A new head nurse discovers her mental health unit has an unusually high incidence of critical incidents involving aggression
Which milieu interventions or modifications would be likely to help reduce the frequency of such events? Select all that apply. a. Make sure staffing is adequate for the needs of the patient group.
b. Train staff to provide humane, person-centered, strengths-based care.
c. Reward more effective staff with better schedules or pay increases.
d. Increase or decrease the amount of stimulation to match patient needs.
e. Structure patient schedules so patients are kept consistently busy.
f. Monitor the milieu closely, and promptly address stressors or triggers.
A, B, D, F
The key task for the manager and all staff is to design, monitor, and adjust the physical and social milieu so that, as much as possible, it is therapeutic. Staffing should be adequate in number and skills and should be adjusted as needed at least each shift. Care must be humane, effective, patient-centered, and strengths-based. The amount of stimulation is of special importance and should be adjusted upward or downward for each patient and for the group at large as their needs change. Monitoring the milieu for stressors and triggers is key to preventing undesired incidents. However, as professionals, staff should aspire to provide highly effective care without expectation of special rewards. Patients recovering from psychiatric disorders need breaks, periods where stimulation and demands upon them are reduced, to adequately process and respond to internal and external experiences.
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