J Am Psychiatr Nurses Assoc [JOURNAL]
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200 papers
Responding to Escalating Behaviors on a Child Inpatient Unit: Five Elements Often Missing in De-escalation Dialogs.
Delaney KR
J Am Psychiatr Nurses Assoc · 2025 · PMID 40417817 · Publisher ↗
OBJECTIVES: This discussion paper elaborates the elements of patient engagement and teamwork that support the effective use of de-escalation during tense situations marked by increasing threat, lability, or hostility. St...
OBJECTIVES: This discussion paper elaborates the elements of patient engagement and teamwork that support the effective use of de-escalation during tense situations marked by increasing threat, lability, or hostility. Staff training often involves de-escalation techniques which equip staff with important basic skills. Yet what often fails to be explained during training are subtle elements operating on inpatient child/adolescent milieus that are critical to the effectiveness of this intervention. METHODS: Synthesis of practice experience and the literature on select elements such as milieu leadership, teamwork, and relationship leverage which supports de-escalation efforts on child inpatient psychiatric units. RESULTS: Five elements of inpatient practice were identified: teamwork, charge nurse leadership, staff holding a common understanding of behavior and a sense of the underlying dynamics of aggression, and use of relationship leverage. How these elements support de-escalation is briefly discussed. Included in the elaboration of these elements are the strategies unit managers might draw upon to cultivate these critical team and engagement elements. CONCLUSION: Unit leadership should find opportunities to cultivate knowledge and skills related to teamwork, a shared understanding of a youth's behavior, the dynamics underlying aggression, and building engagement. These dimensions of practice are nuanced and often involve implicit aspects of teamwork and unit culture. Yet they are critical to keeping units safe and supporting de-escalation. These elements and how they support de-escalation should be articulated and cultivated with novice staff and new team hires.
Seclusion Rates and Workplace Violence on a Psychiatric Emergency Department Unit.
Moran Jimenez JD, Walden C, Carey A … +4 more , Miller J, Keyes Young K, Morris L, Erbaio T
J Am Psychiatr Nurses Assoc · 2025 · PMID 40415706 · Full text
INTRODUCTION: Actions of physical violence, harassment, or other threatening and intimidating behavior characterize workplace violence, often subsequently followed by seclusion to maintain safety in emergency department...
INTRODUCTION: Actions of physical violence, harassment, or other threatening and intimidating behavior characterize workplace violence, often subsequently followed by seclusion to maintain safety in emergency department (ED) and psychiatric settings. Though there is no universally identified benchmark of acceptable rates of seclusion, April to September 2023 preintervention rate of seclusion hours on a psychiatric ED unit at a public state hospital in the southeast was 5.57/1,000 patient care hours, exceeding current comparison data from Centers for Medicare and Medicaid Services (CMS) for calendar year 2022 with a state average, 0.26/1,000 patient care hours and national average, 0.35/1,000 patient care hours. AIM: This project aimed to reduce seclusion rates through the implementation of a violence risk identification and management protocol. METHODS: Interventions included brief training and implementation of a violence risk protocol using the Violence Assessment Tool (VAT) and seclusion debriefing. RESULTS: Reports of workplace violence decreased by 25% in the psychiatric ED and 17% across the adult psychiatric inpatient units, and there was a cumulative decrease in Inpatient Psychiatric Facility Quality Reporting seclusion rates by 5% across the adult psychiatric inpatient units where the components of the VAT were communicated in report from the psychiatric ED. CONCLUSION: Early identification of violence risk, patient-specific agitation factors, and de-escalation preferences in the ED setting may have the potential to improve safety through reduced seclusion and workplace violence events. Future research could study patient perspectives of the VAT as a patient-centered tool in de-escalation to reduce seclusion.
A Community-Driven Mental Health Solution: Lay Mental Health Ambassadors.
