Management of Violence and Aggression Project

Board: Grampian

Theme: Violence and Aggression

Contact: Steve McMaster, Risk Management Advisor (Violence and Aggression)

NHS Grampian was awarded money from the Working Well Challenge Fund for a Management of Violence and Aggression Project.

In December 2009, NHS Grampian’s Clinical Governance and Risk Management Unit (CGRMU) along with input from the Staff Nurse Development Programme (SNDP) recruited four newly qualified Staff Nurses for a period of 3.5 months each to undertake a project by the end of March 2010. The nurses were employed to promote the available tools and systems to help frontline staff in the prevention and management of V&A.

The aim of the project was to provide specialist frontline support to nursing staff with a view to changing current culture and promoting independence in the prevention and management of violence and aggression.

In order to achieve this ward nursing staff were visited on an ad hoc basis for informal discussions regarding V&A in their area, incident reporting using the DATIX system, guidelines, training and support. Through these discussions, training requirements and several difficult patients were identified. Steve McMaster will continue to support these areas now the project has ended

In addition, to continue to provide support, a network of V&A link nurses has been established. This will enable the Risk Management Advisor to update staff with guideline amendments and changes in contact details and training availability. Link nurses will also have a direct contact point for queries and advice on V&A risk assessment and care planning.

Positives:

  • Staff awareness of guidelines and available support tools to help with the prevention and management of V&A has in general been increased
  • Staff felt the project was worthwhile, face to face discussions were helpful, the information was delivered well, awareness of guidelines had increased, the Risk Management Advisor’s role was better understood and staff were now more likely to report V&A incidents on DATIX
  • Staff now feel better supported
  • Personal achievement for the four newly qualified nurses
  • Improved communication skills, interpersonal skills and the opportunity for professional networking
  • Discussion at ward level of the importance of DATIX reporting of V&A incidents and the benefits of data recording as per NHSG policy
  • Clarification of the role of the Risk Management Advisor for V&A
  • Identification of support requirements in frontline areas with regard to managing difficult patients
  • Following the project evaluation and comparing results with the 2008 study, there appears to be overall improved knowledge of the available support tools in place for the prevention and management of V&A
  • Finally the results indicate there is improved understanding of the Zero Tolerance Promise with the majority of staff in agreement that the promise is effective in the management of V&A

Challenges:

  • Some wards were too busy for ad hoc visits but overcome by making appointments
  • Met in some instances with disinterest but overcome with enthusiasm and ability to listen

Suitable for national roll out:

  • NHS Grampian did not comment on this

For further information on the project please contact Steve McMaster, Risk Management Advisor (Violence and Aggression), on 01224 (2)24933 or emails.mcmaster@nhs.net