SESLHD PROCEDURE COVER SHEET...SESLHD PROCEDURE Aggression Universal Precautions (AUP) PR 341 Revision 1 Trim No. T14/8985 Date: July 2014 Page 2 of 18 THIS DISTRICT DOCUMENT BECOMES

SESLHD PROCEDURE

COVER SHEET

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NAME OF DOCUMENT

Aggression Universal Precautions (AUP)

TYPE OF DOCUMENT

Procedure

DOCUMENT NUMBER SESLHDPR/341

DATE OF PUBLICATION July 2014

RISK RATING High

LEVEL OF EVIDENCE

NSW Ministry of Health Policy Directive ‘Zero Tolerance Response to Violence in the NSW Health Workplace’ PD2005_315

REVIEW DATE July 2015

FORMER REFERENCE(S)

Former ‘Zero tolerance response to violence in the workplace’ SESLHNPD/78

EXECUTIVE SPONSOR or

EXECUTIVE CLINICAL SPONSOR

Sharon Litchfield Director Workforce Services

AUTHOR

Dieter Schultejohann

WHS Officer, Health Safety and Wellbeing [email protected]

POSITION RESPONSIBLE FOR THE DOCUMENT

Peggy Pollock

Manager, Health Safety and Wellbeing [email protected]

KEY TERMS

Aggression management, Management of violence in the workplace, Management and care of patients who display violent behaviour.

SUMMARY

The purpose of this procedure is to:

Establish and maintain a workplace safety culture through the early detection, documentation and management of violence and aggression throughout the organisation.

To clearly define categories for violent behaviour

Implement a standard behaviour communication system

Provide a set of minimum control strategies for potential violence

mailto:[email protected]



SESLHD PROCEDURE

Aggression Universal Precautions (AUP) PR 341

Revision 1 Trim No. T14/8985 Date: July 2014 Page 1 of 18

THIS DISTRICT DOCUMENT BECOMES UNCONTROLLED WHEN PRINTED OR DOWNLOADED UNLESS REGISTERED BY LOCAL DOCUMENT CONTROL PROCEDURES

1. POLICY STATEMENT SESLHD recognises its duty of care to all workers, patients, visitors, volunteers, contractors and students through the minimisation of harm and protection from acts of aggression and violence. The Aggression Universal Precautions (AUP) Procedure has been developed to ensure SESLHD has a systematic framework that complies with requirements outlined in NSW Ministry of Health Policy Directive 'Zero Tolerance Response to Violence in the NSW Health Workplace' PD2005_315. Aggression is defined as any incident in which an individual is abused, threatened or assaulted and includes verbal, physical or psychological abuse, threats or other intimidating behaviours, intentional physical attacks, aggravated assault, threats with an offensive weapon, sexual harassment and sexual assault. While SESLHD may not be able to prevent all initial unanticipated acts of aggression the organisation provides this procedural framework to:

o Manage the initial incident to minimise the risk of adverse outcomes to patients and workers

o When possible prevent a reoccurrence from the same person

o When a reoccurrence of violence or aggression cannot be prevented due to the person’s clinical condition, that the care management systems are implemented to minimise the risk of further aggression and the associated adverse outcomes

o Communicate the level of aggression risk represented by a patient to all other SESLHD workers and others present

o Where the aggressor is not a SESLHD patient, provide a written initial warning and management strategy for subsequent breaches of the behaviour code which is transparent, documented and auditable.

2. BACKGROUND

This procedure is intended as SESLHD’s minimum standard for the management of aggression including verbal abuse, physical violence, intimidation, and threats against SESLHD workers perpetrated by patients, visitors and other non-workers.

The purpose of this procedure is to:

Establish and maintain a workplace safety culture through the early detection, documentation and management of violence and aggression which improves patient care and the safety of all involved.

Set standards of behaviour which are acceptable and clearly define behaviours which require management.

http://www0.health.nsw.gov.au/policies/PD/2005/PD2005_315.html



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To implement a standard communication code system for the identification and communication of a person’s aggressive behaviour and subsequent potential aggression risk level.

Define the aggression management processes and standard controls used for all aggressors - patient, visitor or other person on SESLHD premises.

