Disruptive bEhavior manageMEnt ANd Prevention in Hospitalized Patients Using a behaviORal Intervention Team: Study Protocol for a Pragmatic, Cluster, Cross-over Design
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Behavioral Problem
- Sponsor
- Vanderbilt University
- Enrollment
- 3800
- Locations
- 1
- Primary Endpoint
- Percent of violence control measures utilized
- Status
- Completed
- Last Updated
- 5 years ago
Overview
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
Investigators
Ruth Kleinpell
Professor
Vanderbilt University
Eligibility Criteria
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.
Outcomes
Primary Outcomes
Percent of violence control measures utilized
Time Frame: 6 months
By extracting medications, restraints, and sitters ordered from the electronic health records
Percent of patient injurious behaviors reported
Time Frame: 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
Time Frame: 1 year
By administering surveys to participants
Secondary Outcomes
- Rate of unit nursing staff retention(1 year)
- Patient length of stay(6 months)