ensure all patients and visitors are aware of zero tolerance policy to aggressive behaviour
consider TV surveillance cameras with screens visible to patients and visitors so they are well aware that all behaviour is being monitored and recorded
ensure the ED is designed for patient and staff security in the event of incidents
ensure there is an appropriate security response system in place
all staff should have adequate training on managing the agitated or violent person
ensure timely and appropriate communication, particularly to those waiting long periods and to those in high stress situations
be caring, calm, empathetic and professional in your approach to patients and their relatives, but be assertive early when their behaviour is becoming inappropriate.
address unrealistic expectations early
be cogniscent of cultural variations in behaviours, expectations and attitudes
be aware of past aggressive behaviour patterns of the patient
drug-affected patients can be very irrational and become rapidly agitated without warning, particularly with drugs such as
metamphetamine / meth / ice.
be alert for clinical deterioration and treat pain or agitation early and adequately
ensure an adequate security response is attended for the expected arrival of agitated patients brought by police or ambulance, and ensure a timely initial clinical assessment to risk manage them
call security response EARLY before it gets out of hand
avoid presence of hand guns being carried by hospital security as this may escalate severity of some incidents whilst having little additional benefits.
nursing staff should document Behaviours of Concern (on a BoC chart) along with normal vital signs for all patients and escalate any rise in level of concern to medical staff.