Business teach all members to perform a job in order

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business) teach all members to perform a job in order to run the business→ led to the supported employment model, which has been more effective in helping persons with SMI achieveemployment
Known predictors of violence and management strategies for potentially violent patients Chap.27, pg 515-528Predictors of Violence1.Signs and Symptoms that usually (not always) precede violence:a.Hyperactivity→ most important predictor of imminent violence (pacing, restlessness, etc)b.Increasing anxiety and tension→ clenched jaw or fist, rigid posture, fixed or tense facial expression, mumbling to self (pt may have sob, sweating, & rapid pulse)c.Verbal abuse→ profanity, and argumentativeness d.Loud voice, change of pitch; or very soft voice causing others to strain to heare.Intense eye contact or avoidance of eye contact2.Recent acts of violence, including property violence3.Stone silence4.Alcohol and drug intoxication5.Possession of weapon or object that may be used as a weapon6.Isolation that is new7.Milieu characteristics conducive to violence:a.overcrowdingb.staff inexperiencec.provocative or controlling staffd.poor limit settinge.arbitrary revocation of privileges De-Escalation Techniques: Practice PrinciplesMaintain pts self-esteem and dignityMaintain calmness (yourself and pt)Assess pt and situationIdentify stressors and stress indicatorsRespond as early as possibleUse calm, clear tone of voiceInvest timeRemain honestEstablish what the pt considers to be his/her needBe goal-orientedMaintain a large personal spaceAvoid verbal strugglesGive several optionsMake clear the optionsUtilize a nonaggressive postureUse genuineness and empathyAttempt to be confidently awareUse verbal, nonverbal, and communication skillsBe assertive (not aggressive)
Assess for personal safetyKnow safety and legal considerations for seclusion and restraint Chap. 27Seclusion→“the involuntary confinement of a patient alone in a room, or area from which the patient is physically prevented from leaving.” the goal is never punitive; rather the goal is safety of the patient and othersRestraint→“any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the ability of the patient to move his/her legs, arms, body, or head freely.”Prior to an episode of seclusion, a patient must be assessed for contraindicationsof seclusion:pregnancyCOPDhead or spinal injuryseizure disorderabusehx of surgery or fracturemorbid obesitysleep apneaPatient may not be held in seclusion or restraint without an order from a licensed practitioneronce in a restraint, pt must be directly observed and formally assessed at frequent, regular intervals for level of awareness, level of activity, safety within restraints, hydration, toileting needs, nutrition, and comfort

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Term
Spring
Professor
MaryLeveillee
Tags
Nursing, Major depressive disorder, acute mania

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