ABSTRACT INTRODUCTION: De-escalation techniques consist of a series of communicative and behavioral interventions aimed at preventing the escalation of heteroaggressive acute symptoms. The implementation of these techniques is a key prevention strategy to improve the skills of health professionals in the effective and safe management of patients in critical conditions. The objective of this study is to identify the level of theoretical and practical knowledge of de-escalation techniques of nurses related to the U.O.C. Psychiatric Diagnosis and Care Service (SPDC), the U.O.C. of the Mental Health Centres (CSM) and the U.O.C. First Aid (PS) of the AST of Ascoli Piceno. MATERIALS AND METHODS: An exploratory study of a monocentric observational type was conducted, by administering a self-completed cognitive questionnaire. The study recruited nurses from U.O.C. SPDC, CSM and PS of the AST of Ascoli Piceno and returned 92 statistical units, adjusting the confidence level to 95%. The data were collected between 10 July 2024 and 1 September 2024. RESULTS: Of the 92 nurses initially enrolled, 76 answered the questionnaire, with a response rate (RR) of 82.6%. 56.6% of the sample consider experience in psychiatric settings "very useful" while 3.9% do not think it is "at all" useful. The majority of the sample admits to know how to identify behavioral strategies during the escalation phase of aggression. Indeed, 66.7% of the sample involved has implemented a competent modus operandi in the management of aggressive actions and therefore considers the theme and the formation of aggression in the health setting to be relevant. DISCUSSION: This survey has analyzed the profile of nurses at the AST Ascoli Piceno and their experience in managing aggression in psychiatric and emergency settings. Most of the sample has a good level of training, but limited experience in psychiatric care. 67.4% of the nurses know the M.O.A.S., while 28% have never attended specific courses on aggressive behaviour. The research highlights the need to strengthen continuing education through training projects and company protocols aimed at improving the safety of health professionals at risk of heteroaggressive attacks. CONCLUSIONS: The survey showed a nursing sample with good academic training, but with room for improvement in managing aggression in psychiatric and emergency settings. Limited experience and low participation in specific courses suggest a strong partnership with health management to enhance the skills of health professionals, safety in work settings and quality of care. In support of this, a company training project is proposed to increase the training of all health professionals on de-escalation techniques in hetero-aggressive acute diseases. KEYWORDS: Aggression, De-escalation techniques, Nurses, Prevention;
ABSTRACT INTRODUZIONE: Le tecniche di de-escalation consistono in una serie di interventi comunicativi e comportamentali mirati a prevenire l’escalation nelle acuzie eteroaggressive. L’implementazione di tali tecniche si configura come una strategia di prevenzione fondamentale per migliorare le competenze dei professionisti sanitari nella gestione efficace e sicura dei pazienti in condizioni critiche. L’obiettivo dello studio consiste nell’individuare il grado di conoscenze teorico-pratiche delle tecniche di de-escalation degli infermieri afferenti l’U.O.C. Servizio Psichiatrico Diagnosi e Cura (SPDC), le U.O.C. dei Centri di Salute Mentale (CSM) e le U.O.C. Pronto Soccorso (PS) dell’AST di Ascoli Piceno. MATERIALI E METODI: È stato condotto uno studio esplorativo di tipo osservazionale monocentrico, tramite la somministrazione di un questionario conoscitivo autocompilato. Lo studio ha arruolato gli infermieri delle U.O.C. SPDC, CSM e PS dell’AST di Ascoli Piceno ed ha restituito 92 unità statistiche, adattando il livello di confidenza al 95%. I dati sono stati raccolti nel periodo compreso tra il 10 Luglio 2024 e il 1° settembre 2024. RISULTATI: Dei 92 infermieri inizialmente arruolati, 76 hanno risposto al questionario, con un Response Rate (RR) pari al 82,6%. Il 56,6% del campione ritiene “molto utile” fare esperienza nei setting psichiatrici mentre il 3,9% ritiene che non sia “per nulla” utile. La maggioranza del campione riconosce di saper individuare strategie comportamentali durante la fase di escalation dell’aggressività. Difatti, ben il 66,7% del campione coinvolto ha implementato un modus operandi competente nella gestione degli agiti aggressivi e, pertanto, ritiene attuale