MOCA Flashcards

1
Q

What is the Occupational Health & Safety Act (2004)?

A

We share a responsibility to minimise risks in our work environment.
Training is part of this
• Duty of employer to provide appropriate training
• Duty of employee to attend training
Occupational aggression and violence consists of harassment, bullying, security, clinical aggression.

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2
Q

What is respondent aggression?

A
  • Emotionally directed
  • Limited control
  • Motivated by fear, frustration & powerlessness
  • The goal when de-escalating would be to listen and support to alleviate distress
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3
Q

What is operant aggression?

A
  • Goal directed - motivated by gaining desired outcome
  • In control
  • Based on manipulation, power and intimidation
  • The goal when de-escalating would be to be clear, consistent, to set limits and encourage adaptive ways for the patient to get what they need.
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4
Q

What are the static factors involved in a risk assessment?

A
  • Hx of Aggression
  • Cohort–socialmores, style
  • Developmental stage, Individual coping skills
  • Age
  • Drug and alcohol Hx
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5
Q

What are the dynamic factors involved in a risk assessment?

A
  • Mental state
  • Psychosocial supports/ stressors (eg: family, friends)
  • Physical state–incl. capacity to be violent
  • Current pre-occupation with violence, threats
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6
Q

What risks are associated with constraint?

A
  • Trauma experienced by the client & staff
  • Risk of injury to staff or client
  • Positional Asphyxia
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7
Q

What are signs of exhaustion?

A
•  Chronic fatigue
•  Anger at those making
demands
•  Self-criticism for putting
up with demands
•  Reduced work
performance
•  Cynicism, negativity &
irritability
•  A sense of feeling
overwhelmed/weighed down
•  Over-reacting easily •  Frequent headaches •  Weight loss or gain
•  Sleeplessness and depression
•  Shortness of breath
•  Suspiciousness
•  Feelings of helplessness
•  Increased degree of risk taking drugs
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8
Q

What are the effects of exhaustion?

A

Increased exhaustion + decreased tolerance = decreased interpersonal skills

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9
Q

What is emotional exhaustion (burnout)?

A

“A state of physical, emotional and mental exhaustion caused by long term involvement in emotionally demanding situations.”

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10
Q

What is environmental awareness?

A
  • Particular issues in the environment are known to be triggers for clinical aggression in the workplace.
  • We all have a responsibility to be aware of the triggers to clinical aggression in their own clinical area, and to try and minimise the impact of these whenever possible.
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11
Q

What is self-awareness?

A

• Self-awareness is an individual tendency to pay attention to his/her own emotions, attitudes and behaviour in response to specific situations.
• In the case of health care workers, self- awareness is their insight in into how their emotional make-up influences patient care.
Consider:
• What can influence our reaction to aggressive behaviour?
• How can staff responses contribute to aggressive behaviour?

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12
Q

What is patient awareness/perspective talking?

A

• Attempt to understand what is causing the patient’s aggression and intervene accordingly
Consider:
• What makes patients angry within your work environment?
• What factors can influence patient aggression in your work area?

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13
Q

What strategies can you use to become self-aware?

A
  • Know your own triggers
  • Manage your own emotions
  • (anxiety, anger & fear)
  • Use self-talk
  • Remain calm
  • Don’t get personal
  • ignore personal insults
  • Utilise breathing and muscle relaxation
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14
Q

What are some examples of non-verbal strategies?

A
•  Non-threatening body position
•  Maintain eye contact
•  Stand slightly to the side – do not
confront
•  Hands down
•  Move slowly
•  Maintain a safe distance
•  Do not allow yourself to be trapped, or trap the person
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15
Q

What are some examples of therapeutic engagement strategies?

A
  • Empathise
  • Validate emotions
  • Paraphrase & clarify
  • Be honest & don’t make false promises
  • Negotiate & problem-solve – aim for a ‘win-win’ situation
  • Help the person ventilate & identify coping strategies
  • Learn from an experienced colleague
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16
Q

What are some examples of behavioural interventions?

A
  • Give limited choices
  • Offer an illusion of choice
  • Short, simple, one step instructions
  • Allow time to consider
  • Repeat yourself, do not assume you have been understood
  • Consider other tactics; redirection / diversion, the persons behaviour management plan, time-out etc
  • Involve other staff if appropriate
  • Model the behaviour you expect the person to use then respond
  • Don’t contradict or argue
  • Point out consequences in a calm non-threatening way
17
Q

What are the key differences in communication when the risk escalates?
(crisis communication?

A
  • Self Control
  • Active Listening
  • Assertive and direct communication
  • Preparing for an emergency – communication with the team. Know how to get out/get help/instigate emergency procedures
18
Q

What are some examples of strategies to maintain self care?

A
  • Recognise the symptoms
  • Spend time with other people
  • Use your support system
  • Talk about your feelings
  • Listen to others talking about their feelings
  • Use positively strategies from the past
  • Avoid additional stress
  • Work to follow usual routine
  • Exercise regularly
  • Eat healthily
  • Get enough sleep
  • Engage in typical leisure activities
  • Seek professional support
19
Q

What factors should be reviewed when considering using reasonable force?

A
  • Previous history of violence
  • Size and strength of the attacker
  • Size and strength of the person being attacked
  • Whether the person being attacked made every effort to vacate the scene at the first opportunity
  • Was the force used to ward off the attack proportional to the force used by the attacker
20
Q

What are the principals of self defence?

A

• Be clear about your legal rights & responsibilities
• Be aware of policies & guidelines
• Be mentally prepared and aware of your
surroundings & exits
• Use only the amount of force required to protect and defend yourself
• Protect yourself without causing unnecessary harm to the attacker
• You are accountable for your actions
• Do not take unnecessary risks in the course of your duties

21
Q

What are your two legal defences when considering physical action?

A
  • Defence of Necessity - requires a belief in the need to act to protect another or protect property.
  • Self-Defence - dependent upon using proportional force to protect oneself against imminent danger.
22
Q

Negligence can only be determined after an event if all FOUR of the following are established:

A
  • Duty of Care - client, family, carers, other staff
  • Dereliction of Duty of Care - “The test of Reasonableness”
  • Damage - physical, emotional or financial
  • Direct Cause - there is a clear relationship