Molewyk Doornbos M, Zandee GL
J Am Psychiatr Nurses Assoc · 2025 · PMID 40415705 · Publisher ↗
BACKGROUND: Urban, ethnically/racially diverse, impoverished people are predisposed to experience unaddressed depression and anxiety. The use of lay mental health ambassadors (MHAs) may effectively expand access to menta...
BACKGROUND: Urban, ethnically/racially diverse, impoverished people are predisposed to experience unaddressed depression and anxiety. The use of lay mental health ambassadors (MHAs) may effectively expand access to mental health care in underserved neighborhoods. AIMS: This study described the role of lay MHAs as they provided mental health prevention in their communities. METHODS: Using community-based participatory research in the context of long-term partnerships between a department of nursing and three urban, racially/ethnically diverse, and impoverished neighborhoods, the researchers trained 22 Black, White, and Hispanic neighborhood residents to serve as lay MHAs. Descriptive data were collected on the MHAs, their "touches" (mental health conversations) with community residents, responses to these "touches," and role satisfaction of the MHAs. RESULTS: The MHAs conducted 3,782 "touches" with 1,614 persons during the 28 months of data collection. The recipients of the "touches" were primarily female, middle-aged, and Black. The MHAs employed the strategies of listening and teaching self-care/coping strategies most often. Neighborhood residents' major "take aways" from the "touches" were education and resources. The MHAs were highly satisfied with their role. MHA mental health literacy increased, and mental health stigma decreased from before to 4 to 9 months after training. CONCLUSIONS: The community-driven solution of training lay MHAs to do preventive, upstream mental health work in their neighborhoods holds potential to address existing mental health inequities. This study contributes to an emerging evidence base that can empower communities and nurses to collaborate in the development of useful research agendas, meaningful policy, and tailored mental health care.
The Value of an Educational Intervention on Knowledge, Attitudes, and Practices Related to Seclusion and Restraint Use in a Psychiatric/Mental Health Setting.
Bryant CK, Hampton D, Woods MA … +1 more , Zim Okoli C
J Am Psychiatr Nurses Assoc · 2025 · PMID 40400420 · Publisher ↗
ObjectivesThe use of seclusion and restraint is common in hospitals, particularly in adult psychiatric settings. This pilot evaluation project assessed the impact of a web-based educational intervention on the knowledge,...
ObjectivesThe use of seclusion and restraint is common in hospitals, particularly in adult psychiatric settings. This pilot evaluation project assessed the impact of a web-based educational intervention on the knowledge, practices, and attitudes of front-line nurses concerning seclusion and restraints and on the actual use of restraints and seclusion in an inpatient psychiatric hospital setting.MethodsA quasi-experimental, pre- and post-assessment design was used to evaluate the impact of a 20-min targeted education intervention on knowledge, practices, and attitudes toward the use of seclusion and restraint among 40 psychiatric-mental health providers.ResultsAttitudes regarding the use of seclusion and restraints, including a greater willingness to acknowledge patients' rights and the emotional impact of seclusion and restraint use significantly improved post-educational intervention. Improvements were also observed in the comprehension of appropriate seclusion and restraint practices and the effects of staffing levels on seclusion and restraint utilization. Hospitalwide seclusion rates decreased by 35%, and restraint rates post-educational intervention decreased by 58%.ConclusionThis pilot evaluation study demonstrated that targeted education significantly improved attitudes and practices related to seclusion and restraint among psychiatric-mental health nurses and providers. Mean attitude scores increased from 32.7 to 36.8 post-intervention ( = .002), and mean practice scores improved from 33.9 to 35.2 post-intervention ( = .004). The decrease in hospitalwide seclusion and restraint rates post-intervention indicates the intervention could be effective for reducing the reliance on restrictive interventions.
A Mindfulness-Based Intervention: Effects on Psychiatric Nurses Well-being and Burnout.
Gianella E, Owens RA, Quinn Griffin MT … +1 more , Fitzpatrick JJ
J Am Psychiatr Nurses Assoc · 2025 · PMID 40400413 · Publisher ↗
BACKGROUND: Burnout has been shown to negatively affect the physical and emotional health of staff; contribute to rising costs; negatively impact patient satisfaction, worsen patient outcomes, and increase rates of safet...
