Developing Entrustable Professional Activities to Enhance Application of an Aggression Prevention Protocol

Maguire, Tessa
Willetts, Georgina
McKenna, Brian
Daffern, Michael
Garvey, Loretta
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Journal Article
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Elsevier BV

AIM: The research aim of this study was to seek feedback from prevention of aggression training experts about the suitability of Entrustable Professional Activities (EPAs) as an assessment tool for an Aggression Prevention Protocol. The protocol was designed to structure intervention to prevent aggression and reduce the use of restrictive practices following risk assessment using a validated instrument (the Dynamic Appraisal of Situational Aggression).

BACKGROUND: Preventing aggression and limiting the use of restrictive practices are key priorities for inpatient mental health services. Assessing clinical activities using a competence framework has limitations, particularly when determining complex interventions. EPAs could provide a suitable method for assessing complex clinical activities like de-escalation and limit setting, which comprise some of the interventions in the Aggression Prevention Protocol. EPAs are new to forensic mental health nursing; therefore, feedback was sought regarding the utility of EPAs to assess aggression prevention interventions.

METHODS: Data were collected via focus groups including 11 aggression prevention experts from Australia and New Zealand. A thematic analysis, comparative analysis and a Strength, Weakness, Opportunity and Threats analysis was conducted.

RESULTS: Three themes were interpreted from the data: 1) Frameworks such as the APP are needed to work towards elimination of restrictive practices; 2) APP-EPAs afford an opportunity to set the standard for practice; and 3) 'who watches the watchers', were identified by the experts as well as areas to enhance EPAs prior to introduction into practice.

CONCLUSIONS: EPAs address a practice-gap and offer a framework to assist movement towards elimination of restrictive practices, while prompting best-practice, self-reflection and practice improvement guidance.

Entrustment , Intervention , Mental health nursing , Psychiatric nursing , Restrictive practices , Risk assessment , 4203 Health Services and Systems , 4205 Nursing , 42 Health Sciences , Clinical Research , Violence Research , Prevention , Mental Health , Mental health , 3 Good Health and Well Being , 1110 Nursing , 1302 Curriculum and Pedagogy , Nursing , 3901 Curriculum and pedagogy , 4204 Midwifery , 4205 Nursing
Nurse Educ Pract, ISSN: 1471-5953 (Print); 1873-5223 (Online), Elsevier BV, 73, 103827-. doi: 10.1016/j.nepr.2023.103827
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© 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (