Interventions for disruptive behaviors. Use and success

Area of Science:

• Geriatric Medicine
• Nursing Practice
• Healthcare Management

Background:

• Healthcare providers frequently encounter disruptive behaviors from geriatric patients.
• These behaviors negatively impact provider efficiency, patient-provider relationships, and overall patient well-being.
• Systematic clinical studies on the impact of disruptive behaviors in geriatric inpatient care are lacking.

Purpose of the Study:

• To develop a taxonomy for disruptive behaviors in geriatric inpatient settings.
• To study the frequency and nature of disruptive behaviors on a geriatric evaluation and management (GEM) unit.
• To examine the nursing interventions used to manage these behaviors and their effectiveness.

Main Methods:

• A taxonomy of disruptive behaviors was developed and applied.
• Nursing staff on a GEM unit were observed over 8 weeks.
• Experienced RN observers documented disruptive behaviors and nursing interventions.
• Data were collected on 97 disruptive events involving 87 patients.

Main Results:

• Disruptive behaviors are prevalent on GEM units.
• Nursing staff recognized only 50% of disruptive behaviors.
• Single interventions were successful 45% of the time.
• Multiple simultaneous interventions, though potentially more effective, were used in only 16% of cases.
• Intervention selection may correlate with staff education level.

Conclusions:

• Disruptive behaviors in geriatric patients require systematic recognition and management strategies.
• Current intervention practices are often single-focused and underutilized in combination.
• Further research is needed to optimize intervention protocols and address the impact of staff education on intervention effectiveness.