The Future of Education

Edition 14

Accepted Abstracts

Quality and Safety Issue

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Ensuring patients receive quality and safe care services is a key ingredient of effective health care delivery. The healthcare organization focuses efforts toward guaranteeing patient safety because this leads to better quality of care. In mental health care settings, patient safety is important considering that mental health patients get exposed to a wide range of risks attributed to various mental health disorders. D’Lima et al., noted that patient safety focuses on preventing harm when providing health care services. Patient safety concerns particularly arise in inpatient psychiatric settings because the violent and aggressive behaviors of mental health patients might predispose them to accidents or even issues that undermine the delivery of quality care.

Mental health patients often pose a risk to themselves and others when they exhibit violent and aggressive behaviors. As Slemon, Jenkins, and Bungay  noted, the patient safety concerns associated with psychiatric inpatient settings often affect health staff and other patients within this setting. The violent and aggressive behaviors can lead to physical injuries and affect health staff psychologically. Consequently, they might impact negatively on the performance inpatient psychiatric ward staff thus compromising the quality of care provided to mental health patients. Therefore, patient safety is viewed as a key consideration in inpatient psychiatric settings.

Clinical staff in inpatient psychiatric settings conventionally employ seclusion and restraints to handle patients with aggressive behavior. One quality improvement strategy is the use of less restrictive measures and shifting the focus to patient-centered approaches to deal with violent and aggressive psychiatric patients. The application of seclusion and restraints is only recommended in the event less restrictive measures prove to be ineffective in managing psychiatric patients engaged in aggressive behaviors. Gaynes et al., acknowledged that psychiatric hospital staff should use these approaches in case the aggressive behavior endangers “the immediate physical safety of the patient, a staff member, or others”. The reduction of violent and aggressive behaviors using less restrictive measures as opposed to seclusion and restraints helps in improving the quality of care while guaranteeing patient safety.

The quality improvement strategy adopted in dealing with psychiatric patients who exhibit aggressive behaviors addresses various aims for improvement. These aims include patient-centered, safe, and effective care. Interprofessional collaboration is important in improving quality when it comes dealing with aggressive behavior in inpatient psychiatric settings. Interprofessional collaboration can particularly help in determining effective and less restrictive measures that psychiatric ward staff can use to manage violent and aggressive behavior among patients. Interprofessional collaboration can also help in determining factors contributing to or exacerbating this behavior among psychiatric patients. Consequently, it becomes easy to develop effective and patient-centered approaches to deal with aggressive behavior.

In conclusion, patient safety is important in health care delivery. In inpatient psychiatric settings, violent and aggressive behavior among patients raises patient safety concerns and undermines the quality of care offered. Violent and aggressive behaviors might lead to psychiatric ward staff experiencing physical injuries or psychological consequences that may compromise the quality of care that mental health patients receive. Usually, psychiatric staff responsible for managing inpatient psychiatric patients use seclusion and restraints as the first option when they encounter violent and aggressive patients. However, employing less restrictive measures is a key quality improvement strategy that can guarantee patient safety and better care for inpatient psychiatric patients. The use of patient-centered approaches ensures that these patients also receive quality care.





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