BACKGROUND: Burnout has been shown to negatively affect the physical and emotional health of staff; contribute to rising costs; negatively impact patient satisfaction, worsen patient outcomes, and increase rates of safety events as well as mortality. Some research suggests that the practice of mindfulness could help nurses with burnout, but attrition rates are high due to the time commitment. In recent studies, the use of a 3-min mindfulness practice showed positive results. AIMS: This research aimed to determine if a 3-min mindfulness-based intervention can decrease burnout and improve overall well-being in psychiatric nurses. METHODS: An online 3-min mindfulness breathing space was used as the intervention. Burnout and well-being were measured prior to the intervention and at 2 weeks post-intervention. RESULTS: The total sample included 46 psychiatric nurses; for the 16 who completed the pre- and post-well-being instrument, overall well-being increased. There was no difference in burnout scores from pre- to post-intervention. CONCLUSIONS: This is a promising intervention for psychiatric nurses that increases overall feelings of well-being.
Self-Management in Bipolar Disorder: A Meta-Synthesis of Qualitative Evidence.
Aksoy C, Gökalp K
J Am Psychiatr Nurses Assoc · 2025 · PMID 40400227 · Publisher ↗
BackgroundThere is a need to strengthen the existing qualitative literature to begin exploring the self-management experiences of individuals with bipolar disorder.AimThis meta-synthesis aimed to identify the common comp...
BackgroundThere is a need to strengthen the existing qualitative literature to begin exploring the self-management experiences of individuals with bipolar disorder.AimThis meta-synthesis aimed to identify the common components of self-management in individuals with bipolar disorder and provide a synthesis of the qualitative literature on self-management strategies and patients' experiences with bipolar disorder.MethodThe SPIDER framework tool guided the development of an appropriate search strategy. Studies published between 2011 and 2023 in widely used health databases, including PubMed, Cochrane, and Science Direct, were searched. Included studies underwent quality assessment, and data were synthesized and analyzed using the thematic synthesis method.ResultsThe synthesis identified four analytical themes, encompassing 14 subthemes. These themes include (a) understanding bipolar disorder, (b) coping strategies, (c) changing lifestyle behaviors, and (d) social support. Most of the included studies encompassed self-management strategies and experiences developed to cope with the symptoms of the illness.ConclusionsIndividuals diagnosed with bipolar disorder identified effective self-management strategies, including exercising, regular and sufficient sleep routines, and maintaining social connections. They stressed the importance of being competent, self-aware, and resourceful. Additionally, understanding how they perceived bipolar disorder was crucial for making sense of past mood experiences.
APNA Position Statement: Youth Suicide Prevention.
J Am Psychiatr Nurses Assoc · 2025 Jun · PMID 40323131 · Publisher ↗
Abstract loading — click title to view on PubMed.
PMH Nurses: Architects of Change Through Innovation.
Shea JM
J Am Psychiatr Nurses Assoc · 2025 Jun · PMID 40320890 · Publisher ↗
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Introducing Virtual Reality to Home-Based Primary Care Veterans With Dementia.
Kaneshiro AG
J Am Psychiatr Nurses Assoc · 2025 · PMID 40271986 · Publisher ↗
INTRODUCTION: Persons with dementia (PwD) can experience behavioral and psychiatric symptoms (BPS), impacting their quality of life and sense of well-being. Symptoms can occur due to environmental changes, frustration wi...
