Behavior management on an acute brain injury unit: evaluating the effectiveness of an interdisciplinary training program.
OBJECTIVE
To measure the effect of behavior management training on restraint use and prn medication delivery on an acute inpatient brain injury unit.


METHODS
Interdisciplinary staff and hospitalized brain injury patients on a 20-bed unit within a freestanding rehabilitation hospital.


METHODS
Staff participated in the Nonviolent Crisis Intervention (NCI) program from the Crisis Prevention Institute.


METHODS
Applied physical restraints and delivered prn medications.


RESULTS
Despite comparable patient levels of agitation severity across the duration of the study, the use of physical restraints initially declined and then increased after training. Data collected on prn medication delivery also indicated a trend for an increase in the delivery of select medication categories across time.


CONCLUSIONS
NCI training resulted in a temporary, short-lived reduction in physical restraint use, but had an inverse effect on prn medication delivery for select categories of medication. Medication delivery significantly increased over time and restraint use eventually exceeded baseline level. Ramifications of these results are discussed.
Beaulieu
Cynthia
C
Brain Injury Program, Brooks Rehabilitation Hospital, Jacksonville, FL 32216, USA. cynthia.beaulieu@brookshealth.org
Wertheimer
Jeffrey C
JC
Pickett
Lee
L
Spierre
Louise
L
Schnorbus
Tonya
T
Healy
Wendy
W
Palmer
Candace
C
Jones
Amy
A
D000328:Adult; D000368:Aged; D000374:Aggression; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D000927:Anticonvulsants / Q000008:administration & dosage; D000928:Antidepressive Agents / Q000008:administration & dosage; D014150:Antipsychotic Agents / Q000008:administration & dosage; D001521:Behavior Therapy; D001569:Benzodiazepines / Q000008:administration & dosage; D001930:Brain Injuries / Q000523:psychology* / Q000534:rehabilitation*; D003221:Confusion; D003419:Crisis Intervention; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology; D007318:Inservice Training; D008297:Male; D008875:Middle Aged; D011567:Psychiatric Department, Hospital; D011618:Psychotic Disorders / Q000534:rehabilitation; D012149:Restraint, Physical / Q000706:statistics & numerical data*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000927:Anticonvulsants; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D001569:Benzodiazepines