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Patient and Family Member Violent Situations in a Pediatric Hospital: A Descriptive Study
Della J Derscheid1, Judith E Arnetz2
1Mayo Clinic, MN, United States.
Insights
This study examined violent incidents in pediatric hospital settings. Key findings include common behaviors like hitting and kicking, with behavior dyscontrol and seizures as frequent patient conditions during these events.
Area of Science:
- Pediatric healthcare
- Hospital safety
- Behavioral emergencies
Background:
- Pediatric patients and families can experience significant stress during hospitalization.
- Understanding the dynamics of violent situations in inpatient pediatric settings is crucial for improving patient and staff safety.
Purpose of the Study:
- To document violent situations involving pediatric patients or their families in an inpatient hospital environment.
- To identify demographic, medical, and mental health factors associated with these incidents.
Main Methods:
- A descriptive study utilizing two data sources: recipients of Behavioral Emergency Response Team (BERT) interventions and surveys of pediatric healthcare staff.
- Data collected from a large urban academic hospital in the Midwestern United States.
Main Results:
- Common physical patient behaviors included hitting (60-77%) and kicking (53-82%).
- Fifteen (75%) BERT responses were for violent situations, with behavior dyscontrol (53%) and seizures (40%) being the most common conditions.
- Staff experiencing violent situations were often registered nurses (79%) from general medical units (75%).
Conclusions:
- Violent situations in pediatric inpatient units involve specific patient behaviors and underlying medical/mental health conditions.
- Healthcare providers' awareness of hospitalization stress, co-occurring conditions, and resources like BERT can aid in violence prevention.
Purpose:
The intent of this study is to report on violent situations involving the pediatric patient and/or the patient's family member in the inpatient hospital setting.
Design And Methods:
This descriptive study used two independent samples: Behavioral Emergency Response Team (BERT) recipients and surveyed pediatric healthcare staff at a pediatric hospital within a large urban Midwestern academic hospital in the United States.
Results:
Per BERT recipients (N = 26) and staff survey respondents (N = 91), common physical patient behaviors were, respectively, hitting (60%, 77%) and kicking (53%, 82%). Fifteen (75%) patient BERT responses were for violent situations. The most common mental health condition among patients in violent situations was behavior dyscontrol (n = 8, 53%), which was absent among calls for non-violent situations (n = 5). Seizures, which was the most common medical condition among patients in BERT violent situations (n = 6, 40%), was proportionately slightly greater than among non-violent situations (n = 1, 20%). Staff who reported experience with violent situations (n = 64, 73%) were from general medical units (n = 48, 75%), and registered nurses (n = 53, 79%).
Conclusions:
This study helped illuminate demographic, medical and mental health clues about violent situations with patients and family members on pediatric inpatient hospital units.
Practice Implications:
Pediatric patients and families may struggle to cope during hospitalization. Healthcare providers' knowledge about co-occurring conditions, stress related to hospitalization and use of BERT as a resource may help prevent violent situations.
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