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Quality Improvement Presentation

Improvement of the Crisis Prevention Tool and Safety Plan for the
Kekela Mental Health Unit at Queens Medical Center

By: Kristina, Lauren, Darren, Gary, & Amy


NURS 362 - Fall 2015

PICOT - Population / Patient Problem


Who is your patient?
Adult mental health clients in an acute care setting
What is the patient problem?
Current assessment tool is not patient-friendly
(lengthy, cumbersome)
Poor patient compliance in completing crisis
prevention assessment and development of crisis
plan
Poor accessibility of crisis plan for nurses
Safety issue

PICOT - Intervention
What do you plan to do for the patient?
Revise the current crisis prevention assessment
form to be more streamlined and user-friendly.
Utilize personalized crisis prevention information
provided by patient in order to prevent/minimize
crisis by recognizing warning signs and deescalating a situation through coping strategies.

PICOT - Comparison
What is the alternative to your plan?
Keep the crisis assessment tool that is (not) being
used/utilized
Utilize different tools
State of Hawaii Department of Health, Child
and Adolescent Mental Health Division
National/International:
Nonviolent Crisis Intervention Training (CPI)
Resource Guides for creating Safety Plans
Crisis Assessment Tool (CAT)

PICOT - Outcome & Time


What outcome do you seek?
New tool to be patient-nurse friendly ( compliance)
A simplified, concise crisis prevention assessment
tool
Implement on daily census
What is the time frame?
Implement - immediately
Analysis - at least 1 month

Evaluation
Verbal feedback
Measure utilization
Safety plan on file for each patient
Measure simplicity
Pt. and nurses verbalizes understanding
Measure ease of use
Decreased amount of time to complete
safety plan

References

Change your team [blog]. (2013). Retrieved from: http://changeyourteam.com/wpcontent/uploads/2013/09/cliff-blog-shutterstock_123670591.jpg

Child and Adolescent Mental Health Performance Standards. (n.d.). Retrieved September
14, 2015, from http://health.hawaii.gov/camhd/files/2013/07/Orange-Book.pdf

CPI (2012). Nonviolent Crisis Intervention Participant Workbook. Milwaukee, WI

Data Assessment Registry Mental Health & Addiction.Crisis Assessment Tool (CAT) (n.d).
Retrieved from https://dmha.fssa.in.
gov/DARMHA/Documents/SFY2016ANSAManual_08282015.pdf

Heckemann, B., Zeller, A., Hahn, S., Dassen, T., Schols, J., & Halfens, R. (2015). The
effect of aggression management training programmes for nursing staff and students
working in an acute hospital setting. A narrative review of current literature. Nurse
Education Today, 35(1), 212-219. doi:10.1016/j.nedt.2014.08.003

References, Cont

Mid-Valley Behavioral Care Network (2009). Personal Action/Crisis Prevention Plan.


Retrieved from: http://www.mvbcn.
org/home/mv1/smartlist_144/personal_actioncrisis_prevention_plan.html

Rings, J. A., Alexander, P. A., Silvers, V. N., & Gutierrez, P. M. (2012). Adapting the
Safety Planning Intervention for Use in a Veterans Psychiatric' Inpatient Group Setting.
Journal Of Mental Health Counseling, 34(2), 95-109.

Roberts, A. & Ottens, J. (2005). The seven-stage crisis intervention model: a road map
to goal attainment problem solving, and crisis resolution. Retrieved from: http://btci.
edina.clockss.org/cgi/reprint/5/4/329

The Parent/Professional Advocacy League (PPAL) & Massachusetts Behavioral Health


Partnership (MBHP) (2011). Crisis Planning Tools for Families: Companion Guide for
Providers. Retrieved from: https://www.masspartnership.com/pdf/Crisis-PlanningTools_Guide_for_ProvidersFinal.pdf

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