Author(s): Joshua Moran Jimenez, DNP, PMHNP, CPHQ, CARN, NE-BC
Advanced Practice Provider
Medical University of South Carolina

Jennifer Reynolds, MS, BSN, RD/LD, RN
Assistant Nurse Manager
Medical University of South Carolina

Tracey Rudolph, BSN, RN, PMH-BC
Clinical Staff Leader
Medical University of South Carolina

Jonah Burrell, BA, BSN, RN
Clinical Practice Nurse Expert-Registered Nurse Clinical Staff Leader
Medical University of South Carolina

Sealy Crider, BSN, CEN, SANE-A
Clinical Practice Nurse Expert
Medical University of South Carolina

Kate Snider, BSN, RN
Relief Staff Leader
Medical University of South Carolina

Competency Domain: Performance & Process Improvement

Description: The purpose of this presentation is to describe the use of a de-escalation debriefing tool (Huckshorn & LeBel, 2024) following escalation events in the adult emergency department to identify effective patient-centered approaches in de-escalation. Implementation of an evidence-based protocol including using a de-escalation debriefing tool to identify antecedents, triggers, and effective patient-centered de-escalation approaches may improve patient and staff safety through reduced seclusion or restraint use and reports of workplace violence. Tool:What is the name of the tool used? De-escalation Debriefing Tool (Huckshorn & LeBel, 2024) Problem:At the project site, the pre-intervention rate of seclusion hours for the units exceeds the state and national averages (Medicare, 2025). The site has a policy for seclusion of patients presenting imminent risk of harm but there is no standardized process for debriefing following escalation events. Workplace violence impacts the United States by approximately $151 billion annually, averaging roughly $250,000 an incident (Chapin & Koller, 2022). Tool Selection:Why did you select this tool to solve this problem? Describe what made it the best tool for the problem.Evidence supports post-incident debriefing as a part of a multi-modal approach to reduce seclusion rates through incorporating safety initiative programs such as Six Core Strategies (6CS) and Safewards (Gaynes et al., 2017; Putkonen et al., 2013; Wieman et al., 2014; Fletcher et al., 2017; Bowers et al., 2015; Huckshorn & LeBel, 2024). Usage:Following incidents of escalation, the charge nurse would lead a debriefing huddling the team and reviewing each of the questions: including what surrounded the event/leading up to the event, the response, evaluation of what went well and what may be improved. Results:Measures include % adherence completing debriefing tool compared to number of escalation events necessitating seclusion or restraint. Outcome measures include seclusion/restraint rates as well as workplace violence reports. Barriers to success include improving staff adherence through reinforcing education during monthly staff meetings.