Page 10 - UHN Centre for Mental Health Impact Report 2023
P. 10

ACUTE CARE & GENERAL PSYCHIATRY






            Protecting Patients and Staff                                                                                      Alternatives to Restraints


            Creating a Safer Healthcare Enviornment at UHN.                                                                    Staff Nurses Emphasize Trauma-Informed Approaches.




                                                                                                                                In a recent quality improvement project, two nurses — Megan
                                                                                                                                Smith and Rachel Yang —highlight the range of options available
                                                                                                                                instead of depending on physical restraints in mental health care.

                                                                                                                                “We wanted to promote alternative approaches that are the least
                                                                                                                                traumatizing,” says Rachel. “Trauma-informed care is the most
                                                                                                                                important aspect of mental health nursing.”

                                                                                                                                The resource created — “Enhancing the Use of Alternative                          “To witness the
                                                                                                                                Approaches to Physical Restraints” — covers a range of prevention              outstanding work
                                                                                                                                strategies: from ways to build rapport with patients and enhance                        Rachel and
                                                                                                                                assessment skills, to grounding techniques and the benefits of
                                                                                                                                daily behavioural activation therapy.                                         Megan did on this
                                                                                                                                                                                                                   project makes
                                                                                                                                Megan and Rachel drew on their nursing experience and                           me so proud to
                                                                                                                                education and also brought in evidence-based components via                         be a nurse at
                                                                                                                                research. Their resource was shared with Centre for Mental                                    UHN.”
                                                                     Dr. Christian Schulz-Quach and Ms. Charlene Reynolds
                                                                                                                                Health colleagues and posted on the unit department site.                           – Ms. Aideen Carroll,
            When a UHN patient poses a danger to                 buttons, as well as increased security and                                                                                                            Advance Practice
            themselves or others and the situation               psychiatry expertise.                                          “We thought creating this educational resource would be a great                          Nurse Educator
            could escalate beyond the abilities of                                                                              opportunity to support and empower our new nurses and let
            present staff to manage, a Code White                To ensure timely interventions and estab-                      them know that there are other options,” says Megan.
            is initiated — a coordinated emergency               lish clear roles and responsibilities, the
            response to safeguard individuals from               committee participated in a large scale                       Ms. Megan Smith and Ms. Rachel Yang
            violence at the point of care.                       quality improvement project, which
                                                                 included conducting a needs assessment
            UHN recently formed an organization-                 with 250+ members of Team UHN and
            wide committee, co-led by the Centre                 identifying three priorities:
            for Mental Health’s Dr. Christian Schulz-
            Quach, staff psychiatrist, and Charlene                    •  Implementing a comprehensive
            Reynolds, Clinical Director, to review                      training program tailored to sites
            incidences and improve Code White                           and program.
            responses, management and training.                        •  Standardize Code White protocols
                                                                        into a 16-step process.
            Code White’s have an immense emotion-                      •  Explore establishing dedicated Code
            al and psychological impact on patients                     White teams at each site.
            and staff. While these complex situations
            occur throughout UHN, needs vary across              Implementing these priorities will
            sites and programs. High-incidence areas             enhance prevention, de-escalation and
            require enhanced support, such as panic              safety for both UHN patients and staff.
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