Set minimum standard control strategies and practice for all workers and managers to follow in the management of potentially aggressive patients and others.

Improve patient care through identifying, documenting and communicating what may trigger patient aggressive behaviours. Develop strategies (controls) to prevent or minimise the risk of aggressive responses during care delivery.

Ensure that when any violent incident occurs, a documented plan is in place to manage that incident and appropriate action is consistently taken to protect health service workers, patients, visitors and property from the effects of such behaviour.

3. RESPONSIBILITIES

3.1 Workers will:

Implement respectful interactions in all patient and public contact situations:

o Keep a safe distance from patients and the public

o Ask for acknowledgement and permission before any interaction

o Continually assess their responses for signs of the person feeling unsafe

o Be prepared to move away if required.

Learn and implement DEBRA

Detect – observe and monitor the patient or visitor for changes in behaviour or mood

Escalating – determine if the changes in patient or visitor mood or behaviour are

moving toward aggression

Behaviour – assess the level of threatening behaviour and what actions are required

to prevent or control further escalation

Respond – use the generic controls relevant to the level of behaviour and initiate the

Patient Aggression Management Care Plan

Alert – communicate to other workers the aggression risk potential of the patient

concerned

Learn and use the Aggression Universal Precautions (AUP) behaviour definitions to:

o Confirm the patient’s AUP code or need for aggression assessment before interaction with the patient

o Follow the standard AUP control protocols and implement the AUP care plans controls.

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Ensure new or other workers entering their work area are advised about the local process for communicating the AUP code for their patients.

If unexpected aggression occurs:

o Attempt to de-escalate the person and act to address the cause of the behaviour as quickly as possible within the limits of safety, or so long as judged safe to do so

o Recognise when de-escalation is not effective and move away from immediate danger, call for assistance, implement the appropriate clinical response and/or AUP management plan, and escalate to Code Black if required

o Where possible identify, respond to and report the cause of the change in aggressive behaviour, and document.

Report all incidents:

o To the appropriate line manager through IIMS for their advice and action

o Involving aggressive behaviour from patient relatives, visitors and others in IIMS as SAC 2 incidents to notify and flag to senior management the need for their action.

3.2 Line Managers will:

Ensure all workers are trained in and are using the Zero Tolerance and AUP approaches to managing patient and visitor interactions

For Departments where patients who are deemed high risk (AUP code (D)) are routinely admitted, ensure all contact workers are trained and competent in Module 2 Aggression Training and rosters are managed accordingly

Provide appropriate safe staffing levels to work with the patient as per AUP staffing and/or local aggression management/patient care planning, specialling (one to one nursing) business rules and safe work practices (line managers should escalate staffing deployment needs which are outside of their delegation and based on risk, to senior management)

Ensure documented AUP care plans are developed and updated for all patients who are identified through the coding system to be a risk for exhibiting aggressive behaviour

Establish local processes for communicating AUP codes to all workers entering or working in their work area

Display Zero Tolerance and AUP promotional material in the Department/ward for the advice of patients and visitors (please see Appendices)

Where the patient may require restraint as part of their behavioural controls ensure:

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o All of the patient’s contact workers have restraint training that meets the needs for their department

o The restraint is clinician led (as per NSW Ministry of Health Policy Directive ‘Aggression, Seclusion & Restraint in Mental Health Facilities’ PD2012_035 and SESLHD Policy 'Security - physical response' PD110) for maximum patient and worker safety across all shifts

o Assess the need for a Security presence should they be required to assist or intervene and coordinate accordingly

o Inform Security of:

Patients who pose an aggression risk in the ward

The patient Aggression Management Care Plan and controls

The AUP code assigned to the patient

Security’s role in the event of a Code Black call that involves a patient

Line manager or delegated senior in charge, when called to assist a worker in the de-escalation of a patient or visitor will:

o Respond promptly

o Confirm all clinical indicators are within range

o Where possible identify the triggers that may have contributed to the change in behaviour or caused the aggression

o If safe to do so, attempt to de-escalate the person and/or implement other control measures as appropriate

o If the aggressive behaviour continues to escalate, implement Code Black

o Adopt the role of co-ordinator

When Security arrive:

o Provide the following information - brief background, what has already been done to attempt to resolve the situation and what the current situation is now

o Discuss with Security a coordinated plan to attempt to manage the situation from this point

o Where staff are trained in physical restraint, coordinate the activities of Department/ward staff in assisting Security if a physical restraint is required