il tema e la formazione dell’aggressività nel setting sanitario. DISCUSSIONE: La presente indagine ha analizzato il profilo degli infermieri dell'AST Ascoli Piceno e la loro esperienza nella gestione dell'aggressività in contesti psichiatrici ed emergenziali. La maggior parte del campione presenta un buon livello di formazione, ma un'esperienza limitata in ambito psichiatrico. Il 67,4% degli infermieri conosce la scala M.O.A.S., mentre il 28% non ha mai partecipato a corsi specifici sugli agiti aggressivi. La ricerca evidenzia la necessità di rafforzare la formazione continua tramite progetti formativi e protocolli aziendali volti a migliorare la sicurezza dei professionisti sanitari a rischio di acuzie eteroaggressive. CONCLUSIONI: L'indagine ha evidenziato un campione infermieristico dotato di una buona preparazione accademica, ma con margini di miglioramento nella gestione dell'aggressività nei contesti psichiatrici e di emergenza. L'esperienza limitata e la scarsa partecipazione a corsi specifici suggeriscono di instaurare una solida partnership con la dirigenza sanitaria affinchè si potenzino le competenze dei professionisti sanitari, la sicurezza nei setting lavorativi e la qualità assistenziale. A sostegno di quanto emerso, si propone un progetto formativo aziendale mirato ad incrementare la formazione di tutti i professionisti sanitari sulle tecniche di de-escalation nelle acuzie eteroaggressive. KEYWORDS: Aggressività, Tecniche di de-escalation, Infermieri, Prevenzione.
Tecniche di de-escalation nella prevenzione della contenzione nelle acuzie psichiatriche eteroaggressive
GALLI, MARTINA
2023/2024
Abstract
ABSTRACT INTRODUCTION: De-escalation techniques consist of a series of communicative and behavioral interventions aimed at preventing the escalation of heteroaggressive acute symptoms. The implementation of these techniques is a key prevention strategy to improve the skills of health professionals in the effective and safe management of patients in critical conditions. The objective of this study is to identify the level of theoretical and practical knowledge of de-escalation techniques of nurses related to the U.O.C. Psychiatric Diagnosis and Care Service (SPDC), the U.O.C. of the Mental Health Centres (CSM) and the U.O.C. First Aid (PS) of the AST of Ascoli Piceno. MATERIALS AND METHODS: An exploratory study of a monocentric observational type was conducted, by administering a self-completed cognitive questionnaire. The study recruited nurses from U.O.C. SPDC, CSM and PS of the AST of Ascoli Piceno and returned 92 statistical units, adjusting the confidence level to 95%. The data were collected between 10 July 2024 and 1 September 2024. RESULTS: Of the 92 nurses initially enrolled, 76 answered the questionnaire, with a response rate (RR) of 82.6%. 56.6% of the sample consider experience in psychiatric settings "very useful" while 3.9% do not think it is "at all" useful. The majority of the sample admits to know how to identify behavioral strategies during the escalation phase of aggression. Indeed, 66.7% of the sample involved has implemented a competent modus operandi in the management of aggressive actions and therefore considers the theme and the formation of aggression in the health setting to be relevant. DISCUSSION: This survey has analyzed the profile of nurses at the AST Ascoli Piceno and their experience in managing aggression in psychiatric and emergency settings. Most of the sample has a good level of training, but limited experience in psychiatric care. 67.4% of the nurses know the M.O.A.S., while 28% have never attended specific courses on aggressive behaviour. The research highlights the need to strengthen continuing education through training projects and company protocols aimed at improving the safety of health professionals at risk of heteroaggressive attacks. CONCLUSIONS: The survey showed a nursing sample with good academic training, but with room for improvement in managing aggression in psychiatric and emergency settings. Limited experience and low participation in specific courses suggest a strong partnership with health management to enhance the skills of health professionals, safety in work settings and quality of care. In support of this, a company training project is proposed to increase the training of all health professionals on de-escalation techniques in hetero-aggressive acute diseases. KEYWORDS: Aggression, De-escalation techniques, Nurses, Prevention;File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12075/19995