Resource Library-Psychiatric Emergency Department Reduces Inpatient Psychiatry Seclusion Rates and Workplace Violence Reports

Video Transcription

Video Summary

Josh Moran Jimenez presents a DNP evidence-based practice project aimed at reducing psychiatric seclusion and workplace violence in a 12-bay psychiatric emergency department and affiliated adult inpatient psychiatric units. The team implemented a standardized Violence Assessment Tool (VAT) for all ED patients, used VAT risk levels to guide interventions, and conducted post-incident debriefings to identify triggers, effective de-escalation strategies, and improvement opportunities. Education was provided before go-live and reinforced through monthly meetings, shared governance, and unit champions; audits supported adherence. During implementation, 78% of patients had a documented VAT score; 10% screened high risk. Debriefing forms were completed for 52% of seclusion events, and about half of VAT information was communicated during inpatient handoff. Seclusion rates trended downward but were affected by a high-acuity outlier month; excluding it, post-intervention seclusion decreased ~33%. Workplace violence reports decreased overall by ~46% across units. Lessons included the value of champions and workflow simplicity, with limitations related to acuity, staffing, and documentation. Future plans include integrating tools into the EHR and safety reporting system.

Asset Caption

Speakers: Joshua Moran Jimenez, BSN, RN, CPHQ, NE-BC, CPAHA, CARN, PMH-BC, Christa Walden, BSN, RN, PMH-BC, Alexa Carey, BSN, RN, PMH-BC

The purpose of this presentation is to discuss efforts to reduce violence and seclusion rates on a psychiatric emergency services unit. Through the implementation of an evidence-based protocol that includes assessment of violence risk using a validated tool, identifying de-escalation and coping techniques, and post-incident debriefs rates of violence and seclusion declined. The session will include a brief background, a description of the setting and population, interventions used, pre- and post-intervention data, lessons learned, limitations, future recommendations, and implications for practice.

Meta Tag

Competency Tag PPI3

Competency Tag Description Use change management principles and tools for improvement projects and initiatives

Domain Tag Performance and Process Improvement

Keywords

psychiatric seclusion reduction

workplace violence prevention

Violence Assessment Tool (VAT)

psychiatric emergency department

de-escalation and post-incident debriefing

DNP evidence-based practice project