Once the incident has concluded: o Refer to Section 8.5 ‘Post Incident Response’ of the NSW Ministry of Health

Policy Directive 'Zero Tolerance Response to Violence in the NSW Health Workplace' PD2005_315

o For non-patient incidents report the incident to the senior manager in IIMS by rating it as SAC 2

o Ensure that the Aggression Management Care Plan for the patient is reviewed and amended with any new controls as required to reduce the risk of aggression reoccurring or manage the patient as required.

http://www0.health.nsw.gov.au/policies/pd/2012/PD2012_035.html


http://www.seslhd.health.nsw.gov.au/Policies_Procedures_Guidelines/Corporate/Governance/documents/PD-110-Security-PhysicalResponse.pdf




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3.3 Security Officers will:

For those patients with (D) and (W) codings that they engage with, seek the current AUP care plans, their aggression triggers and preferred de-escalation techniques or other prescribed patient management methods

When called to a Code Black, attend the scene promptly and where possible seek a briefing from the In-Charge before engaging with the person concerned

Follow the agreed department Aggression Management Care Plan for patient control and coordinate with the ward staff regarding the roles within the team

Upon request from the In-Charge and after reviewing all evidence consider where appropriate, the timing and issue of the Behaviour Request notice to the person concerned

Report the incident following standard reporting processes ie. IIMS, brief the security manager on the details of the incident and issue the Behaviour Request Notice where required.

3.4 Security Managers will:

Monitor incident reports from the security teams and review incidents for:

o Number and frequency of incidents, nature and severity of previous incidents committed by an individual

o The requirement for further risk management planning with department managers that may involve security

o The need to meet with senior managers or the site Executive and the aggressor to consult on agreed behaviours while on SESLHD premises

o The need for subsequent meetings with the site Executive and an aggressor who continues to intimidate or threaten the safety of patients, workers or visitors after agreed commitments to the contrary.

3.5 Senior/Service/Stream Managers will:

Promptly respond to requests by managers to assist with the management of aggression from visitors or relatives or patients without clinical cause, as follows:

o Assist managers in ensuring adequate staffing levels based on AUP rating and care plans to manage the identified aggression risks in their workplace

o Contact the person concerned by letter or phone call to explain both the rights and responsibilities that exist in relation to safety and the consequences of persisting with any behaviour that is a risk to the safety of everyone involved. At times it might be appropriate to arrange a face to face meeting to discuss safety concerns

o Send the appropriate AUP system letters amended as required

o Review all details of each case considering the effect the repeated non-clinically derived aggression is having on:

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The safety of other patients and visitors

Impact on other patient care activities

The workers’ safety

The reputation of the organisation

Community expectations for a safe environment free of intimidation in SESLHD facilities

o Consult with the site Security Manager on appropriate actions taken to date and other possible options for managing the individual concerned

o Meet with the individual concerned, department manager and Security Manager to develop an agreed level for their behaviour

o Take a prompt and consistent approach to aggression management by taking action for each subsequent reported offence or breach of agreed standards of behaviour by individuals concerned

o Enforce service restrictions or site attendance limitations as prescribed in the procedure.

3.6 Medical staff will:

Learn and use the AUP codes for levels of aggression

Confirm the AUP code for the patient or the need for an aggression assessment before interaction with the patient

Follow the standard AUP control protocols or implement the AUP care plans controls

Participate in the development of the aggression management care plan for the patient in consultation with other clinicians, allied health, the department manager and workers who are engaged in caring for the patient with the aim of preventing the incident from reoccurring.

Reinforce and promote appropriate behaviour from patients of SESLHD

Meet with the patient, senior management and department manager where their patient has been involved in an aggressive incident to:

o Be aware of the behaviour displayed by the patient

o Support the maintenance of appropriate behaviour from the patient while on SESLHD premises

o Reinforce SESLHD’s and the NSW Ministry of Health’s stance on aggression in health care with the patient.

