134 A Code Staff Assist for Acutely Agitated Patients Reduces the Incidence of Patient and Staff Safety Events

Nationally, mental health chief complaints accounts for 7-10% of emergency department patient visits. Agitated patients presenting to departments require increased ancillary staff resource utilization and contributes the incidence verbal physical attempted assaults on staff. Timely interventions are necessary reduce risk harm. Acutely agitated need be evaluated immediately in a coordinated effort rapid de-escalation. The goal this study is evaluate impact multidisciplinary team medical non-medical members evaluation, intervention, safe disposition planning acutely department. A workgroup convened together Kaizen Lean Process Improvement design assess root cause factors contributing agitation, safety events “Code Staff Assist” workflow (Figure 1) was implemented September 2019. code activation brings primary nurse, provider, pharmacist, trauma technician, security personnel bedside expeditiously patient, attempt de-escalation, when unsuccessful, administer treatment 2) avoid event from occurring. This cohort focused all whom Code Assist activated prior or response an assault urban, level 1 trauma, academic outcomes measured were frequency notifications using notification. total 553 activations took place between 2019 April 2021 3). involved 32% female 68% male patients. Prior Assist, mean 11 monthly occurred. As 2021, there have been 3 per month, ∼73% reduction 4). There increasing presence seeking resources departments. It imperative educate providers about recognizing early signs who escalate become agitated. improves outcome interventions. When possible, de-escalation techniques should first. approach has reduced events, improved resources, continues encourage expeditious department.View Large Image Figure ViewerDownload Hi-res image Download (PPT)View (PPT)