Challenging behaviour in Mental Health Services: Combining psychological perspectives

Direct and collateral effects of staff-worn protective equipment on injury prevention from child aggression

OBJECTIVE

The present study measured arm and other body injuries to classroom staff that were caused by a student who had developmental disabilities and treatment-resistant aggression.

METHODS

Following a baseline (no equipment) phase, staff wore protective equipment on their arms but not on other areas of their body.

RESULTS

The frequency of self-reported arm injuries increased with protective equipment, but injury severity decreased. Wearing the protective equipment was also associated with more injuries to other areas of the body.

CONCLUSIONS

Staff-worn protective equipment may reduce the severity but not the frequency of staff injuries from aggression; as well, the presence of protective equipment may set the occasion for increased injuries to non-protected areas of the body.

Preventing injury from child aggression: a single-case evaluation of the effects of staff-worn protective equipment

OBJECTIVE

This single-case study of a boy with autism and high-frequency aggression concerned the effects of classroom teachers wearing protective equipment (gloves) on injuries produced to their hands as well as injuries sustained to non-protected areas of the body.

METHODS

A reversal-type design was used to evaluate the effects of protective equipment relative to a baseline (no protective equipment) phase, a low-demand activity phase without protective equipment and a low-demand activity phase with protective equipment.

RESULTS

The protective equipment intervention eliminated hand injuries, did not result in other types of injuries, was not associated with increased aggression and was rated favourably by the classroom teachers.

CONCLUSION

The findings suggest that staff-worn protective equipment may be a valuable component of comprehensive clinical safety programmes within service settings for children with intellectual and developmental disabilities.

Registered nurses' and behavior health associates' responses to violent inpatient interactions on behavioral health units

BACKGROUND

Violence carried out by patients against nursing staff unsettles and threatens coworkers as they care for individuals admitted to inpatient psychiatric units.

OBJECTIVE

This study explored nursing staff's individual and group responses to violent incidents performed by patients against caregivers.

DESIGN

This qualitative study used focus groups to collect data from professional nurses and behavioral health associations (N = 19) recruited from urban, inpatient psychiatric unit. Data were analyzed thematically.

RESULTS

Sharing information about violence, intervening therapeutically, intervening nontherapeutically, recognizing team influences, experiencing emotions following violence, and understanding the work environment comprised the major themes of the experience.

CONCLUSIONS

Findings may stimulate discussions and education sessions that address strategies helpful to nursing staff so that incidents are prevented and staff is supported following such disturbing events. Events of workplace violence, including those occurring on behavioral mental health in inpatient units, require accurate individual and aggregate reporting to develop interventions and evaluate effectiveness of violence reduction strategies.