SEE ALSO: Earn CE: Anxiety Disorders
Assessment Team on the Case
The medical clinical staff can call upon the MHAT team for the following needs:
• acute change in patient’s behavior that cannot be readily identified as a medical complication;
• signs of agitation, aggression, and/or violence;
• signs of substance abuse withdrawal (i.e., shaking, increased pulse, increased agitation, hallucinations);
• any Baker Act question;
• any Baker Act patient attempting to leave;
• patient expresses thoughts and/or plan to harm self or others;
• applying restraints for violent purposes (all four (4) point, leather restraints);
• any questions in determining if restraint is for violent or non-violent purposes; and
• questions regarding the Clinical Institute Withdrawal Assessment detox physician orders for alcohol withdrawal.
The journey toward this achievement evolved after several months of communication and education for the hospital staff on the MHAT’s purpose. The frequency of the calls for the MHAT increased, reaching an average of 40.6 in April, May, and June 2012. Staff members began to better understand the purpose and experienced how beneficial the MHAT was in providing ideas and solutions to resolve the dangers they were facing. Now, four years since its implementation, the frequency of calls has decreased to an average of 17.6 in October, November, and December 2014, as the clinical staff realized they are now often able to handle violent or irate patients.
TEAM FOCUS: Davillee Hawkins, RN, (left) Sandra Curran, RN, and Jacob Temple, DNP, NEA-BC, ANP-BC, talk over a patient case. Photo courtesy Lakeland Regional Health Medical Center, Lakeland, Fla.
A total of 23 MHAT calls were made for the organization across a two-year period. The team has become more mindful of the increasing signs of agitation in an MH patient that could result in a potentially unsafe situation. The MHAT’s achievement is evident throughout the organization, and is now used in other units to promote and better ensure the safety of patients, staff, and visitors.
Lastly, the new goal of this dynamic team of nurses is outreach outside of their own unit to other acute care organizations that do not possess this specialty response team. Sharing this team’s significant achievement will inspire other organizations to educate their staff on how to de-escalate violent situations that arise involving mental health patients. Increasing the medical clinical staff’s competency, specifically their ability to demonstrate therapeutic measures more mindfully to the hospitalized mental health patients, better ensures safety for both themselves and the patient.
Above all, safety is at the core of the nursing team’s focus and through this innovative team, outreach to patients and staff is positively impacted.
Jacob Temple is the director of patient care services and director of the Mental Health Service Line at Lakeland Regional Health. He was instrumental in the development of the MHAT. He also is an adjunct professor of nursing at Polk State College.