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HSC – PSYCHEALTH 2012

HSC – PSYCHEALTH 2012. Six Core Strategies Presentation. Funded By Research and Workplace Innovation Program of the Workers Compensation Board of Manitoba. Preventing Violence, Trauma and the use of Seclusion and Restraints in Mental Health Setting. SIX CORE STRATEGIES.

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HSC – PSYCHEALTH 2012

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  1. HSC – PSYCHEALTH2012 Six Core Strategies Presentation

  2. Funded By Research and Workplace Innovation Program of the Workers Compensation Board of Manitoba

  3. Preventing Violence, Trauma and the use of Seclusion and Restraints in Mental Health Setting

  4. SIX CORE STRATEGIES 1) Leadership and Organizational Change 2) Using Data To Inform 3) Workforce Development and Training 4) Seclusion and Restraint Prevention Tools 5) Consumer Involvement in Inpatient Programs 6) Debriefing Activities

  5. Leadership and Organizational Change Leadership and Organizational Change- includes: Creating a vision, living the organizational values, using human technology, using data to inform, and valuing exemplary performance.

  6. Seclusion/Restraint Prevention Tools Recognizing the applicability of crisis prevention to service settings and the importance of prevention strategies. Making environmental changes that incorporate sensory modulation and sensory/ comfort rooms.

  7. Identifying and Managing Seclusion and Restraint Risk Factors Staff become familiar with the concept of risk assessments and the role they play in helping to prevent injuries. This includes the perceived lack of individualized care, rigid use of the medical model, and high routinized staff tasks.

  8. Workforce Development Outlines the new and changing roles of staff amidst the cultural change as well as providing staff with fundamental opportunities to education and training to meet workforce objectives.

  9. Debriefing Activities Tools designed to rigorously analyze a critical event, to examine what occurred and to facilitate improved future outcomes given the similar circumstances.

  10. Peer Roles in Inpatient Settings Staff learns to appreciate the rationale behind self-help and peer support and their key role in seclusion and restraint reduction efforts.

  11. SO WHY DO WE WANT THIS? • Obligation to treat patients using the least restrictive means possible • Coercive or traumatizing settings do not foster hope, healthy relationships, prosocial behaviours or trust • Risk management issues related to both patients and staff (Litigation, WCB claims, PTSD) • Evidence based research drives change in clinical practice (Can’t ignore the obvious) • Consistent with the WRHA mission and philosophy

  12. AND • To promote recovery/hope models rather than custodial care • To promote better relationships with patients and families • To practice to full professional scope • Recognition that there has to be a better way to serve our patients • To define work as “Treatment Based” rather than “Punitive” as seen by some of our patients • To diminish opportunities related to retraumatization of patients

  13. Summary Analysis With the exception of a slip and fall incident this last year ($880.01), All WCB compensable injury claims have been as a direct result of restraint and seclusion over the previous four years ($71,707.18) The cause and effect relationship reveals that, the fewer times staff restrain and secluded, fewer staff related injuries occur. Compensable time loss and the associated rehabilitation is only a small measure of a multitude of intrinsic factors that administrators must consider when evaluating employee injuries. (Staff morale/satisfaction, impact of absenteeism on team, traumatic stress to staff/patients, etc.)

  14. Do these strategies compromise staff safety? The short answer is: There is no compromise in staff safety!!!! The long answer (which is pretty short) is that staff injury rates have decreased dramatically. WCB compensable time loss is at a historic low.

  15. One claim for WCB cost unrelated to seclusion accounted for $10,600.00.

  16. Preventing Violence, Trauma, and the Use of Seclusion and Restraint in Mental Health Settings program was progressively introduced April 1, 2011. Two compensable time loss claims have occurred during the year, one on April 15, 2011 (3 days) and one on July 10, 2011 (2 days). There has not been any compensable time loss for the last 16 months on PY3-South.

  17. Patients are not Aggressive if They are SEDATED True statement - Monitoring the use of prn medications is as important as monitoring WCB indicators -To date, there has been a 20% decrease in the use of intramuscular prn medications that we traditionally use. Haldol, Ativan -Accuphase (long-acting antipsychotic) use is almost nonexistent

  18. We now have irrefutable evidence that literally every compensable staff injury has been directly caused by staff having to restrain and seclude a patient on PY3-South. Logically then, if staff are not restraining and secluding patients than compensable staff injury rates might very well be reduced to zero; at least on PY3-South

  19. The Six Core Strategies Work This is evidenced informed practice that can work on wards such as a high risk for violence Mental Health ICU setting, but can be successfully implemented in any other type of Mental Health setting. It is unquestionably cost effective on a multitude of levels.

  20. Thank you Questions???

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