Date of Graduation

Spring 5-19-2017

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions


The aims of this CNL Internship Project are to decrease the number of incidents in which patients are escorted out of the clinic via staff or SFPD due to violent/aggressive behavior, are put on a 5150 hold, or who are absent without official leave (AWOL) or leave against medical advice (AMA) by 70% within 12 months of initiating an evidence-based staff training program on therapeutic communication and de-escalation techniques and implementing a de-escalation and safety intervention protocol and to achieve 100% improvement in staff perception of preparedness to manage escalating patient events and maintain safety. This project is being implemented in a psychiatric urgent care clinic San Francisco, where rest and rehabilitation is provided for individuals experiencing an exacerbation of a mental illness.

Staff education and training in-service sessions were conducted regarding de-escalation techniques and the utilization of an evidence-based, standardized de-escalation and safety protocol. Results from a Likert-type scale survey administered before and after training in-service sessions and implementation of the De-Escalation and Safety Intervention protocol revealed significant improvement in staff perception of preparedness individually and as a team to safely manage escalating patient crises as well as in usefulness of the protocol. Results from a post-teaching effectiveness survey revealed 100% of staff feel strongly (5/5) that the de-escalation techniques taught and the implementation of the standardized protocol are effective methods to incorporate into practice. Results regarding 70% decrease in adverse patient discharges are still pending as post-implementation patient discharge data collection is in progress until April 2018.

CNL Poster.pptx (2572 kB)