|
Abstract
|
Background: Many studies have reported on the management of difficult and aggressive behaviours in Emergency and Psychiatry settings in the medical literature. Yet, there appears to be a paucity of research that has examined the prevalence and management of difficult or aggressive behaviours in patients in acute surgical wards following traumatic injury.
Aim: The aim of this clinical audit was to evaluate staff's understanding of, and perceived competence working with difficult and aggressive behaviours.
Method: Sixty-eight staff from multidisciplinary teams within trauma, burns, and neurosurgical units at Royal Perth Hospital completed a survey assessing the prevalence and type of difficult behaviours encountered, confidence in dealing with challenging behaviours, and understanding of best practice management plans.
Results: A striking 74% of staff reported exposure to difficult or aggressive behaviours at least once per week. Eighty-two, 47, and 50% of staff identified physical violence, verbal abuse, and sexual harassment respectively as the most difficult behaviours to manage. Staff believed that patient anger, frustration and pain were the main contributors to difficult or aggressive behaviours. Notably, very few staff believed mood-related difficulties (e.g., depression, post traumatic stress), which are common in this setting, were related to the occurrence of challenging behaviours. Curiously, staff reported a moderate to high level of confidence in managing difficult behaviours in their workplace, despite reporting limited effectiveness of systematic behavioural management policies and practices in their workplace.
Discussion: These preliminary findings suggest a high frequency of difficult and aggressive behaviours in acute trauma settings. Since staff did not perceive available behavioural management policies and practices to be effective, their confidence in their ability to manage challenging behaviours may stem from reliance on their personal resources. |