Post Anesthesia Care Unit Comprehensive Safety Quality Improvement Project on De-Escalation of Patients

Title

Post Anesthesia Care Unit Comprehensive Safety Quality Improvement Project on De-Escalation of Patients

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Document Type

Presentation

Department

Nursing

Additional Department

Medicine

Abstract

Background: Violence within the healthcare setting has risen significantly, and have crossed into areas where staff are less prepared to manage and deescalate challenging patient encounters. This lack of knowledge and confidence has led to increased staff stress, burn out, and can potentiate poor patient outcome.

Methods: A pre/post-simulation quality improvement project was performed within a tertiary hospital Post-Anesthesia Care Unit in Upstate New York to evaluate the effect of simulation on feelings of confidence preparedness in patient de-escalation with PACU nurses and patient care technicians. The project evaluation included the Thackrey’s Clinician Confidence in Coping with Patient Aggression (CCPA) Instrument, De-Escalation Aggressive Behavior Scale (EDABS), and a project-specific simulation evaluation tool.

Results: There was a statistically significant difference in the mean scores for the CCPA data pre and post across all questions. There was no correlation between length of being a RN (p < .498), length of working in the PACU (p < .492), or having any de-escalation training (p < .786), on the CCPA data. There was a statistically significant, moderate positive correlation between age and ability to protect yourself physically from an aggressive patient, r(98) = .592, p < .026. There was no other correlation with age and other CCPA questions.

Conclusion: Simulations can be successfully used to train, develop and improve staff confidence in patient de-escalation.

Implications: By implementing and combining de-escalation, on line training with high fidelity in situ simulation followed by a debrief, during orientation, should improve the level of confidence in the PACU prior to an escalated incident.

Publication Date

11-3-2023

Comments

Mary Gaukler Giannavola, MS, MBA, RN, MEDSURG-BCa.; Basil Verghese, MD, FACP, FHMb; Deborah Maier, DNP, RN, ACCNS-AG, CCRN-Kc

Rochester General Hospital

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Post Anesthesia Care Unit Comprehensive Safety Quality Improvement Project on De-Escalation of Patients

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