INTRODUCTION: Persons with dementia (PwD) can experience behavioral and psychiatric symptoms (BPS), impacting their quality of life and sense of well-being. Symptoms can occur due to environmental changes, frustration with being asked to do things they can no longer do, underlying medical conditions, and medication interactions. Fatigue, fear, and misperceptions can lead to BPS, such as apathy, depression, irritability, agitation, and repetitive questions. Medication as treatment of BPS for PwD can lead to side effects and the potential for worsening the symptoms for older adults. Medication should only be considered when non-drug approaches fail. AIMS: This project aimed to introduce virtual reality (VR) to home-based primary care veterans with dementia to determine the effect of VR on psychological well-being in PwD. METHODS: Three consecutive days of VR sessions were completed to evaluate psychological well-being before and after VR intervention. RESULTS: VR was associated with a significant reduction in frustration or agitation when asked to finish a task. After the intervention, veterans had fewer disapproving or angry verbalizations during contact with others and completed more than 5 min of a single activity. They showed fewer facial expressions of fright and demonstrated less frowning or crying. Compared to pre-intervention, veterans demonstrated less pulling away from others, less listlessness, less resistance to being involved in an activity, and asked repeated questions less frequently after the VR intervention. CONCLUSIONS: VR can be a non-pharmacological management technique for decreasing BPS in PwD to increase their psychological well-being.
A Narrative Review of Strategies and Interventions to Mitigate Microaggressions as a Form of Workplace Violence.
Marie Fletcher P, Paige Owen C, Djukic M
J Am Psychiatr Nurses Assoc · 2025 · PMID 40256998 · Full text
BACKGROUND: Workplace violence is an urgent issue for psychiatric mental health nurses. While physical workplace violence is overt, microaggressions are covert. Microaggressions are brief, daily offenses that communicate...
BACKGROUND: Workplace violence is an urgent issue for psychiatric mental health nurses. While physical workplace violence is overt, microaggressions are covert. Microaggressions are brief, daily offenses that communicate negativity. An estimated 90% of healthcare providers report experiencing microaggressions. However, evidence-based strategies and interventions for mitigating microaggressions in healthcare settings are not well established. AIMS: The purpose of the review was to identify strategies and interventions for addressing microaggressions that are applicable to nurses. METHOD: The evidence-based literature review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases included Web of Science, Embase, CINAHL, and PubMed. Published articles from 2010 to 2024 were included if they: (a) discussed strategies or interventions for reducing microaggressions and (b) included health professions students, educators, healthcare workers, or first responders in the sample. After a preliminary review, deduplication and eligibility criteria screening of 102 articles, 17 articles were included in the review. RESULTS: Of the 17 articles, seven reported on communication strategies and eight on interventions. Four articles highlighted microinterventions as a strategy to address microaggressions. Seven of the eight intervention studies used a descriptive, pre/post-test design. All intervention studies targeted medicine professionals and none nurses. Most interventions effectively raised awareness and the ability to recognize microaggressions, but the effectiveness to reduce microaggressions was not measured. CONCLUSIONS: Findings suggest further research is needed on strategies and interventions addressing microaggressions, particularly for nurses.
The "Good Nurse" Narrative, Speaking Up, and the Prevention of Violence in the Workplace.
Hauenstein EJ
J Am Psychiatr Nurses Assoc · 2025 · PMID 40248911 · Publisher ↗
BACKGROUND: Assaults on nurses from patients or other nurses are endemic in healthcare settings. Still, nurses underreport or are silent about workplace aggression. Nurses' silence is embedded in social and organizationa...
BACKGROUND: Assaults on nurses from patients or other nurses are endemic in healthcare settings. Still, nurses underreport or are silent about workplace aggression. Nurses' silence is embedded in social and organizational structures that discriminate against them and make speaking up unsafe. AIM: The aim of this article is to examine professional identity attributes and how they intersect with prevailing social and organizational cultural norms to suppress nurses' voices. To determine how professional identities are gendered socially and culturally, a keyword focused cultural inquiry was conducted. METHODS: Attributes identified by keywords were extracted from 20 research reviews or data-based studies. Ten studies that reported results as linguistic data identified attributes of professional nurses; an additional 10 studies of this kind reported attributes of professional women outside the discipline. The keyword attributes were quantified then compared using word cloud analysis. The Master Narrative Framework was used to situate these identities within master narratives of gender and violence. RESULTS: Both identities examined were composed of terms socially and culturally attributed to women including "compassionate, respectful, a listener, kind, honest, empathetic, trustworthy, gentle, caring, and friendly." Nurses' identity attributes were reported as qualities of a good nurse while professional women attributes were presented as sources of gender discrimination. CONCLUSIONS: Speaking up is critical to understanding workplace violence, yet nurses do not routinely report aggression or take action to prevent violence in their workplace. Understanding their silence as a response to gender discrimination provides potential avenues for enabling nurses to speak up to improve their work conditions.
