This document is a summarised version of the PPG Emergency Department DG-CC4 Use of Distraction and Calming Strategies in Western Health Sunshine Hospital and Footscray Hospital Emergency Departments. This summary has been created to be Emergency Department specific, and has been endorsed by the ED Leadership Team. Staff should review the PPG if they require further information.
This QRG aims to guide Sunshine and Footscray Emergency Departments’ clinical staff in the use of distraction and calming strategies with patients presenting in a distressed state and/or displaying behaviors of concern.
Distraction can be an effective short-term tool to support and calm patients presenting in a distressed state. Distraction creates a sense of safety and stability, aids relaxation and reality orientation, and facilitates engagement and communication.
These strategies will be available in Sunshine Hospital and Footscray Hospital Emergency Departments.
This document provides the relevant detail required to support the WH guidelines related to the Use of Distraction and Calming Strategies in Western Health Sunshine Hospital and Footscray Hospital Emergency Departments. It therefore applies to all Footscray and Sunshine ED staff.
In partnership with Western Health’s mental health service providers, the Directors and Nurse Unit Managers of Western Health Sunshine Hospital and Footscray Hospital Emergency Departments have responsibility for the implementation and embedment of, and compliance with, this QRG.
Distraction can facilitate:
- A sense of safety and stability
- Relaxation and reality orientation
- Engagement and communication
Implementing distraction and calming strategies aims to improve the experience of patients in our EDs by reducing the impact of the potentially triggering emergency department environment, and assisting to prevent escalation of behaviour.
Access and Inventory
Distraction and calming “Pastime Packs” can be accessed at both Sunshine Hospital and Footscray Hospital Emergency department floor storage rooms. The Inventory will be managed by the equipment nursing team at the associated site.
These contain the following:
- Information sheet for patients to support and assist self-guided use
- Mindfulness colouring sheets
- Word searches
- Hidden object activities
- Colouring crayons
- Stress ball
- Foam ear plugs
Use of Distraction and Calming Strategies with Patients
These resources are available to be offered to an appropriate patient (see below) in order to assist to prevent escalation of behaviour or assist with patient engagement – for example during assessments or discharge planning.
For patients offered the Pastime Pack:
- Take the patient through the information sheet and show them the items.
- Patients are encouraged to self-monitor and engage with these items for distraction and calming purposes.
Any ED clinician (EMH, Nursing, Medical or ACE) can identify a patient as being suitable for being offered a Pastime Pack, where:
- Patient has a BOC score ≤2, and has only scores for confused and/or irritable.
- A BOC score >2 will require discussions with partner mental health services, a senior medical officer, or the Mental Health Nurse Navigator.
- Hand hygiene must be completed by patients and staff prior to use.
- Pastime Packs are single-use only, and can go with patients upon discharge from the emergency department.
- If staff are aware of any broken or missing items, please notify the equipment nursing team.
- Use of Pastime Packs is to be documented in Emergency Department Adult Flow Chart with the Pastime Pack sticker including time of provision.
Figure 1. Pastime Pack sticker
Appendix A: Information Sheet
Appendix B: Inventory
Distraction and Calming Pastime Packs
Emergency Department DG-CC4 Use of Distraction and Calming Strategies in Western Health Sunshine Hospital and Footscray Hospital Emergency Departments