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4. PROCEDURE

While the vast majority of patients who present to health care facilities constitute no risk or minimal risk of aggression, incidents of aggression can and do occur. There may be many reasons for this, including the inherently stressful process of illness and hospitalisation and the manifestation of a clinical condition. AUP attempts to acknowledge this by providing a framework whereby the potential for aggression is considered in a more conscious way by realising that everyone has the potential to become aggressive and universal precautions must be undertaken. Refer to AUP Flowchart Appendices 1-3 (Appendix 1, Appendix 2, Appendix 3)

4.1 Aggression Universal Precautions

While engaged with the public and in patient care all SESLHD workers are to consider the public and patients and follow the basic Aggression Universal Precautions. In interacting with patients and the public, SESLHD staff are to:

o Remain respectful during all interactions and episodes of care

o Where possible do not enter the other person’s personal space

o Where possible ask for permission prior to delivery of personal care

o Continually assess for signs of rising agitation

o Be prepared to move away if required

While working all SESLHD workers are to maintain a situational awareness of patients and other people in the area they are working in and use the standard approach of DEBRA as follows:

Detect – observe and monitor the patient or visitor for changes in behaviour or mood

Escalating – determine if the changes in patient or visitor mood or behaviour are moving

toward aggression

Behaviour – define the level of a person’s aggressive behaviour and what actions are

required to prevent or control the signs of aggressive behaviour

Respond – use the generic controls relevant to the level of behaviour and implement the

Patient Aggression Management Care Plan

Alert – communicate to other workers the aggression risk potential of the patient

concerned

4.2 Patient Assessment

Refer to: Appendix 1 AUP New Patient Flowchart Appendix 2 AUP Previously AUP Coded Patient Flowchart

Appendix 4 AUP Behaviour Code Poster Appendix 5 AUP Behaviour Codes and Staff Actions Poster

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Appendix 6 Patient Aggression Management Care Plan

All SESLHD admitted patients must be assessed and have that assessment clearly marked on their file for the advice of all other workers who participate in the care of the patient.

Although Emergency Departments are not expected to apply the AUP rating to all patients, they are expected to communicate any aggression risks to the receiving ward so they can use this as part of their initial rating.

The initial assessment period will last until the end of the shift or at the end of the initial care period. The staff member assigned to provide observations or care to the patient will be responsible for recording the AUP code according to any signs of aggression or behaviours that are a risk to safety (Appendix 4 and Appendix 5).

Any behaviour which is aggressive or a risk to safety must be promptly reported and documented. Where the behaviour is observed by a non-clinical staff member, this must be reported to and documented by the clinician/nursing staff assigned to the patient for that shift. Each facility/service will determine how the AUP code and any care plans will be recorded. Some possible methods could include:

o Observation charts

o Patient Handover Care Plan

o Sample patient Aggression Care Plan (Appendix 6).

Where the patient has not displayed any behaviours of concern at the end of the first period of care for the patient (end of shift or care service provided), the patient’s file must be marked with the AUP code (A) to indicate ‘Assessed’ - no observed behaviour that is a risk to safety.

Assessment and re-assessment must occur at every shift or period of care.

The patient’s aggression status and any change in status must be communicated to all staff involved with the patient at clinical handover, on referral to a care provider, and on the change in assessment. The recorded Care Plan is to be updated promptly according to the change in status of the patient.

This assessment and AUP code application must be consistently applied to all patients to ensure that the minimal aggression risk is clearly communicated and that SESLHD or individual workers apply a common standard to all patients.

4.3 Escalating Behaviour

Refer to: Appendix 1 AUP New Patient Flowchart

Appendix 2 AUP Previously AUP Coded Patient Flowchart At no time should any workers place themselves at risk by approaching the person who is displaying aggression without having reasonable belief that the person will respond to

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advances for care or assistance without a negative or violent reaction. When a worker identifies or is confronted by a person whose behaviour is a threat to safety:

Where safe to do so, verbally engage with the person to calm them, determine the cause of the behaviour and address the cause wherever possible, other options to be considered may include a clinical review or requesting assistance from colleagues

Where all reasonable options have been attempted and/or the behaviour continues to escalate and there is a risk to safety, the worker is to alert the In Charge and/or initiate the Code Black procedure

4.4 Code Black

After the Code Black is initiated in the department all workers are to follow the local Code Black arrangements and strive to ensure the safety of themselves, other patients and visitors.

