title: The Four S Model in action for de-escalation. An innovative state hospital-university collaborative endeavor.
abstract: In this article, the Four S Model is presented as a working clinical framework for generating structured nursing interventions and treatment plans. The de-escalation process, formalized by the De-escalation/Alternative to Restraint Flowsheet, is one way in which the model is being operationalized to reduce seclusion and restraints. As shown by the flowsheet, the model allows for integration of mental health and mental illness. It spans the scope of nursing practice at all levels, from para-professional to advanced practice nurse, by integrating the mental health concepts of communication, leadership, clinical judgement, critical thinking, and caring within its framework. Most important, the flexibility to individualize treatment that is built into the model allows for generalization to all psychiatric presentations.
authors.affiliation: University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA.
authors.forename: Nidhi
authors.initials: N
authors.lastname: Chabora
authors.forename: Margaret
authors.initials: M
authors.lastname: Judge-Gorny
authors.forename: Kim
authors.initials: K
authors.lastname: Grogan
mesh_terms: D000223:Adaptation, Psychological; D001007:Anxiety / Q000451:nursing* / Q000517:prevention & control; D006778:Hospitals, Psychiatric / Q000458:organization & administration*; D006783:Hospitals, State / Q000458:organization & administration*; D006801:Humans; D007373:Interinstitutional Relations; D016294:Models, Nursing; D009515:New Jersey; D009723:Nurse-Patient Relations; D009737:Nursing Records; D010347:Patient Care Planning / Q000458:organization & administration*; D010353:Patient Education as Topic; D010356:Patient Isolation / Q000706:statistics & numerical data; D011568:Psychiatric Nursing / Q000458:organization & administration*; D012149:Restraint, Physical / Q000706:statistics & numerical data; D017751:Safety Management / Q000458:organization & administration; D012579:Schools, Nursing / Q000458:organization & administration*; D012944:Social Support; D012985:Software Design; D017749:Total Quality Management / Q000458:organization & administration*