Managing Acute Behavioural Disturbances in the Emergency Department Using the Environment, Policies and Practices: A...

Area of Science:

• Emergency Medicine
• Psychiatry
• Healthcare Management

Background:

• Acute behavioural disturbances (ABDs) are increasing in emergency departments (EDs), impacting safety and staff wellbeing.
• Non-pharmacological interventions for ABDs include environmental modifications, policies, practice changes, and education.
• Effective management strategies for ABDs in EDs are urgently needed.

Purpose of the Study:

• To systematically review the efficacy of non-pharmacological interventions for managing acute behavioural disturbances in EDs.
• Focus on strategies involving environmental, architectural, policy, and practice changes.

Main Methods:

• Systematic literature search of multiple databases (CINAHL Plus, PsycINFO, MEDLINE, EMBASE) from 1985-2016.
• Included studies on environmental modifiers, policy, and practice interventions for adult ABDs in EDs.
• Narrative synthesis of findings, assessing efficacy outcomes like incidence, severity, injuries, and staff/patient perceptions.

Main Results:

• Limited number and low quality of studies on ED ABD management interventions.
• Preliminary evidence suggests potential benefits of specialized behavioral rooms and ED modifications.
• Evidence for efficacy is low, with a lack of controlled studies supporting environmental changes.

Conclusions:

• A significant gap exists in the literature regarding evidence-based interventions for ABD management in EDs.
• There is a critical need for robust evidence to guide safe and effective ABD management in increasingly demanding ED settings.