Violence risk screening begins at the first point of care for all nurses.

In the Emergency Department (ED), the Violence and Aggressive Screening section is part of the ED Screening PowerForm (e.g. ED Screening – Adult or ED Screening – Pediatrics).

Click the Nurse Activity column for the selected patient in ED LaunchPoint. Then select the ED Screening task and click Document to open the ED Screening PowerForm.

In the inpatient settings, the Violence and Aggression Screening section is part of the admission PowerForms (e.g: Admission History Adult or Admission History Pediatric).

Select the Admission History task in CareCompass and click Document to open the relevant PowerForm for documentation.

NOTE: The Violence and Aggressive Screening section can also be part of other types of PowerForms (e.g. Ambulatory Adult Assessment, Surgical Assessment, etc.) that apply to other clinical settings. Follow site policy to complete initial violence risk screening documentation.

 

If violence risk assessment is done at a time other than admission, access a new Violence Risk Alert Screen PowerForm from the Assessments Ad Hoc folder.

REMINDER: Each incident of violence or aggression requires a Violence Risk Alert Screen PowerForm to be completed.

  

Enter relevant information in the corresponding fields within the Violence and Aggression Screening section as appropriate.

Here are some highlights when you document the Violence and Aggressive Screening section:

Select the appropriate response as per your assessment from the yellow mandatory fields: Violence and Aggression Screening, Based on risk screening the following action is indicated, and Violence Risk Screen Action.

  If there is an identified violence risk, activate the Violence Risk Process Alert via PowerForm by selecting Activate Alert in the Violence Risk Screen Action field.


 

Right click on the field that has (Ref) label to open the reference text information with additional links to Health Authorities surrounding application and removal of the Violence Risk alerts.


 

Complete the remaining questions as necessary.

These questions identify the patient’s current presentation, location, risk factors and in-the-moment actions.

This screening tool is not a care plan, but is meant to support the Violence Risk Care Plan note.

The Support and Intervention information is in-the-moment documentation, meant to support care planning via the Violence Risk Care Plan.

It does not replace appropriate assessments, and exists to support unit or organization processes.


 

If Violence and Aggression Screening is accessed through admission or initial screening documentation, complete the rest of the PowerForm as necessary. When done, click the green check mark  to sign the documentation.

 

If Activate Alert is selected in the Violence Risk Screen Action field, you will see the Violence Risk process alert automatically populate on the Banner Bar. Hover over the process alert to see the full list.

In addition to the process alert, the system will automatically place the Violence Risk order when Activate Alert is selected in the PowerForm.

NOTE: The Violence Risk order will also be available in ad hoc ordering.

 

Once the Violence Risk order is automatically placed, additional High Risk Alert  icon or equivalent will be auto-populated in the multi-patient level resources (e.g. CareCompass, Clinical Leader Organizer, ED LaunchPoint, etc.) to alert other health care team members regarding the violence risk.

Hover over the High Risk Alert  icon or the equivalent to view the details of the alert.

 

NOTE: The Violence Risk alert will also appear in the alerts widget / workflow page (if applicable) to communicate risk to staff that do not have CareCompass or Clinical Leader Organizer, such as allied health.

 

IMPORTANT: Placing a Violence Risk order DOES NOT replace verbal communication about the patient’s violence risk to other health care team members. Violence Risk process alert will continue to follow the patient and cross encounters. It is important to determine if the Violence Risk process alert should be discontinued or changed to Historical Violence Risk when the patient is ready for discharge. Please refer to Discontinue Violence Risk Alert section later in this help topic.

 

After selecting Activate Alert in the Violence Risk Screen Action field, the system will also automatically place the Complete Violence Care Plan order.

 

This order generates the associated task to document the Violence Risk Care Plan PowerForm. For further details, please refer to the CST Cerner Help topic: Document Violence Risk Care Plan


 

Complete/update the Violence Risk Care Plan PowerForm and/or update any paper copies of the care plans as necessary.

Communicate the patient’s violence risk to the healthcare team as per your site-specific workflows.

  

Follow site policy to determine when to remove the Violence Risk process alert. If the Violence Risk alert can be discontinued, document details of discontinuation of alert on Violence Risk Alert Screen PoweForm. 

REMINDER: As the removal of the Violence Risk alert can pose an immediate risk to staff, patients, and visitors, it is strongly recommended that clinicians review their organizational policy before acting.

 

To document discontinuation of the Violence Risk process alert on the Violence Risk Alert Screen PowerForm:

Navigate to Form Browser.

Right-click on the most recently completed Violence Risk Alert Screen PowerForm and select Modify.


 

Scroll down to locate the Violence Risk Screen Action field. Deselect the previous documented response(s) and select Recommend that alert to be discontinued.

REMINDER: DO NOT modify the previously documented Process alert indicated response in the field that titles with Based on risk screening, the following action is indicated.

 

In the Review Violence Risk Alert section:

Select an appropriate alert discontinue reason. 

 Add additional comment if applicable..

Click the green check mark  to sign the PowerForm.




If Recommend that alert to be discontinued is selected in the Violence Risk Screen Action field, the associated task will be generated to remind you to manually remove the Violence Risk process alert and cancel/discontinue Violence Risk order as necessary.




Removal of the Violence Risk process alert can be done via PM Conversation.

In the patient chart, select Process Alert from PM Conversation.


 

Search for the appropriate facility and click OK.


 

Click on the white box below Process Alert.


 

Select and move Violence Risk from the Selected field to the Available field.

Click Complete.


 

Refresh the patient chart so that the Violence Risk process alert falls off from the Banner Bar.


 

Click Done or Chart Done to remove the completed Discontinue Violence Risk Process Alert task from the task list (e.g. CareCompass).

NOTE: If the Violence Risk process alert is not discontinued, it will follow the patient across encounters. The primary nurse will then need to assess and verify patient’s violence risk status.

 

 

After removing the Violence Risk process alert, discontinue the patient’s Violence Risk order on the Orders page.

Communicate the changes to the health care team as per site policy.