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Improving the Confidence of Inpatient Rehabilitation Staff to Assess and Manage Agitation
Frank Jackson1, Alicia Hegie1, Cassidy MacArthur1
1Providence St. Luke's Rehabilitation Medical Center, Spokane.
Purpose:
The primary goal of this project was to improve the confidence of inpatient rehabilitation staff in assessing and managing patients with agitation.
Design:
A quality improvement (QI) initiative was implemented.
Methods:
Online, case-based education was provided to all nursing and therapy rehabilitation staff. Laminated decision trees were posted on all units paired with electronic medical record (EMR)-embedded prompts for completion and interpretation of the Agitated Behavior Scale (ABS) to guide clinical care of patients with agitation. Staff were asked to complete surveys before and after the education.
Results:
In all, 326 staff completed surveys before reviewing online agitation education and 240 submitted responses after education completion. Most staff perceived training was helpful (n=192, 80%), and significantly higher confidence assessing and managing patients with agitation were observed after training (P<0.01).
Clinical Relevance:
For inpatient rehabilitation professionals, training can improve confidence, together with embedding nonpharmacological recommendations into the EMR to navigate patient agitation.
Conclusions:
Education targeting the standardized use of the ABS and evidence-informed agitation management techniques can improve inpatient rehabilitation clinicians' confidence in assessing and managing patients with agitation. Further work is warranted to elucidate whether increased confidence in assessing and managing patients with agitation can lead to reduced levels of work-related burnout.
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