These guidelines are not binding on nurses, other providers of the interprofessional team, or the organizations that employ them. The use of these guidelines should be flexible, and based on individual needs and local circumstances. They constitute neither a liability nor discharge from liability. While every effort has been made to ensure the accuracy of the contents at the time of publication, neither the authors nor the Registered Nurses' Association of Ontario (RNAO) gives any guarantee as to the accuracy of the information contained in them or accepts any liability with respect to loss, damage, injury, or expense arising from any such errors or omission in the contents of this work.With the exception of those portions of this document for which a specific prohibition or limitation against copying appears, the balance of this document may be produced, reproduced, and published in its entirety, without modification, in any form, including in electronic form, for educational or non-commercial purposes. Should any adaptation of the material be required for any reason, written permission must be obtained from RNAO. Appropriate credit or citation must appear on all copied materials as follows: Registered Nurses' Association of Ontario. (2017). Crisis intervention for adults using a trauma-informed approach: Initial four weeks of management (3rd ed.). Toronto, ON: Author. This work is funded by the Ontario Ministry of Health and Long-Term Care. All work produced by RNAO is editorially independent from its funding source.# Table of Contents

# How to Use This Document
This best practice guideline (BPG) G is a comprehensive document that provides resources for evidence-based practiceG. It is not intended to be a manual or how-to guide; rather, it is a tool to guide best practices and enhance decision-making for nurses G other health-care providers, social service G providers, and police officers working with adults (18 years and older) who are experiencing or have experienced crisis G. This Guideline should be reviewed and applied in accordance with the needs of individual organizations or practice settings and with the needs and preferences of the persons experiencing crisis and their families G who are accessing the health system for care and services. In addition, this Guideline offers an overview of appropriate structures and supports for providing the best possible evidence-based care.
Nurses, other health-care providers, social service providers, police officers, and administrators who lead and facilitate practice changes will find this document invaluable for developing policies, procedures, protocols, educational programs and assessments, interventions, and documentation tools. Furthermore, nurses and other health-care providers, social service providers, and police officers who provide direct response and/or care will benefit from reviewing the recommendations and the evidence that supports them. We particularly recommend that practice settings and police agencies adapt this Guideline in formats that are user-friendly for daily use.
If your organization is adopting this Guideline, we recommend you follow these steps:
- Assess your existing crisis-related policies, procedures, protocols, and education programs in relation to the recommendations in this Guideline.
Identify existing needs or gaps in your crisis-related policies, procedures, protocols, and educational programs.
- Note the recommendations that are applicable to your setting and that can be used to address your organization's existing needs or gaps.
- Develop a plan for implementing or integrating recommendations, sustaining best practices, and evaluating outcomes.
Implementation resources, including the RNAO Toolkit: Implementation of Best Practice Guidelines (2012), are available at www.RNAO.ca.