Harm Reduction as an Essential Psychiatric Mental Health Nursing Skill.
Kameg B
J Am Psychiatr Nurses Assoc · 2025 · PMID 40219798 · Publisher ↗
OBJECTIVE: In 2023, over 20 million individuals in the United States experienced a mental health condition and a co-occurring substance use disorder. As many as 42% of individuals with a mental health condition report pa...
OBJECTIVE: In 2023, over 20 million individuals in the United States experienced a mental health condition and a co-occurring substance use disorder. As many as 42% of individuals with a mental health condition report past-year illicit drug use, and as many as 6% report past-year opioid use. Given the high rates of psychiatric comorbidity and mortality associated with opioid use disorder, it is imperative that psychiatric mental health nurses not only view opioid use disorder as a brain-based, chronic remitting-relapsing disease but also leverage non-stigmatizing clinical approaches to improve patient outcomes. Harm reduction is a practical and transformative approach that seeks to empower people who use drugs with the choice to live healthy, self-directed, and purpose-filled lives. This article provides an overview of theoretical harm reduction approaches and tangible harm reduction interventions to inform psychiatric mental health nursing practice. METHODS: Relevant literature was reviewed related to harm reduction and its role in psychiatric mental health nursing practice. RESULTS: Harm reduction as an ethos is discussed, in addition to practical harm reduction strategies such as opioid antagonists for overdose reversal, fentanyl test strips, syringe service programs, and supervised consumption sites. The importance of patient engagement is highlighted as necessary in improving health outcomes among those who use substances. CONCLUSIONS: Given the conclusive evidence that a harm reduction approach and associated interventions are lifesaving, it is the ethical duty of psychiatric mental health nurses to implement and advocate for harm reduction across the healthcare continuum.
Student Registered Nurse Anesthetists' Perceptions of Substance Use [Formula: see text].
Foli KJ, Forster AK, Bostic LA … +3 more , Zhang Z, Zhang L, Stone L
J Am Psychiatr Nurses Assoc · 2025 Jun · PMID 40219763 · Publisher ↗
BACKGROUND: Nurses enrolled in certified registered nurse anesthetist programs are taught to be experts in complex pharmaceutical agents, often under high stakes conditions. Such conditions may create maladaptive coping...
BACKGROUND: Nurses enrolled in certified registered nurse anesthetist programs are taught to be experts in complex pharmaceutical agents, often under high stakes conditions. Such conditions may create maladaptive coping mechanisms, such as substance use. However, exploration of student registered nurse anesthetists' (SRNAs) perceptions of substance use and drug diversion have only been minimally described in the literature. AIMS: The study aims were to (a) investigate SRNAs' ratings of the American Association of Nurse Anesthesiology's (AANA) recommended strategies to reduce drug diversion and (b) analyze qualitative responses to open-ended items related to the use of substances. METHODS: Approximately 400 students responded to an online survey in March 2021. The survey was randomly sent to 3,000 SNRAs who were members of the AANA (return rate of 13%). Descriptive statistics and paired -tests were calculated to determine differences between strategies viewed as effective and strategies that have been implemented. A descriptive content analysis was conducted to derive themes from four open-ended questions. RESULTS: For all 11 AANA strategies, the means for effectiveness were significantly higher than means for strategies that were implemented, indicating that strategies were seen as effective, but were not being implemented. The highest scored perceived effectiveness strategy was "Creating a safe environment for prompt reporting." Themes captured a high-pressured, high-stakes educational environment, characterized by rigidity and incivility. CONCLUSIONS: Policies to support a safe environment to encourage students to self-report substance use, an awareness of alternative-to-discipline programs, and reintegration into educational programs should be formulated and implemented by educational institutions.
