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Use of Distraction and Calming Strategies in Emergency Departments

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.

Overview

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.

Applicability

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.

Responsibility

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.

Guideline/Process Details

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.

Pastime Packs

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.

Appropriate Patient

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.

Infection Prevention

  • 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.

Documentation

  • 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

Appendix A: Information Sheet

Appendix B: Inventory

Distraction and Calming Pastime Packs

Printed 10 page set of activities (loose leaf):

  • Mindfulness colouring sheets
  • Word searches
  • Hidden object activities

 

Crayons
Stress Ball
Foam ear Plugs

Supporting Documentation

Emergency Department DG-CC4 Use of Distraction and Calming Strategies in Western Health Sunshine Hospital and Footscray Hospital Emergency Departments

Document Governance

Title: Use of Distraction and Calming Strategies in Emergency Departments
Version: 1.0
Date Published: January 2022
Date of scheduled review: May 2023
Author: Approver:
SHED Leadership Team SHED Leadership Team

 

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