Need help with crisis intervention training

Specialties Psychiatric

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Specializes in Gerontology, Med surg, Home Health.

I'm a DNS of a skilled facility. Gone are the days of sweet little old ladies and men who sit quietly and rock in their chairs and play BINGO. Nursing homes are filled with dual diagnosis younger residents and most of us are ill prepared to deal with violent/aggressive behaviors of young, strong men.

Does anyone have a crisis intervention training program that's free or cheap and would be willing to share? My staff does a great job but we had a resident grab a very heavy metal 3 hole paper punch. He was threatening to hit them. Instead of walking away, which is what I would have done, they attempted to take it from him. Luckily no one got hurt. I need some training materials to give them the tools they need to try to deescalate these kinds of behaviors. Thanks.

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Specializes in psych, addictions, hospice, education.

Here's a site: Crisis Prevention Institute (CPI Training) | CPI

Where I've worked, (psych places) it's been required for all staff, to go through CPI training. They might be able to help you, although for a fee. I see on the site that they have a free resource pack, however.

If there's a psych hospital or a general hospital with a psych unit nearby, you might be able to find someone who can help you, and even do an inservice for you, for a fee (but less than CPI would charge). Probably someone at nearby places has someone who does inservices in-house. Often the inservices are required yearly or every other year, just like all the other required inservices.

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Specializes in Psych. Violence & Suicide prevention..

I agree with Whispera. I am certified to train others as are many of my colleagues at my facility.

Contact your local community partners including the hospitals you contract with. They all should have a workplace violence prevention program. The police have been known to provide out reaches as well.

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Your state department of mental health (or whatever your state calls it) may also have some good resources and recommendations for you.

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Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,.

CapeCodMermaid, I read your post when you first posted it. I wanted to tell you that there are other programs besides CPI.

I heard CPI is awesome because you can actually defend yourself with defensive blocks.

My psych facility used something different. I can not recall the name. Supposedly, ours was different because it focused on verbal deescalation along with proper body alignment do that you can take a hit without getting hurt.[emoji38] crazy as that sounds, with good team work, I was fine for about a year in that facility.

We also learned how to duck and hold our hands up to protect the vulnerable parts of our bodies. It sounded silly at the time, and still does, Somewhat, but I never knew it to come to that.

We also learned safe "take-downs". It was fun to learn in class with my co-workers. [emoji3] as an LVN, I never had to do a take down personally, but I did initiate the need for help and at times, administered PRN B-52s, mid crisis.

I finally recalled the name: it is Pro -Act. In my faculty they emphasized the verbal de escalation portion and also emphasized the fact that techs/aides were mandated to respond.

I honestly felt very safe there, in spite of the high psych acuity, due to our awesome techs/aides and decent (though imperfect) facility policies.

I think that you supervise a SNF, cape cod. I'm not sure what methods you are allowed to use.

Where I'm located, geographically, SNFs often have their hands tied when dealing with pts who are aggressive/violent because of pt rights.

That's one reason I liked working in acute hospitals and psych units: we were allowed, by law to use techniques that actually worked.

When I worked in SNFs/ALFs, it was a lot more challenging to help dangerous pts because 1) no one was trained and 2) the laws I think prevents hands on and also prohibits "chemical restraints"

HTH!

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Specializes in ER/PSYCH/DMH/DMR.

I don't know if you are still following your comments at this time or not but group on Providence has a special this week on all things Psych online.Also WRCH has ongoing

classes for providers in the state.

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Specializes in Nephrology, Med/Surg.

WRCH ?

Thanks

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Specializes in ER/PSYCH/DMH/DMR.

Worcester Recover Center and Hospital used to be Worcester State Hospital

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If you are serious about training your staff look into Mandt. They are a lot better than CPI. Also, there is a woman in Chicago who has created a program called virtual tranquilizer. It focuses on using neurological approaches to deescalation with minimal use of medication. Trauma informed care is a great model to institute and it's free. With a Geri population you really want to keep meds to a minimum as they tend to backfire on you. Avoid use of benzodiazepine and haldol.Resperdol is least dangerous. Structure, reality orientation in the milieu and regularly scheduled de-prescribing sessions for multiple meds are integral. Med holidays and closely monitored renal functions are also useful so you don't end up with organic problems.

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Ours was called satori. It taught a lot of verbal de escalation as well as physical interventions. I found that watching them all very closely and intervening as soon as you notice they seem agitated or they start to isolate. There are always early warning signs.

Keep your voice calm, don't try to argue or have a power struggle, listen, and be patient. Encourage them to talk to you when they are upset and don't blow them off. If you are busy remind them you care and they are important they will just have to wait a second.

Stay firm and consistent but still caring.

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Specializes in Psych.

Therapeutic Options of Virginia is the best crisis intervention I have participated in- it is based off of a gentleman's work, but I am unable to recall what his name is at the moment. It works well for the geri population as it teaches trauma based care as well as how to NOT leave bruises/otherwise harm the patient when restraining. I feel that CPI is more of an acute care intervention that allows staff to be a bit more aggressive in their interventions with patients/others to maintain safety.

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If you are serious about training your staff look into Mandt. They are a lot better than CPI. Also, there is a woman in Chicago who has created a program called virtual tranquilizer. It focuses on using neurological approaches to deescalation with minimal use of medication. Trauma informed care is a great model to institute and it's free. With a Geri population you really want to keep meds to a minimum as they tend to backfire on you. Avoid use of benzodiazepine and haldol.Resperdol is least dangerous. Structure, reality orientation in the milieu and regularly scheduled de-prescribing sessions for multiple meds are integral. Med holidays and closely monitored renal functions are also useful so you don't end up with organic problems.

I'm interested in learning about trauma informed care training but having a hard time finding information on line as I'm not quite sure what exactly I'm looking for. I'm looking to take courses or certifications on my own, that might make me more attractive to hiring managers. I'm having a hard time breaking into psych nursing and it was recommended that i look into taking trauma informed care training as something to beef up my resume.

Could you provide more information for me please, and possible a link where I could take a course? Greatly appreciated.

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