Psychiatric Nursing's Role in Advancing Suicide Prevention.
Hampton MD
J Am Psychiatr Nurses Assoc · 2025 Jun · PMID 40159994 · Publisher ↗
Abstract loading — click title to view on PubMed.
Methods of Suicide Among Nurses Globally: Examination of Epidemiological and Cohort Evidence.
Kreuze E, Merwin EI, York J
J Am Psychiatr Nurses Assoc · 2025 · PMID 40110987 · Full text
AimExamine methods of suicide among nurses cross-nationally.MethodsThe literature was searched to identify epidemiological and cohort studies that analyzed suicide mortality among nurses cross-nationally. Studies were in...
AimExamine methods of suicide among nurses cross-nationally.MethodsThe literature was searched to identify epidemiological and cohort studies that analyzed suicide mortality among nurses cross-nationally. Studies were included if nurse suicide mortality was analyzed, and if methods of suicide among nurses were concurrently examined. In total, 22 studies were included, 16 of which were epidemiological and 6 of which were cohort.ResultsAcross all studies, nurse suicide decedents from 11 countries were represented. Across most global studies, self-poisoning and hanging were two frequently utilized methods of suicide among nurses. However, in the United States, two common suicide methods included self-poisoning and firearms. While there was likely overlap with respect to public reporting of global cases, in China and India, leading methods included jumping from a building and hanging, respectively. Taken together, despite some inconsistencies, self-poisoning was one of the most frequently reported suicide methods among nurses across studies.ConclusionAdditional research is important in building the evidence base, particularly with respect to ranking methods of suicide, and further differentiating between suicide methods used by female and male nurses cross-nationally. Additional cross-national research regarding specific substances utilized in suicide self-poisoning deaths is also needed. Because means restriction represents a key suicide prevention strategy, these data are needed to inform means restriction interventions among nurses.
The Missing Link in Behavioral Health: Defining Competencies for Crisis Response Teams.
Olmedo A, Metili C, Mayfield A … +2 more , Betts D, Weaver T
J Am Psychiatr Nurses Assoc · 2025 · PMID 40105040 · Publisher ↗
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Keeping Our Patients and Ourselves Safe: Evidence-Based Knowledge to Prevent and Manage Violence in PMH Nursing Care.
Beeber LS, Delaney KR, Martinez AJS
J Am Psychiatr Nurses Assoc · 2025 · PMID 40071823 · Publisher ↗
Abstract loading — click title to view on PubMed.
Storytelling in Care: Leveraging Narrative Identity and Suicide Narratives for Advanced Suicide Risk Assessments.
Gay M
J Am Psychiatr Nurses Assoc · 2025 · PMID 40071712 · Publisher ↗
OBJECTIVE: To explore how integrating Narrative Identity (NI) theory and the Suicidal Narrative (SN) framework into nursing practices can enhance suicide risk assessments and therapeutic engagement, promoting resilience,...
OBJECTIVE: To explore how integrating Narrative Identity (NI) theory and the Suicidal Narrative (SN) framework into nursing practices can enhance suicide risk assessments and therapeutic engagement, promoting resilience, hope, and recovery among patients. METHODS: This study reviews existing literature on NI and SN frameworks, examining their theoretical foundations and applicability in nursing. It analyzes how these frameworks improve understanding of patient suicidality through qualitative assessment of personal narratives and identifies practical steps for implementation in clinical settings. RESULTS: The integration of NI and SN into nursing practices has shown potential in improving the quality of suicide risk assessments. It enables nurses to gain a deeper, empathetic understanding of the factors influencing each patient's suicidality, fostering enhanced therapeutic engagement. Challenges such as time constraints and the need for specific training in narrative techniques are identified. CONCLUSIONS: Incorporating NI and SN into nursing assessments can significantly enrich the suicide risk assessment process, providing a more nuanced and empathetic approach that focuses on individual patient stories. However, effective implementation requires overcoming several barriers, including enhancing nurse training in narrative methods and adjusting clinical workflows to accommodate more in-depth patient interactions.
