MIAHTAPS: Patient Aggression Assessment Tool

Methodist Hospital RN Education2016

Park Nicollet’s commitment to safety is a top priority. Workplace violence prevention is key to keeping patients, guests, and team members safe.

One strategy of workplace violence prevention is assessing individual patients for risk of aggression. MIAHTAPS (pronounced my-uh-taps) is a patient aggression assessment tool. This e-learning will focus on the tool’s purpose, components, and utilization at Methodist Hospital.

Objectives

•Explain purpose and utilization of the MIAHTPAS aggression assessment tool

• Identify interventions for individuals at risk of aggression•Describe the MIAHTAPS documentation process•Recall the purpose and process of the Visual Cue and Epic

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As we know, workplace violence can take many forms and can take place anywhere within the organization.

Let’s look at where we are seeing episodes of aggression at Methodist Hospital.

Aggressive Behaviors: 2013-2015

132

86

60 61

43

2721

7 14

38

0

20

40

60

80

100

120

140

5th floor MH

8th floor MH

6th floor MH

4th floor MH (all)

3rd floor MH: 3N

2nd floor MH: 2NS

7th floor MH

3rd floor MH: L&D

3rd floor MH

all other areas

*Code Green and near Code Green events per floor at Methodist Hospital.

I understand workplace violence can affect anyone. So, how can we predict violent behaviors in individuals?

The best predictor of violent behavior is past violence. A specific tool, the MIAHTAPS can help us. Let’s take a look!

MIAHTAPS

MIAHTAPS is an assessment tool for aggression and is similar to other assessment tools such as the Braden Scale for skin or the CAM for delirium.

These tools help identify those at risk and provide interventions based upon individual risk scores.

Braden Scale for skin CAM for deliriumMIAHTAPS for aggression

Pilot on 5W/8W resulted in increased awareness of aggressive behavior potential and utilization of preventative interventions

MIAHTAPS

MIAHTAPS, an acronym for seven features of a risk of aggression assessment

The assessment includes the #1 predictor of violence, a history of violence

For all patients > 18 years of age:

•upon admission •once every 8 hour shift •as needed with status change

MIAHTAPS

* Expectation for EC staff: complete once for all patients > 18 years of age and as needed with status change

MIAHTAPS

•The MIAHTAPS assessment consists of 7 simple yes or no questions

•These are not questions asked of the patient. Instead, the answers are based solely on the RNs observations of the patient’s behavior

MIAHTAPS Assessment Tool: Feature Descriptions and Scoring

Risk LevelsLow

ModerateHigh

Severe

A score is automatically calculated only when each of the 7 features are addressed.

Once a score is calculated, a risk level is assigned and we can implement interventions accordingly.

Nurses will be charting and viewing MIAHTAPS and

interventions in Epic. Let’s take a closer look.

Documentation

• Upon Admission • Once every 8 hour shift• As needed with status

change

All documentation is charted in Epic

• MIAHTAPS Assessment

• Interventions for scores > 1

* Expectation for EC staff: complete once for all patients > 18 years of age and as needed with status change

MIAHTAPS Assessment and Interventions begin May 18th, 2016 on all inpatient Methodist Hospital departments.

Thank you for completing the MIAHTAPS: Patient Aggression Assessment Tool e-learning module

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