Related Experiment Video
Updated: May 16, 2025
The Resident-intruder Paradigm: A Standardized Test for Aggression, Violence and Social Stress
Published on: July 4, 2013
Preventing aggression in a pediatric inpatient unit: a best practice implementation project
Johnna Riddick1,2, Jorri Davis1,2, Michelle Palokas1,2
1School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA.
Insights
This study aimed to reduce patient aggression in pediatric units by implementing best practices. While compliance improved slightly, further efforts are needed to better prepare staff for managing aggressive behavior.
Area of Science:
- Healthcare Management
- Evidence-Based Practice
- Pediatric Mental Health
Background:
- Increasing rates of aggressive behavior from pediatric patients with mental health issues in inpatient settings.
- Need for improved staff preparedness and intervention strategies.
Purpose of the Study:
- To implement and evaluate best practices for preventing patient aggression in a pediatric inpatient unit.
- To improve staff's ability to manage and prevent aggressive patient behavior.
Main Methods:
- Utilized the JBI Model of Evidence-Based Healthcare and Implementation Framework.
- Conducted baseline and follow-up audits using eight evidence-based practices.
- Implemented strategies including unit protocols and electronic health record modifications.
Main Results:
- Identified gaps in policy, trigger identification, and care plan use.
- Developed a unit protocol, trigger documentation process, and electronic health record aggression care plan.
- Overall compliance with evidence-based practices increased from 30% to 34%.
Conclusions:
- The evidence implementation project showed a modest increase in compliance with best practices.
- The project has potential long-term benefits for staff preparedness in managing pediatric patient aggression.
- Continued work is necessary to further enhance compliance and patient safety.
Introduction:
In pediatric inpatient settings, there has been an increase in patients with mental health problems who display aggressive behavior toward staff.
Aim:
The aim of this project was to prevent aggression in patients in a pediatric inpatient unit through the promotion of best practices.
Methods:
The project was guided by the JBI Model of Evidence-Based Health care and the JBI Evidence Implementation Framework. An audit and feedback strategy was used, with baseline and follow-up audits conducted. Eight evidence-based practices were used for the audit criteria. Strategies to improve compliance with best practices were implemented following the baseline audit. A follow-up audit was conducted to measure any changes in clinical practice.
Results:
Gaps between evidence and practice were identified for three of the audit criteria. Barriers included the lack of a policy for preventing or managing aggressive behavior in patients, the lack of a process to identify triggers of aggressive behavior, and inconsistent use of the aggression prevention care plan in the electronic health record. To address these barriers, the project team created a unit protocol, or written guidance, for preventing aggressive behavior, implemented a process to document triggers, and developed a general aggression care plan in the electronic health record. Overall compliance with evidence-based practices increased from 30% to 34%.
Conclusions:
This evidence implementation project used a clinical audit process, which led to a small overall improvement in compliance with evidence-based practices. This project has a potential long-term benefit, with staff being better prepared to prevent aggressive outbursts in patients in the general pediatric unit. However, further work is required to continue improving compliance with evidence-based practices.
Spanish Abstract:
http://links.lww.com/IJEBH/A358.
More Related Videos
Related Concept Videos
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:47Aggression
01:24Operant Conditioning Intervention
In operant conditioning, behaviors that are...
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
01:30Ethical Dilemmas II
01:24Nursing Process for Patient and Caregiver Teaching II: Planning and Implementation