ANALYSIS OF EMPLOYEES SAFETY IN THE PROCESS OF MENTAL HEALTH CARE TREATMENT OF PATIENTS WITH VIOLENT BEHAVIOUR

V delu je obravnavana varnost zaposlenih pri obravnavi nasilnega vedenja pacienta v zdravstveni negi s področja mentalnega zdravja. Z raziskavo smo želeli ugotoviti, ali v zdravstvenih ustanovah imajo, uporabljajo in upoštevajo smernice ter standarde za izboljševanje varnosti in prikazati, ali imajo zaposleni v zdravstveni negi s področja mentalnega zdravja zagotovljeno varnost z uvedbo in uporabo smernic, standardov in upoštevanjem zakonov pri nasilnih incidentih. Za instrument raziskovanja smo uporabili anketni vprašalnik za zaposlene v zdravstveni negi s področja mentalnega zdravja. Za drugi del instrumentarija smo uporabili poizvedovanje, opravili smo standardizirani intervju z vodji zdravstvene nege oziroma z zaposlenimi s področja kakovosti v bolnišnici o uporabi standardov, smernic, kliničnih poti v ustanovah in o analizi incidentov na letni ravni. K sodelovanju smo povabili vse psihiatrične ustanove v Sloveniji. Povabilu so se odzvale Psihiatrična bolnišnica Ormož, Psihiatrična bolnišnica Begunje, Psihiatrična bolnišnica Idrija in Psihiatrična bolnišnica Vojnik. Vzorec je zajel zaposlene v zdravstveni negi, to so srednje medicinske sestre ali zdravstveni tehniki in diplomirane medicinske sestre ali diplomirani zdravstveniki v psihiatričnih bolnišnicah na sekundarni ravni v Sloveniji v obdobju od 12. 2. 2013 do 14. 3. 2013. Ugotovili smo, da se zaposleni v zdravstveni negi s področja mentalnega zdravja v psihiatričnih bolnišnicah na sekundarni ravni počutijo varne na svojih delovnih mestih. Za obravnavo pacienta, ki izkazuje nasilno vedenje, uporabljajo smernice, standard oziroma klinično pot za uporabo posebnih varovalnih ukrepov in upoštevajo zakonodajo. Za izboljšanje varnosti zaposlenih v zdravstveni negi s področja mentalnega zdravja pri obravnavi nasilnega vedenja pacienta predlagamo izobraževanje zaposlenih s področja preprečevanja nasilnih incidentov, s področja obravnave nasilnega pacienta in področja kakovosti. Potrebno je uvesti standard za obravnavo nasilnega pacienta v psihiatričnih bolnišnicah ter ga uporabljati in upoštevati.The following master thesis covers the safety of employees who deal with violent behavior of patients in the health care concerning mental health. Our survey aimed to find out if health institutions have, use and take into account the guidelines and standards for improving safety. Furthermore, we tried to show if employees in the field of mental health care are provided with enough safety ensured by the implementation and use of guidelines, standards and legal acts when dealing with violent incidents. A questionnaire was used as an instrument of the survey, whereby the interviewees were employees working in the area of mental health. The second part of the instrument included inquiriesa standardized interview was conducted with heads of health care and employees, covering the issues of quality of hospital use of standards, guidelines and clinical ways in institutions, as well as the analysis of incidents at an annual level. We invited all psychiatric institutions across Slovenia to participate. We received a response from the Psychiatric Hospital Ormož, Psychiatric Hospital Begunje, Psychiatric Hospital Idrija and Psychiatric Hospital Vojnik. The pattern included employees in health care, namely nurses or health care technicians, graduate nurses or graduate health care workers in psychiatric hospitals at a secondary level in Slovenia from 12th February 2013 to 14th March 2013. We discovered that the employees working in the field of mental health in psychiatric hospitals at a secondary level feel safe at work. When dealing with patients who show signs of violent behavior, they employ guidelines, standards and the clinical way to use specific safety measures, while following the legislation. In order to improve the safety of employees in the field of mental health when dealing with violent behavior of a patient, we recommend further education of employees in the area of prevention of violent incidents, managing a violent patient and quality. It is necessary to implement a standard for dealing with violent patients in psychiatric hospitals and therefore follow and use it