Improving Access to Mental Health Care in Residents of Long-Term Care Living Facilities.
Arends R, Walker V, Engbrecht M
J Am Psychiatr Nurses Assoc · 2025 · PMID 40018741 · Publisher ↗
OBJECTIVE: Residents of long-term care facilities have reduced access to mental health care due to the availability of providers, transportation, and staff or family members who must accompany the resident. As a result,...
OBJECTIVE: Residents of long-term care facilities have reduced access to mental health care due to the availability of providers, transportation, and staff or family members who must accompany the resident. As a result, many residents wait up to 6 months for a first appointment with a psychiatric provider or utilize their primary care provider to meet their mental health care needs. METHODS: To increase access to mental health care, tablets were placed in long-term care facilities to access telehealth visits with mental health providers. Psychiatric visits were conducted via telehealth to assess, diagnose, and treat residents of the facilities. Psychiatric Mental Health Nurse Practitioners also worked to ensure the correct diagnosis and treatment were applied to each resident. In addition, there was a focus on prescribing psychotropic medications such as antipsychotics and benzodiazepines only when clinically indicated and at the lowest effective doses and ensuring gradual dose reduction efforts were being conducted safely. RESULTS: Results of this project showed a decrease in time to first appointment from 6 months to 20 days, an increase in the application of clinical criteria to determine diagnoses, improvement in initiating gradual dose reduction requirements when clinically indicated, and resident, staff, and family satisfaction with care. CONCLUSIONS: The results of this project show that it is feasible and safe to provide mental health visits to residents of long-term care facilities through telehealth and should be considered to improve access to mental health care services for this population.
Pitfalls and Platforms in Workplace Violence Prevention.
Blair EW, Allen DE, Delaney KR … +6 more , Lindvall R, McGill A, Polacek M, Schneider L, Sharp D, Weaver T
J Am Psychiatr Nurses Assoc · 2025 · PMID 40008635 · Publisher ↗
OBJECTIVE: To identify common pitfalls of workplace violence (WPV) prevention programs, as well as platforms for effective WPV prevention and management. This discussion paper elaborates on these pitfalls and platforms,...
OBJECTIVE: To identify common pitfalls of workplace violence (WPV) prevention programs, as well as platforms for effective WPV prevention and management. This discussion paper elaborates on these pitfalls and platforms, sharing ideas on how to maintain safety and provide support for both colleagues and patients. METHODS: The American Psychiatric Nurses Association (APNA) Council for Safe Environment (CSE) members met monthly to discuss WPV prevention, guided by evidence-based information, clinical expertise, and scholarly work. Concepts around WPV prevention were organized into common pitfalls in WPV prevention programs and optimum WPV prevention platforms. Pitfalls include reliance on attempts to control patients through strict rules, restrictions, and risk identification and monitoring. Alternatively, effective platforms include engagement-focused, relationship-based, trauma-informed and recovery-oriented practices. Education to develop staff skills and expertise beyond crisis prevention training and violence assessment is highlighted, giving voice to nurses' intuitive expertise in preventing, identifying, and diverting aggressive behaviors. Peer and organizational support interventions for nurse victims of violence are also examined. RESULTS: Safe environments are enhanced when staff are actively engaged in efforts to discern and meet individual needs, engage with the patient, build trust, and communicate hope for recovery. Organizational cultures founded on concepts of trauma-informed care can provide the support victims of violence need to recover and develop resilience and post-traumatic strength. CONCLUSION: Risk management strategies alone are ineffective means of preventing WPV in psychiatric settings. Organizations must strike a balance between ensuring safety and providing a therapeutic atmosphere.
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