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De-escalation Techniques

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Name: Brittny Brown
Mental Health Activity
An excessively active motor state coupled with a tense interior state is referred to as
agitation. Agitation can be an indication of a more serious medical or psychiatric issue that
poses a risk to the patient's life, or it can be a sign that they are under physical or
psychological stress. One of the first signs of agitation is motor hyperactivity. Hand motions,
tapping of the feet, and pacing are indicative of this kind of purposeless, repetitive activity.
When someone is agitated, their field of vision narrows and they become less aware of their
environment.The Behavioural Activity Rating Scale (BARS) is the standardized rating scale
used to evaluate the agitated patient. Anger is indicated by a BARS score greater than 4. Any
agitation episode needs to be addressed with a verbal de-escalation attempt as the initial step.
In addition to fostering a therapeutic alliance, this aids in the patients' self-distress
management. When de-escalating the patient, ten components should be applied. 1. Be
mindful of others' personal space 2. Avoid provocations 3. Make spoken contact 4. Be
succinct; 5. Recognize your desires and emotions 6. Pay close attention to what the patient is
saying 7. Agree to disagree or agree to disagree 8. Establish boundaries 9. Provide options
and hope 10. Brief the personnel and patient.
Using these techniques in a clinical setting can help create and preserve control over
routine patient interviews, making the atmosphere safer and more encouraging for both
patients and staff. These methods foster a more therapeutic relationship, increase patient
cooperation, and improve communication. In de-escalating circumstances, it is important to
pay attention to the tone and volume of speech because these factors have a considerable
impact on how the assessment proceeds. Based on clinical observations, instances were noted
where healthcare professionals displayed aggression toward agitated patients, resulting in a
rapid escalation of the situation. During one incident, a patient, who was pacing and
expressing agitation through hand gestures, was confronted by a healthcare worker who
loudly demanded to know what was wrong. This approach led to increased frustration and
escalated agitation levels, prompting the patient to engage in violent behaviors such as
shouting and throwing objects. Consequently, the patient had to receive stat medications and
be restrained with four counts. The situation could have been handled more effectively if the
healthcare provider had been more sensitive to the patient's emotions and if de-escalation
techniques, as outlined above, had been employed.
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