Risk Factors for Violence
This brain region, when impaired, reduces impulse control and increases aggression risk.
What is the prefrontal cortex?
In this phase, patients may be loud and angry but are still able to engage verbally.
What is the pre-escalation phase?
This communication style involves acknowledging feelings without agreeing with behavior.
What is validation?
This is the first priority when dealing with an aggressive patient.
What is safety (for patient, staff, and others)?
A history of this type of childhood experience is strongly linked to later violent behavior.
What is trauma or adverse childhood experiences (ACEs)?
This is the priority intervention during the pre-escalation phase: offering choices, active listening, and calm communication.
What is verbal de-escalation?
“I can see you're upset. Let's figure this out together” is an example of this technique.
What is empathetic communication?
This action—keeping yourself between the patient and the exit—is something you should avoid.
What is blocking the exit or trapping yourself?
This neurotransmitter imbalance is commonly associated with increased impulsivity and aggression.
What is low serotonin?
During the aggressive phase, this type of intervention may become necessary to maintain safety.
What are emergency interventions (e.g., medications, restraints, or seclusion)?
This nonverbal strategy—standing at an angle and maintaining distance—helps reduce perceived threat.
What is non-threatening body positioning?
These should be removed from the environment to reduce risk during escalation.
What are potential weapons or harmful objects?
Substance use of this category of drugs is particularly associated with agitation and violent outbursts.
What are stimulants (e.g., cocaine, methamphetamine)?
Unlike pre-escalation care, this key focus shifts during aggressive escalation.
What is ensuring immediate safety over therapeutic engagement?
Offering two acceptable options to the patient is an example of this de-escalation strategy.
What is limit-setting with choices?
This type of monitoring is required for patients in seclusion.
What is continuous or frequent observation (e.g., q15 min or 1:1 monitoring)?
These observable physical signs—clenched fists, pacing, and a raised voice—indicate this stage of escalation.
What is early escalation or loss of control?
This intervention is appropriate early but often ineffective once a patient reaches physical aggression.
What is reasoning or detailed problem-solving?
This nursing intervention involves reducing stimuli such as noise, light, or crowding.
What is environmental modification?
Even in seclusion, this principle must guide care, ensuring dignity and respect.
What is patient-centered care?