Police may be called where it is deemed appropriate to do so.

Where it is safe to do so, one staff member who ideally has a rapport with the person should continue to attempt to de-escalate the situation. If it becomes evident that the person may become physically violent, where possible all persons are to be removed from the immediate area for their safety until Security or Police arrive to manage the situation.

In departments where staff are trained in restraint procedures and where appropriate, a clinician-led restraint may proceed as per NSW Ministry of Health Policy Directive ‘Aggression, Seclusion & Restraint in Mental Health Facilities’ PD2012_035 and SESLHD Policy 'Security - physical response' PD110.

When Security or Police arrive, the most senior person not engaged with the incident is to tell the Security or Police personnel the AUP code for the behaviour displayed thus far and any other relevant information regarding the incident, including a brief background, including what has already been done to attempt to resolve the situation and what the current situation is now.

Security or the Police then assume control of the situation and determine whether to allow the person/s engaged with the individual concerned to continue managing the incident or to intervene and take command.

Where the incident involves a visitor or patient that is not related to a known clinical condition, see section 4.5.

4.5 Visitor or Relative Behaviour Management

Refer to: Appendix 3 AUP Visitor Flowchart Appendix 7 Behaviour Warning Notice

Appendix 8 Conditional Restricted Visiting Notice




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Appendix 9 Termination Notice (Activation of Inclosed Lands Act)

After a non-patient aggression incident the incident is to be reported in IIMS as a SAC 2 to alert the department manager, Service manager, Director of Operations and the Security manager for their advice and action.

The Service Manager, Director of Operations and Security Manager will promptly:

o Meet with the person and discuss the reason for their behaviour and explain the requirements and public expectations placed upon SESLHD to maintain an environment which is free of aggression and violence

o Ensure the person has received a Behaviour Request notice (Appendix 7) from Security officers involved in managing the incident.

Upon subsequent reported occasions of inappropriate behaviour the Service manager, Director of Operations and Security manager will promptly:

o Meet and consult with the person to develop a verbal agreement for their appropriate behaviour while on SESLHD premises

o Explain the process should they become aggressive or violent on SESLHD premises in the future

o Confirm in writing with the person the behavioural agreement and intervention plan should they be involved in another aggression episode using the following templates amended as necessary:

1. Behaviour Warning Notice (Appendix 8) 2. Conditional Restricted Visiting Notice (Appendix 9) 3. Termination Notice (Activation of Inclosed Lands Act) (Appendix 10).

4.6 Patient Aggressive Behaviour Identification

The clinical team must assess if the most likely cause of the aggressive behaviour was as a result of a change/deterioration to the clinical condition. If this is the case, prompt clinical review, treatment and necessary control is required.

4.7 Aggressive Patient Behaviour Management - Non-clinically derived

Refer to: Appendix 7 Behaviour Request Form Appendix 11 Acceptable Behaviour Contract

Appendix 12 Conditional Treatment Agreement Form Appendix 13 Inability to Treat Notice

The incident is to be reported in IIMS as a SAC 2 to alert the department manager, senior management and the Security manager for their advice and action.

The department manager will ensure that:

o The AUP code is upgraded by the responsible clinician/nursing staff to the relevant level on the patient’s file notes and other communication devices

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o All contact workers and departments involved with the patient are informed of the change to the AUP status of the patient and confirm at clinical handover

o Confirm with Security the changes made to the patient’s status and the joint intervention plan should another aggression episode occur

o Consult with the patient, their treating consultant, the Service senior manager, Director or Site Manager and Security on the need for a meeting with the patient to issue or implement either:

1. Behaviour Request notice (Appendix 7) 2. Acceptable Behaviour Contract (Appendix 11) 3. Conditional Treatment Agreement form (Appendix 12) 4. Inability to Treat Notice (Appendix 13).

