Behavioral threat assessment and management: Lessons learned in one VA health care system.
01 Mar 2018-Vol. 5, Iss: 1, pp 42-62
TL;DR: How a VA health care system improved its approach to threat management by applying 10 “lessons learned” is described, including practical reforms put in place to reduce the risk of violence, aggression, and disruptive behavior.
Abstract: This article describes how a VA health care system improved its approach to threat management by applying 10 “lessons learned.” Each lesson is presented with a brief description, including practical reforms put in place to reduce the risk of violence, aggression, and disruptive behavior. These reforms include the creation of a formal workplace violence prevention program, formalization of the threat assessment team’s incident review and response protocols, consistent use of an evidence-based threat assessment tool, and the diversification of the team to promote robust interdisciplinary discussions and greater stakeholder representation.
Citations
More filters
9 citations
01 Jan 2023
TL;DR: The authors provide an overview of general themes consistent across military service, address Moral Injury (MI), highlight elements of deployed experience, review common reactions upon coming home and adjusting, and enumerates strategies for supporting service members and Veterans as they return to post-deployed life to enjoy the freedoms they sacrificed to protect.
Abstract: A meaningfully large population of mental health professionals will encounter, over the course their career, clients who have personal military service history, are partnered with military Veterans, have military Veterans in their immediate or extended family, and/or who have friends and colleagues who served in the military. Mental health professionals therefore are well-advised to gain culture competence with this population. This article provides an overview of general themes consistent across military service, addresses Moral Injury (MI), highlights elements of deployed experience, reviews common reactions upon coming home and adjusting, and enumerates strategies for supporting service members and Veterans as they return to post-deployed life to enjoy the freedoms they sacrificed to protect.
References
More filters
TL;DR: In this article, a survey of 6300 Minnesota licensed registered (RNs) and practical (LPNs) nurses collected data on physical and non-physical violence for the prior 12 months.
Abstract: Aims: To identify the magnitude of and potential risk factors for violence within a major occupational population. Methods: Comprehensive surveys were sent to 6300 Minnesota licensed registered (RNs) and practical (LPNs) nurses to collect data on physical and non-physical violence for the prior 12 months. Re-weighting enabled adjustment for potential biases associated with non-response, accounting for unknown eligibility. Results: From the 78% responding, combined with non-response rate information, respective adjusted rates per 100 persons per year (95% CI) for physical and non-physical violence were 13.2 (12.2 to 14.3) and 38.8 (37.4 to 40.4); assault rates were increased, respectively, for LPNs versus RNs (16.4 and 12.0) and males versus females (19.4 and 12.9). Perpetrators of physical and non-physical events were patients/clients (97% and 67%, respectively). Consequences appeared greater for non-physical than physical violence. Multivariate modelling identified increased rates for both physical and non-physical violence for working: in a nursing home/long term care facility; in intensive care, psychiatric/behavioural or emergency departments; and with geriatric patients. Conclusions: Results show that non-fatal physical assault and non-physical forms of violence, and relevant consequences, are frequent among both RNs and LPNs; such violence is mostly perpetrated by patients or clients; and certain environmental factors appear to affect the risk of violence. This serves as the basis for further analytical studies that can enable the development of appropriate prevention and control efforts.
479 citations
Journal Article•
TL;DR: Examination of how violence from patients and visitors is related to emergency department (ED) nurses' work productivity and symptoms of post-traumatic stress disorder (PTSD) showed significant indirect relationships between stress symptoms and work productivity.
Abstract: The purpose of this study was to examine how violence from patients and visitors is related to emergency department (ED) nurses' work productivity and symptoms of post-traumatic stress disorder (PTSD). Researchers have found ED nurses experience a high prevalence of physical assaults from patients and visitors. Yet, there is little research which examines the effect violent events have on nurses' productivity, particularly their ability to provide safe and compassionate patient care. A cross-sectional design was used to gather data from ED nurses who are members of the Emergency Nurses Association in the United States. Participants were asked to complete the Impact of Events Scale-Revised and Healthcare Productivity Survey in relation to a stressful violent event. Ninety-four percent of nurses experienced at least one posttraumatic stress disorder symptom after a violent event, with 17% having scores high enough to be considered probable for PTSD. In addition, there were significant indirect relationships between stress symptoms and work productivity. Workplace violence is a significant stressor for ED nurses. Results also indicate violence has an impact on the care ED nurses provide. Interventions are needed to prevent the violence and to provide care to the ED nurse after an event. Language: en
381 citations
TL;DR: The results of this analysis suggest that the violence experienced by health care staff is associated with lower patient ratings of the quality of care.
