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Aggressive and disruptive behaviors are often seen on inpatient psychiatric units where patients are in their most acute state, and the direct-care staff and nurses responsible for managing such problem behaviors are placed in high-risk situations for adverse events such as physical or psychological assault and trauma. Workplace injuries resulting from such instances are a substantial burden on the unit, administration, and staff member themselves, and consequently, much energy has been expended to formulate approaches to prevent such injuries (Romani et al., 2020). Studies have shown the implementation of staff training initiatives focused on decreased utilization of restraint and seclusion, incorporation of alternative crisis de-escalation strategies, and fostering coping skill development have lowered the incidence of such problem behaviors reducing the risk to both patients and staff (Eblin, 2019; Kantaris et al., 2020; Romani et al., 2020).

There are multiple programs available to facilities and organizations which incorporate such strategies, and the decision to select a program or switch programs can be a monumental undertaking affecting every level of an organization and requiring significant considerations from all stakeholders involved (Spears & McNeely, 2019). One such program is offered from the Mandt System (2020), and a literature search of the programs resulted in a single research study which found an overall positive effect on the aggression and violence from implementation of the Mandt System, but the results could not be validated due to a scarcity of corresponding research (McDade, 2017). McDade (2017) did not find a decrease in the rate of patient to staff incidents at East Mississippi State Hospital after the implementation of the Mandt System.

A descriptive correlational research design can be utilized to answer the following research question: why did the frequency of patient to staff incidents remain the same after the introduction of the Mandt system? This designed appears to offer the flexibility to examine all possible variables in explaining a rather complex research question by examining the relationships between and among all variable combinations to illuminate any possible correlations capable of offering an explanation to the research question (Gray & Grove, 2021). This explanation could then allow further research by allowing future researchers to test the effect of the removal of some variables.

References

Eblin, A. (2019). Reducing seclusion and restraints on the inpatient child and adolescent behavioral health unit: A quality improvement study. Journal of Child and Adolescent Psychiatric Nursing, 32(3), 122-128. https://doi.org/10.1111/jcap.12248

Gray, J.R., & Grove, S.K. (2021). The practice of nursing research: Appraisal, synthesis, and generation of evidence (9th ed.). Elsevier. 

Kantaris, X., Radcliffe, M., Acott, K., Hughes, P., & Chambers, M. (2020). Training healthcare assistants working in adult acute inpatient wards in psychological first aid: An implementation and evaluation study. Journal of Psychiatric and Mental Health Nursing, 27(6), 742-751. https://doi.org/10.1111/jpm.12633

Mandt System. (2020). Holistic evidence based training to reduce workplace violence. https://www.mandtsystem.com

McDade, Y. (2017). Effectiveness of the mandt system aggression management training in an inpatient behavioral health program (Order No. 10262095). Available from Publicly Available Content Database. (1889551278). https://wilkes.idm.oclc.org/login?url=https://www-proquest-com.wilkes.idm.oclc.org/dissertations-theses/effectiveness-mandt-system-aggression-management/docview/1889551278/se-2?accountid=62703

Romani, P. W., Ariefdjohan, M., Jensen Gaffey, L. L., Torres‐Dominguez, M., & Lister, J. (2020). Relations between patient and staff member characteristics and staff member injury on a psychiatric inpatient unit for children with intellectual or developmental disabilities. Journal of Child and Adolescent Psychiatric Nursing, 33(3), 125-130. https://doi.org/10.1111/jcap.12291

Spears, S., & McNeely, H. (2019). A systematic process for selection of a crisis prevention/de-escalation training program in the hospital setting. Journal of the American Psychiatric Nurses Association, 25(4), 298-304. https://doi.org/10.1177/1078390318794281

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