Management of agitated head-injured patients: a survey of current techniques

Traumatically brain-injured (TBI) patients compose a large portion of the population treated in rehabilitation programs. Because of the increase in the number and acuity of agitated clients on an inpatient unit at Michiana Rehabilitation Institute in South Bend, IN, the authors conducted a study to establish what techniques currently are used to manage this population. A questionnaire was sent to 60 rehabilitation facilities throughout the United States, with a 50% return rate. The use of an interdisciplinary team, primary nursing, and one-to-one monitoring were frequently reported staffing patterns. Orientation for one-to-one attendants and self-defense education were noted as beneficial. The use of behavior modification, physical restraints, environmental modifications, and medications were nearly equally reported. Further research to identify the need for and outcome of specific management techniques is recommended.