4.8 Aggressive Patient Behaviour Management – Clinically derived

Refer to: Appendix 1 AUP New Patient Flowchart ‘Behaviour due to Medical Condition or clinical treatment Yes path’ Appendix 14 Advice to Relatives re AUP Care Plan

The incident is to be reported in IIMS as a SAC 3 to alert the department manager. The manager, in consultation with clinicians and other workers who are engaged in caring for the patient, will:

o Review the incident with the workers involved and coordinate the development of the Aggression Management Care Plan for the patient. The aim of the care plan is to prevent reoccurrence of the incident where possible and to strive to reduce the patients aggression risk level to AUP Code (P)

o Upgrading the AUP code to the relevant level on the patient’s file notes and other communication devices until the care plan is proven to manage or prevent escalation of the patient’s behaviour

o Informing all patient contact workers including those from other departments of the change to the patient’s AUP status and confirm this is communicated at clinical handover

o Confirming with security the changes made to the patient’s care plan and make or update the joint intervention plan should another aggression episode occur.

In consultation with the senior manager, the department manager should determine if it is appropriate to send the patient’s family notification of the AUP status of the patient, reason for status and implemented controls using the Advice to Relatives re AUP Care Plan (Appendix 14).

4.9 AUP Coded Patient is admitted to or attends the Service

Refer to: Appendix 2 AUP Previously AUP Coded Patient Flowchart

Where a patient with an existing AUP code indicating aggression risk potential is:

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1. Transferred/admitted to the ward

2. Sent to a service for diagnostics or treatment.

It is the responsibility of the department transferring the patient to provide the Aggression Management Care Plan for the patient prior to transfer.

The receiving department or service needs to ensure all workers are made aware of the patient’s AUP code and care plan recommendations.

Where indicated by the AUP code or care plan, the manager of the receiving ward or service must ensure appropriate staffing and contact Security confirming their awareness of the patient’s locality, and any agreed plans for support in the event of a Code Black.

4.10 Changes to a Patient’s AUP code

The basic principle of AUP is that if there is a known history of aggressive behaviour then it is possible that this could reoccur depending on some of the contextual factors. Therefore their highest-assessed AUP code remains the same for the life of the episode of care, unless there is a significant body of evidence to demonstrate that the reason or cause for the aggressive behaviour has been effectively eliminated. This is particularly pertinent where the patient has a pathology that is triggering the aggression that is resolving or resolved, hence their behaviour has de-escalated and the code can be accurately downgraded The decision to downgrade the AUP code for a patient must be carefully considered and done in collaboration with all senior members of the team caring for the patient, and made in consensus with the senior treating clinician. Any doubt regarding the sustainability of the downgraded behaviour is better addressed by continuing to code the patient with the higher AUP code.

5. DOCUMENTATION

IIMS Incident Reports Training register – Worker training in - AUP, Zero Tolerance and Restraint (high risk departments only) Appendix 1 AUP New Patient Flowchart Appendix 2 AUP Previously AUP Coded Patient Flowchart

Appendix 3 AUP Visitor Flowchart Appendix 4 AUP Behaviour Code Poster Appendix 5 AUP Behaviour Codes and Staff Actions Poster Appendix 6 Patient Aggression Management Care Plan Appendix 7 Behaviour Warning Notice

Appendix 8 Conditional Restricted Visiting Notice Appendix 9 Termination Notice (Activation of Inclosed Lands Act)

Appendix 10 Behaviour Request Form Appendix 11 Acceptable Behaviour Contract

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Appendix 12 Conditional Treatment Agreement Form

Appendix 13 Inability to Treat Notice Appendix 14 Advice to Relatives re AUP Care Plan

6. AUDIT

This procedure will be audited through the Ministry of Health OHS & IM Profile every two years.

