- Try to redirect the violent behavior with physical outlets for 5. Intervene at the fi 8. Administer tranquilizing medications as ordered by physi- 6. Staff should maintain and convey a calm attitude to the 7. Have suffi 9. If the client is not calmed by “talking down” or by medi-materials) client may not use them to harm self or others.assistance reinforces trust.should be used only as a last resort, after all other interven-a safe and effective way of relieving pent-up tension.cation, use of mechanical restraints may be necessary. The side effects.verbal or behavioral aggression. Offer empathetic response to client’s feelings: “You seem anxious (or frustrated, or an-gry) about this situation. How can I help?” cian. Monitor medication for effectiveness and for adverse the client’s feelings conveys a caring attitude and offering when planning interventions for a violent client. Restraints avenue of the “least restrictive alternative” must be selected client. Respond matter-of-factly to verbal hostility. rity for staff.is contagious and can be transmitted from staff to client.the client’s hostility (e.g., punching bag). control over the situation and provides some physical secu-to client if necessary.so that in his or her agitated, hyperactive state, cient staff available to indicate a show of strength rst sign of increased anxiety, agitation, or This conveys to the client evidence of Mood Disorders: Bipolar Disorders Physical exercise is Validation of Anxiety ●^151
2506_Ch07_145-160.indd 0151 2506 Ch 07 145 - 160 .indd 0 11. The Joint Commision requires that the client in restraints 10. If restraint is deemed necessary, ensure that suffi^151 extremities is not compromised (check temperature, color, pulses); to assist client with needs related to nutrition, hy-dration, and elimination; and to position client so that com-of harm to self or others. fort is facilitated and aspiration can be prevented. Some is available to assist. Follow protocol established by the institution. The Joint Commission formerly, the Joint Commission on Accreditation of Healthcare Organiza-tions [ JCAHO]) requires that an in-person evaluation (by a physician, clinical psychologist, or other licensed indepen-dent practitioner responsible for the care of the patient) be conducted within 1 hour of initiating restraint or seclusion (The Joint Commission, 2010). The physician must reissue a new order for restraints every 4 hours for adults and every 1 to 2 hours for children and adolescents. tions have been unsuccessful, and the client is clearly at risk be observed every 15 minutes to ensure that circulation to cient staff 10/1/10 9:34:50 AM 10 / 1 / 10 9 : 34 : 50 AM
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