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Decline in Pediatric Emergency Department Behavioral Team Activations After Institution of an Agitation Protocol

Hannah Pavlov1, Genevieve Santillanes2, Ilene Claudius3

  • 1From the Department of Emergency Medicine, University of Southern California.

Pediatric Emergency Care
|March 29, 2021
PubMed

Insights

A new agitation protocol in a pediatric emergency department significantly reduced behavioral response team activations by 46%. This clinical protocol improved management of aggressive pediatric patients with psychiatric complaints.

Area of Science:

  • Emergency Medicine
  • Child and Adolescent Psychiatry
  • Healthcare Quality Improvement

Background:

  • Aggressive behavior in pediatric emergency departments is a significant concern.
  • Existing management strategies for pediatric agitation lack standardized approaches.
  • A need exists for effective protocols to manage escalating aggression in pediatric patients.

Purpose of the Study:

  • To evaluate the impact of a newly instituted agitation protocol on the frequency of emergency behavioral response team activations.
  • To assess changes in the utilization of behavioral response teams in a pediatric emergency setting.
  • To determine the effectiveness of a standardized protocol in managing pediatric agitation.

Main Methods:

  • A prospective study comparing behavioral response team activations before and after protocol implementation (February 2016).
  • Retrospective data collection from electronic medical records for patient demographics, interventions, and outcomes.
  • Analysis of behavioral team activations over a 16-month post-protocol period versus a 13-month pre-protocol baseline.

Main Results:

  • Behavioral response team activations decreased by 46%, from 2.4 to 1.3 activations per month.
  • During activations, 81% of patients received psychiatric medications and 81% were physically restrained.
  • Verbal/environmental redirection was attempted in 77% of cases prior to activation.

Conclusions:

  • The implemented agitation protocol led to a substantial reduction in emergency behavioral response team activations.
  • Standardized protocols can effectively manage pediatric agitation and improve patient safety in emergency departments.
  • Further research may explore long-term impacts and specific intervention effectiveness within the protocol.
Abstract

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