7. REFERENCES

7.1 NSW Legislation

Work Health and Safety Act 2011

Work Health and Safety Regulation 2011

How to manage work health and safety risks Code of Practice NSW

Work health and safety consultation, coordination and cooperation. Code of Practice NSW

Crimes Act 1900 No 40 - NSW Legislation - NSW Government

Summary Offences Act 1988 No 25 - NSW Legislation

Anti-Discrimination Act 1977 No 48 - NSW Legislation

7.2 NSW Ministry of Health Policy Directives

NSW Ministry of Health Policy Directive ‘Zero Tolerance Response to Violence in the NSW Health Workplace’ PD2005_315

NSW Ministry of Health Guideline ‘Aggression, Seclusion & Restraint in Mental Health Facilities – Guideline focused upon Older People’ GL2012_005

NSW Ministry of Health Policy Directive ‘Violence Prevention & Management Training Framework for the NSW Public Health System’ PD2012_008

7.3 SESLHD Policies, Procedures, Guidelines and/or Business Rules

SESLHD Procedure ‘Prevention, diagnosis and Management of Delirium in Older People in Acute and Sub-Acute Care’ PD 209

Security - physical response PD110

8. REVISION AND APPROVAL HISTORY

Date Revision No. Author and Approval

June 2013 Draft 0 Document revision commenced

December 2013 Draft 0 Document reviewed, incorporating feedback from stakeholders

July 2014 Draft 1 Approved by District Executive Team 24 July 2014

http://www.legislation.nsw.gov.au/fragview/inforce/act+10+2011+pt.14-div.2+0+N?tocnav=y

http://www.legislation.nsw.gov.au/maintop/view/inforce/subordleg+674+2011+cd+0+N

http://www.workcover.nsw.gov.au/formspublications/publications/pages/whs-consultation-coooperation-coordination-code-of-practice.aspx

http://www.google.com.au/url?sa=t&rct=j&q=crimes%20act&source=web&cd=5&cad=rja&sqi=2&ved=0CEwQFjAE&url=http%3A%2F%2Fwww.legislation.nsw.gov.au%2Fmaintop%2Fview%2Finforce%2Fact%2B40%2B1900%2Bcd%2B0%2BN&ei=GRmwUbf0MMOpiAeeq4F4&usg=AFQjCNH-30dwpIqPBY-bqgfgNsyjyi9fig

http://www.google.com.au/url?sa=t&rct=j&q=summary%20offences%20act&source=web&cd=5&cad=rja&sqi=2&ved=0CEwQFjAE&url=http%3A%2F%2Fwww.legislation.nsw.gov.au%2Fxref%2Finforce%2F%3Fxref%3DType%253Dact%2520AND%2520Year%253D1988%2520AND%2520no%253D25%26nohits%3Dy&ei=6hmwUauSHMyyiQeKzYGwBA&usg=AFQjCNGQ0UU41dLUkdvO2JbnM72Dz5-A8g

http://www.google.com.au/url?sa=t&rct=j&q=anti%20discrimination%20act&source=web&cd=8&cad=rja&ved=0CFoQFjAH&url=http%3A%2F%2Fwww.legislation.nsw.gov.au%2Ffullhtml%2Finforce%2Fact%2B48%2B1977%2Bpt.1-sec.4%2B0%2BN&ei=nRqwUYPILISTiQex5YDoDw&usg=AFQjCNGfE38Mh7fTcFYYb-FIdMtmc9sLoQ



http://www0.health.nsw.gov.au/policies/gl/2012/GL2012_005.html

http://www0.health.nsw.gov.au/policies/gl/2012/GL2012_005.html



http://www.seslhd.health.nsw.gov.au/Policies_Procedures_Guidelines/Clinical/Operations/Documents/PD-209-Delirium.pdf

http://www.seslhd.health.nsw.gov.au/Policies_Procedures_Guidelines/Clinical/Operations/Documents/PD-209-Delirium.pdf


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Appendix 1 – New Patient Flowchart

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Appendix 2 – Previously AUP Coded Patient Flowchart

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Appendix 3 – Visitor Flowchart

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Appendix 4 – Which AUP Code = Which Behaviour?

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Appendix 5 – AUP Codes

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Appendix 6 – Patient Aggression Management Care Plan (Sample)

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Appendix 7 – Behaviour Request

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Appendix 8 – Conditional Restricted Visiting Letter

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Appendix 9 – Termination Notice Letter

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Appendix 10 – Behaviour Warning Notice Letter

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Appendix 11 – Behaviour Contract

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Appendix 12 – Agreement for Treatment under Conditional Arrangements

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Appendix 13 – Inability to Treat Notice

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Appendix 14 – Advice regarding Your Family Member’s Aggression Management Care Plan