbol and asks staff to check with the care team before entering. The staff member is then debriefed on the patient’s condition and behavioral issues. If the patient is aggressive when exposed to loud noise, for instance, the team will know to work quietly in the room. Or if a patient is recovering from surgery and is agitated, staff members can wait until the anesthesia wears off or use the buddy system when entering the room.

“Flagging supports workers’ right to know about potential hazards,” said Jennifer Nidalmia, clinical practice adviser. “It is part of our culture of safety, but by no means is it intended to compromise our patients’ access to quality care.”

If a patient displays abusive behavior, an authorized staff member (manager, supervisor, clinical staff or social worker) documents the behavior as part of a psychosocial assessment, initiates a FYI alert flag, develops a safety plan and then documents progress.

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To qualify for a violence issues flag, the patient must have exhibited clear threats of violence toward others or physical aggression. That includes threatening gestures, swinging at people, grabbing clothes, sexual groping, striking, kicking, pushing, hair-pulling, biting or other attacks.

“The rationale is not to label the patient, but to alert staff to create safety,” Nidalmia said.

Indeed in many patients, aggressive behavior is circumstantial or transitory due to side effects of anesthesia, a urinary tract infection or hospital delirium.

Because of this, health care workers have often tolerated verbal and physical abuse, assuming it is part of the job. Asante’s Workplace Violence Prevention Program aims to change this belief.

“All employees deserve safety and respect regardless of the situation,” said Laura Magstadt, vice president of Nursing at ATRMC.

As an added precaution, security officers will receive a report on patients with flags so they are aware of potential issues as part of their purposeful rounding.

The alert system took effect in November at all Asante facilities, including APP clinics. The flag stays in the patient’s chart so all Asante care teams will be aware and can take safety measures. To learn more, consult the policy, Communication Alerts for Patient Behavioral Harm or Violence, on myAsanteNET.

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