A De-escalation Debriefing Form to Inform Patient-Centered Care and Safety
The purpose of this presentation is to describe the use of a de-escalation debriefing tool (Huckshorn & LeBel, 2024) following escalation events in the adult emergency department to identify effective patient-centered approaches in de-escalation. Implementation of an evidence-based protocol including using a de-escalation debriefing tool to identify antecedents, triggers, and effective patient-centered de-escalation approaches may improve patient and staff safety through reduced seclusion or restraint use and reports of workplace violence.
Tool: What is the name of the tool used? De-escalation Debriefing Tool (Huckshorn & LeBel, 2024)
Problem: At the project site, the pre-intervention rate of seclusion hours for the units exceeds the state and national averages (Medicare, 2025). The site has a policy for seclusion of patients presenting imminent risk of harm but there is no standardized process for debriefing following escalation events. Workplace violence impacts the United States by approximately $151 billion annually, averaging roughly $250,000 an incident (Chapin & Koller, 2022).
Tool Selection: Why did you select this tool to solve this problem? Describe what made it the best tool for the problem. Evidence supports post-incident debriefing as a part of a multi-modal approach to reduce seclusion rates through incorporating safety initiative programs such as Six Core Strategies (6CS) and Safewards (Gaynes et al., 2017; Putkonen et al., 2013; Wieman et al., 2014; Fletcher et al., 2017; Bowers et al., 2015; Huckshorn & LeBel, 2024).
Usage: Following incidents of escalation, the charge nurse would lead a debriefing huddling the team and reviewing each of the questions: including what surrounded the event/leading up to the event, the response, evaluation of what went well and what may be improved.
Results: Measures include % adherence completing debriefing tool compared to number of escalation events necessitating seclusion or restraint. Outcome measures include seclusion/restraint rates as well as workplace violence reports. Barriers to success include improving staff adherence through reinforcing education during monthly staff meetings.
Speakers
Advanced Practice Provider - Medical University of South Carolina
Assistant Nurse Manager - Medical University of South Carolina
Clinical Staff Leader - Medical University of South Carolina
Clinical Practice Nurse Expert-Registered Nurse & Clinical Staff Leader - Medical University of South Carolina
Clinical Practice Nurse Expert - Medical University of South Carolina
Relief Staff Leader - Medical University of South Carolina
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Patient Safety
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Location Virtual
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Organizer NAHQ Next
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