1. Chapter 24 Anger and Aggression
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2. Violence: Warnings Restlessness/hyperactivity
Signs of anxiety and tension
Profanity, argumentativeness
Loud voice or stony silence
Intense glaring eye contact
Intoxication
Carrying a dangerous object
Recent acts of violence B
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3. De-Escalating Techniques
Maintain client’s dignity and self-esteem
Stay calm
Assess situation; identify stressors and what client sees as his need
Use calm voice, non-threatening body language
Be empathetic, genuine, honest
Maintain large personal space
Don’t argue
Give clear options
Assess for own personal safety B
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4. Seclusion/Restraint Guidelines
Use only to protect client or others from harm
Legal requirements
- Team involvement
- RMO signature
- Client/advocate agreement
Assess
- Client mental state
- Risks to clients
- Need for restraint
- Least restrictive method B
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5. Seclusion/Restraint Guidelines, cont.
Observe
- Continually document q15 minutes
- Monitor vital signs
- Circulation
- Safety
- Emotional state
- Early release possible?
Care
- Release restraint q2h, (Limb ROM if limb motion
restricted)
- Provide nutrition
- Hydration
- Elimination B
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6. Seclusion/Restraint Guidelines, cont.
Document
- Precipitating behavior
- Less restrictive alternatives tried and result
- Ongoing observations
- Care given q15 min
- Circumstances of termination of restraint B
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