Transcript Dia 1 - Restraint Reduction Network

de-escalation
supporter
in the Intensive and Forensic
health care
Minco Ruiter, Project leader Inforsa Arkin
Lex Brouwer, de-escalation supporter Inforsa
Contents
• Introduction
• Escalating situations
• Context of changes
• Aggression versus escalation
• De-escalation, the ingredients
• De-escalation supporter, the roles
• Some Results
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introduction
• Arkin: Mental Health Care Amsterdam
• Inforsa: KIB (High Intensive Care short term),
LIZ (High Intensive Care Long term) FPK
(Forensic Care)
• 17 wards, 300 caregivers, 155 patients
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Forensic and Intensive Psychiatric Hospital Inforsa
It happens fast…
1. Molestating the ward…
2. Refusal of medicines
3. Drunk in the garden
4. Provocations during Xmas celebrations
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Context of changes
• Project Diminishing coercion and seclusion
• Nationwide developments:
– Governement pressure
– No solitary confinement
– HIC development
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Results in numbers
Culture of connection
• From controlling to connecting
• Inner safety
• Feeling comforted
• Hospitability
• Relation based care
• Living climate based on support, positivity, trust,
hope, honousty, flexibility versus structure
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Aggression
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Escalation
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De-escalation, using the space
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escalation// de-escalation
We need more people!
He’s really aggressive!!
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escalation// de-escalation
Don’t overreact guys!
I know how he feels!
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it happens fast…
but there is help…
1. Molestating the
1. Dive and connect
ward…
2. Refusal of
2. Acting naive
medicines
3. Drunk in the garden
4. Provocations during
3. Calculated safety
4. Using the relation
Xmas celebrations
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De-escalation supporter
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De-escalation: the ingredients
• Inner drive to connect
• Using all senses
• Being congruent and sincere
• Recognition of the suffering
• Dare to speak
• Use your position and power
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Different roles
• De-escalate
• Mediate
• Cool down
• Slow down
• Support and Train
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Effects and Results
• Prox. 3 times a week in action (registered)
• Prox. 50% about escalation or escalated situation
• Prox. 20% about refusal of medication
• Prox. 60% prevention of further escalation
• Far less forced physical restraint
• A growing culture of focus on de-escalation
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Questions??
[email protected], [email protected]