TY  - JOUR
PY  - 2007//
TI  - Behavioral management leads to reduction in aggression in a child and adolescent psychiatric inpatient unit
JO  - Journal of the American Academy of Child and Adolescent Psychiatry
A1  - Dean, Angela J.
A1  - Duke, Suzanne G.
A1  - George, M.
A1  - Scott, J.
SP  - 711
EP  - 720
VL  - 46
IS  - 6
N2  - OBJECTIVE: Aggression is common in children and adolescents admitted to psychiatric inpatient units. Few interventions for reducing aggressive behaviors have been identified. This study aimed to evaluate the impact of a milieu-based behavioral management program on the frequency of aggressive behaviors in a child and adolescent mental health inpatient unit. METHOD: The behavioral management program incorporated individualized patient management plans, early detection and prevention, staff training, reinforcement of appropriate behaviors, and intervention using the least restrictive option. Outcomes were assessed for 6 months before and after program introduction, and included episodes of aggressive behavior, injuries, use of physical restraint, seclusion, p.r.n. sedation, use of security services, and staffing factors. RESULTS: Implementation of behavioral management led to a significant reduction in the episodes of aggressive behavior (p < .05) and other unwanted outcomes including injuries (p < .05), use of physical restraint (p < .001), and duration of seclusion (p < .001). These outcomes were achieved without reducing the number of admissions, changing the types of patients admitted, increasing staff costs, or increasing the use of p.r.n. medications. CONCLUSIONS: Aggressive behaviors in child and adolescent psychiatric inpatient units can be reduced by implementing a broad-based behavioral management program. These findings highlight the importance of organizational approaches to behavior and risk management.<p />  <p>Language: en</p>
LA  - en
SN  - 0890-8567
UR  - http://dx.doi.org/10.1097/chi.0b013e3180465a1a
ID  - ref1
ER  -