title: Behavioral Emergency Response Team: Implementation Improves Patient Safety, Staff Safety, and Staff Collaboration.
abstract: BACKGROUND
  Staff members working on our nonmental health (non-MH) units (i.e., medical-surgical [MS] units) were not educated in recognizing or deescalating behavioral emergencies. Published evidence suggests a behavioral emergency response team (BERT) composed of MH experts who assist with deescalating behavioral emergencies may be beneficial in these situations. Therefore, we sought to implement a BERT on the inpatient non-MH units at our military treatment facility.
  
  
  OBJECTIVE
  The objectives of this evidence-based practice process improvement project were to determine how implementation of a BERT affects staff and patient safety and to examine nursing staffs' level of knowledge, confidence, and support in caring for psychiatric patients and patients exhibiting behavioral emergencies.
  
  
  METHODS
  A BERT was piloted on one MS unit for 5 months and expanded to two additional units for 3 months. Pre- and postimplementation staff surveys were conducted, and the number of staff assaults and injuries, restraint usage, and security intervention were compared.
  
  
  RESULTS
  The BERT responded to 17 behavioral emergencies. The number of assaults decreased from 10 (pre) to 1 (post); security intervention decreased from 14 to 1; and restraint use decreased from 8 to 1. MS staffs' level of BERT knowledge and rating of support between MH staff and their staff significantly increased. Both MS and MH nurses rated the BERT as supportive and effective.
  
  
  CONCLUSIONS
  A BERT can assist with deescalating behavioral emergencies, and improve staff collaboration and patient and staff safety.
authors.affiliation: Clinical Nurse Specialist, Directorate for Surgical Services, Fort Belvoir Community Hospital, Fort Belvoir, VA.
authors.forename: Cdr Jennifer M
authors.initials: CJM
authors.lastname: Zicko
authors.affiliation: Clinical Nurse Specialist, Inpatient Internal Medicine, Naval Medical Center San Diego, San Diego, CA.
authors.forename: Lcdr Rebecca A
authors.initials: LRA
authors.lastname: Schroeder
authors.affiliation: Navy LIMDU Program Manager, Navy Personnel Command, Deployability Assessment Branch, Navy Personnel Command, Millington, TN.
authors.forename: Cdr William S
authors.initials: CWS
authors.lastname: Byers
authors.affiliation: Doctor of Nursing Practice Student, Uniformed Services University for Health Sciences, Bethesda, MD.
authors.forename: Lt Adam M
authors.initials: LAM
authors.lastname: Taylor
authors.affiliation: Staff Nurse Anesthetist, Naval Medical Center San Diego, San Diego, CA.
authors.forename: Cdr Dennis L
authors.initials: CDL
authors.lastname: Spence
mesh_terms: D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D060731:Emergency Responders; D055317:Evidence-Based Practice; D006801:Humans; D000069469:Medical-Surgical Nursing; D008605:Mental Health Services / Q000592:standards; D061214:Patient Safety / Q000592:standards; D000066553:Problem Behavior / Q000523:psychology*; D011795:Surveys and Questionnaires; D000078329:Workforce; D064450:Workplace Violence
keywords: assault; behavioral emergency; confidence; knowledge; nonpsychiatric/mental health setting; response team; restraints; security; support