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Decreasing patient agitation using individualized therapeutic activities.

Christine Waszynski¹, Patricia Veronneau, Karyn Therrien

¹Christine Waszynski is a geriatric NP in the Department of Geriatric Medicine at Hartford Hospital in Hartford, CT. Patricia Veronneau is the nursing coordinator and Angela Massa and Sarah Levick are staff nurses in the Department of Nursing at Hartford Hospital; at the time of this project, Melissa Brousseau was also a staff nurse at Hartford Hospital. Karyn Therrien is a nursing education supervisor in the Practical Nursing Program at Porter and Chester Institute, Rocky Hill, CT; at the time of this project, she was a nurse manager at Hartford Hospital, where she continues to teach per diem in the Parent Education Program. The Catherine and Alexander Wright Fund provided funding for materials used in the project. Contact author: Christine Waszynski, christine.waszynski@hhchealth.org. The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.

The American Journal of Nursing

|September 17, 2013

Summary

Engaging hospitalized patients with behavior-altering conditions in individualized activities significantly reduced agitation. This approach improved patient safety and well-being during continuous observation.

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Area of Science:

Quality Improvement
Patient Safety
Behavioral Health in Hospitals

Background:

Hospitalized patients with cognitive impairment, delirium, or other behavior-altering conditions often require continuous observation.
Agitation in these patients poses safety risks despite the presence of observers.
Current observation methods may not adequately address patient agitation.

Purpose of the Study:

To test the hypothesis that individualized therapeutic activities can decrease agitation in patients under continuous observation.
To develop and implement a tool for observers to identify patient interests and abilities for activity engagement.
To evaluate the effectiveness of this intervention in reducing patient agitation.

Main Methods:

A quality improvement project was conducted at a level 1 trauma center.
A tool was developed for continuous observers to identify patient abilities and interests.
Individualized therapeutic activities were offered to patients based on their profiles.
Patient agitation was measured using a validated scale before, during, and after activity engagement.

Main Results:

During therapeutic activities, 73% of patients showed decreased agitation levels compared to baseline.
Following the activities, 64% of patients remained less agitated for at least one hour.
The intervention demonstrated effectiveness in reducing agitation in selected patients.

Conclusions:

Individualized therapeutic activities are effective in reducing agitation in hospitalized patients requiring continuous observation.
This intervention offers a promising non-pharmacological approach to manage agitation and enhance patient safety.
Further research is recommended to explore the impact on medication use and restraints.