346 citations
"Behavioral threat assessment and ma..." refers background in this paper
...…how reducing workplace violence aligns with other organization goals, such as improving employee morale, decreasing staff turnover, and reducing injuries, missed work days, and union complaints (Arnetz & Arnetz, 2001; Baydin & Erenler, 2014; Gates, Gillespie, & Succop, 2011; Gerberich, 2004)....
[...]
Journal Article•
TL;DR: Results show that non-fatal physical assault and non-physical forms of violence, and relevant consequences, are frequent among both RNs and LPNs; such violence is mostly perpetrated by patients or clients; and certain environmental factors appear to affect the risk of violence.
Abstract: Aims: To identify the magnitude of and potential risk factors for violence within a major occupational population. Methods: Comprehensive surveys were sent to 6300 Minnesota licensed registered (RNs) and practical (LPNs) nurses to collect data on physical and non-physical violence for the prior 12 months. Re-weighting enabled adjustment for potential biases associated with non-response, accounting for unknown eligibility. Results: From the 78% responding, combined with non-response rate information, respective adjusted rates per 100 persons per year (95% CI) for physical and non-physical violence were 13.2 (12.2 to 14.3) and 38.8 (37.4 to 40.4); assault rates were increased, respectively, for LPNs versus RNs (16.4 and 12.0) and males versus females (19.4 and 12.9). Perpetrators of physical and non-physical events were patients/clients (97% and 67%, respectively). Consequences appeared greater for non-physical than physical violence. Multivariate modelling identified increased rates for both physical and non-physical violence for working: in a nursing home/long term care facility; in intensive care, psychiatric/behavioural or emergency departments; and with geriatric patients. Conclusions: Results show that non-fatal physical assault and non-physical forms of violence, and relevant consequences, are frequent among both RNs and LPNs; such violence is mostly perpetrated by patients or clients; and certain environmental factors appear to affect the risk of violence. This serves as the basis for further analytical studies that can enable the development of appropriate prevention and control efforts.
169 citations
"Behavioral threat assessment and ma..." refers background in this paper
...Health care leaders are often prepared to lend their support and offer needed resources when they understand how reducing workplace violence aligns with other organization goals, such as improving employee morale, decreasing staff turnover, and reducing injuries, missed work days, and union complaints (Arnetz & Arnetz, 2001; Baydin & Erenler, 2014; Gates, Gillespie, & Succop, 2011; Gerberich, 2004)....
[...]
...…how reducing workplace violence aligns with other organization goals, such as improving employee morale, decreasing staff turnover, and reducing injuries, missed work days, and union complaints (Arnetz & Arnetz, 2001; Baydin & Erenler, 2014; Gates, Gillespie, & Succop, 2011; Gerberich, 2004)....
[...]
TL;DR: Results of this review suggest that PVV is a serious problem for health care staff in general hospitals, especially those working in medical and surgical units, and that workplace characteristics and the interaction between patients and staff are important contextual factors that can contribute to the development of violent incidents.
160 citations
"Behavioral threat assessment and ma..." refers background in this paper
...…care settings are also home to disproportionately high numbers of violent and abusive incidents, all of which require careful review and follow-up (Hahn et al., 2008; National Institute for Occupational Safety & Health, 2002; Occupational Safety & Health Administration, 2015; Mayhew & Chappell,…...
[...]
...Health care settings are also home to disproportionately high numbers of violent and abusive incidents, all of which require careful review and follow-up (Hahn et al., 2008; National Institute for Occupational Safety & Health, 2002; Occupational Safety & Health Administration, 2015; Mayhew & Chappell, 2007; Pompeii et al., 2013)....
[...]