Free «Managing Aggression and Combative Patients» UK Essay Paper

Free «Managing Aggression and Combative Patients» UK Essay Paper

Medical Case Report

Sometime around midnight, a young woman about 32 years old was delivered to the medical care unit. It is important to mention that she was later diagnosed with bipolar disorder with psychotic features. According to all the symptoms, she had been using drugs and was aggressive enough to hurt several health providers. The woman bit one of them and another was injured with her personal knife. In addition, the woman was not able to answer questions clearly; she stated she was a police officer. However, the young woman had no documents that could confirm her identity. Even if that information had been true, it would have been odd to see a police officer using drugs. Later on, it was possible to calm her down with the help of a tranquilizer. Obviously, the woman was hallucinating because of the quantity of drugs she had taken: as it turned out later, these were ecstasy and methamphetamine. They were supposed to bring her in high spirits because of their effect, however, the woman was scared, or rather terrified, there was an option that she had been  a witness of a murder, taking into account her profession. Besides, bipolar psychotic disorder is a not a rare disease among police officers; following this point, the patient could have been using drugs with medicines that maintained her optimal mental state.

She was delivered to the therapists and nurses to set her mind at rest with the help of tranquilizers and find out what had happened. As a police officer, the patient had certain privileges: her state was not announced as she might have known valuable information. Besides, unstable mental health of a government servant builds bad reputation for the whole division. Also, the woman needed immediate help of a psychologist who was not available at that moment. It would have been appropriate to provide immediate assistance to patients that serve the government, and who deserve special attention for protecting people and upholding the law.     

Quality and Safety Education for Nurses

In order to simplify the nursing practice and experience, six QSEN competencies were developed (Pre-licensure KSAS, 2014). They include:

  • Patient-Centered Care
  • Teamwork and Collaboration
  • Evidence-Based Practice (EPB)
  • Quality Improvement (QI)
  • Safety
  • Informatics

Here is the analysis of QSEN Competencies that were and were not followed.

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Patient-Centered Care

Patient-Centered Care implies special approach of thoughtful and careful attitude toward a patient, his or her needs and preferences. In this particular case of the 32-year-old woman, patient-centered care was almost absent. Even though the patient was aggressive, health providers should have been more tolerant and attentive to the woman’s protests. In addition, a professional nurse could have reassured the patient and explained that she was in a safe place. However, nothing of the kind was provided; instead, the patient was tranquilized, which was not appropriate at that point. A police officer with bipolar disorder with psychotic features must be treated in a careful way, especially considering the drugs’ impact. Failed patient-centered care may cause unexpected and undesirable consequences, which might be dangerous for the patient’s health. For example, a patient may become more anxious, or lack of trust might provoke more aggression; in addition, medicines must be compatible with the substances that a patient might have taken before.

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Teamwork and Collaboration

Teamwork and collaboration are as important as other competencies, nonetheless, timely and wise collaboration can save patients’ lives or prevent them from having complications of mental or physical state. Maximizing nurse-physician collaboration holds promise for improving the quality of patient care and creates a satisfying working environment for nurses and physicians (Nelson, King & Brodine, 2008). Communication within the nursing team and with patients must be put in order; otherwise, unprofessional work may affect everyone who seeks help. Without any doubt, cooperation between nurses, therapists, psychologists and other health providers needs to be directed to satisfy the patients’ concerns (Nelson, King & Brodine, 2008). It is a merit that a patient was shown to a therapist to establish diagnosis and provide further nursing help. Nevertheless, the patient needed a psychologist as well, because her mental condition left much to be desired. Besides, a psychologist’s assistance could have reduced the aggressive attitude of the patient and, accordingly, the tranquilizer’s usage could have been avoided. For this reason, all health providers have to collaborate as one organism and be available for special cases as readily as possible.

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Evidence-Based Practice

Referring to Fineout-Overholt, Melnyk and Schultz, evidence-based practice is “a problem-solving approach to clinical care that incorporates the conscientious use of current best evidence from well-designed studies, a clinician’s expertise, and patient values and preferences” (p.335). Following this statement, health providers must guarantee it, no matter how aggressive or violent the patient might be. A patient’s values and needs must be of top priority; however, the case demonstrates that medical care was absent. Every detail should count, including the profession of the patient (the duties of a police officer require carrying weapons), thus, an aggressive and armed patient with bipolar disorder deserves attention, care, and immediate help.

Quality Improvement (QI)

Quality Improvement (QI) tells about the methods that increase effectiveness of the provided nursing assistance. There is no limit to perfection, which concerns medical professions as well. Clearly, heath providers need to stick to the basic aims of quality improvement: safety, patient-centered improvement, timely improvement, efficiency and equitability (Quality Improvement in Healthcare). In the above-mentioned case, most of these aims were ignored by the medical unit. To support this statement, the first provided aid was usage of tranquilizers to calm the patient. It seems an unprofessional rather than thoughtful decision. These mistakes should not be permitted in nursing practice and health care system in general.

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Safety should be the primary concern of all medical units, simply because of its connection to help: there is no help without trust. Every patient needs to be sure of his or her safety, namely, the minimum of risk or harm that might be caused (“Should nurses restrain violent and aggressive patients?”, 2011). The given case shows that the patient did not feel safe and secure, this fact, in its turn, had not been taken into consideration momentarily by the nurses. Additionally, even if the patient might be dangerous and aggressive, a professional patient-centered attitude can fix that. Obviously, the unstable and scared 32-year-old woman was looking for protection and support despite her rebellious behavior. One of the urgent things to do is guarantee security, calm the patient down, and inspire trust.

The Importance of Integrating the QSEN Competencies

Taking all the above-mentioned into consideration, one can state that QSEN competencies were not followed and, therefore, the case of this patient could have had a more successful outcome; it would have included better treatment, assistance and provided manipulation. QSEN competencies are valuable and irreplaceable in the process of improvement of health care delivery. Nursing education and practice must contain detailed strategies and methods in order to prepare nurses for deeper research and possible emergencies or at least to provide them with basic approaches to handling non-standard situations or patients. QSEN competencies turned out to be very useful in the quick decision-making process and critical thinking training. Considering the above-mentioned competencies, it will be possible to develop a better quality of healthcare delivery. Proper nursing education and improvement of strategies are the keys to helping medical health units to work like clockwork. For this reason, it is essential to evaluate the actions of health care providers. As well as following the rules and strategies strictly, interaction between all health providers and its constant improvement will bring about the best medical practice.

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