Disruptive bEhavior manageMEnt ANd Prevention in Hospitalized Patients Using a behaviORal Intervention Team

Not Applicable

Completed

• Conditions: Behavioral Problem
• Interventions: Behavioral: Standard of care; Behavioral: Behavioral Intervention Team

• Registration Number: NCT03777241
• Lead Sponsor: Vanderbilt University

Brief Summary

The purpose of the proposed study is to evaluate the impact of a behavioral intervention team (BIT) on 2 adult units: a general medical (8N); a cardiac/medical stepdown (8S) at Vanderbilt University Medical Center (VUMC) with a higher proportion of patients with behavioral health comorbidities.

Detailed Description

The BIT will provide a proactive psychiatric team that will screen all patients on admission, provide consultation to those meeting established criteria, and recommend interventions to the primary care team for consideration. BIT will also serve to model therapeutics tactics in communication and goal setting to the clinical staff.

Research Questions for the proposed study:

Considering that behavioral health co-morbidity is common among hospitalized medical inpatients and is associated with higher costs of care and staff dissatisfaction, we will ascertain whether the addition of dedicated, trained behavioral intervention team, compared to nursing staff training on trauma informed care and de-escalation techniques provides:

1. meaningful, measureable improvement in the prevention and management of disruptive behavior in the healthcare setting at VUMC, and

2. Improvement in staff perceptions of their ability to manage patients exhibiting disruptive, threatening or acting out behavior

Specifically, using a pragmatic, cluster cross-over trial design where the BIT crosses between 8N and 8S, we will test the hypothesis that presence of the BIT results in:

1. Improvement in the prevention and management of patients exhibiting disruptive, threatening or acting out behavior

2. Improvement in staff perceptions of their ability to manage patients exhibiting disruptive, threatening or acting out behavior

Study Timeline

• Study First Submitted: 2018-12-14
• Study First Submitted QC: 2018-12-14
• Study First Posted: 2018-12-17
• Study Start: 2019-03-01
• Primary Completion: 2020-02-09
• Study Completion: 2020-05-11
• Status Verified: 2020-09
• Last Update Submitted: 2020-09-07
• Last Update Posted: 2020-09-09

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 3800

Inclusion Criteria

• All patients admitted to two adult medical surgical units (8N/8S) at Vanderbilt University Medical Center during the study period.
• All clinical nurses and staff on 8N/8S employed during the study period.

Exclusion Criteria

• Patients admitted to the floor before the BIT team has begun the crossover period on the unit.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Standard of Care	Standard of care	The participants in this arm will receive the standard of care.
Behavioral Intervention Team	Behavioral Intervention Team	The participants in this arm will receive the Behavioral Intervention Team.

Primary Outcome Measures

Name	Time	Method
Percent of violence control measures utilized	6 months	By extracting medications, restraints, and sitters ordered from the electronic health records
Percent of patient injurious behaviors reported	6 months	By extracting reports of biting, kicking, throwing, etc. from the electronic medical record
Percent change in nurse comfort and confidence in their ability to manage patients exhibiting disruptive, threatening or acting out behavior	1 year	By administering surveys to participants

Secondary Outcome Measures

Name	Time	Method
Rate of unit nursing staff retention	1 year	By extracting rates from internal human resources records
Patient length of stay	6 months	By extracting data from the electronic health record

Trial Locations

Locations (1)

Vanderbilt University Medical Center; 🇺🇸 Nashville, Tennessee, United States