Citation

Zicko CJ, Schroeder LR, Byers WS, Taylor LA, Spence CD. Worldviews Evid. Based Nurs. 2017; 14(5): 377-384.

Affiliation

Staff Nurse Anesthetist, Naval Medical Center San Diego, San Diego, CA.

Copyright

(Copyright © 2017, Sigma Theta Tau International, Publisher John Wiley and Sons)

DOI

10.1111/wvn.12225

PMID

28372033

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. AIMS: 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. LINKING EVIDENCE TO ACTION: A BERT can assist with deescalating behavioral emergencies, and improve staff collaboration and patient and staff safety.

© 2017 Sigma Theta Tau International.

Language: en

Keywords

assault; behavioral emergency; confidence; knowledge; nonpsychiatric/mental health setting; response team; restraints; security; support