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行为紧急应对小组:实施过程可提高患者安全、员工安全及员工协作水平。

Behavioral Emergency Response Team: Implementation Improves Patient Safety, Staff Safety, and Staff Collaboration.

作者信息

Zicko Cdr Jennifer M, Schroeder Lcdr Rebecca A, Byers Cdr William S, Taylor Lt Adam M, Spence Cdr Dennis L

机构信息

Clinical Nurse Specialist, Directorate for Surgical Services, Fort Belvoir Community Hospital, Fort Belvoir, VA.

Clinical Nurse Specialist, Inpatient Internal Medicine, Naval Medical Center San Diego, San Diego, CA.

出版信息

Worldviews Evid Based Nurs. 2017 Oct;14(5):377-384. doi: 10.1111/wvn.12225. Epub 2017 Apr 3.

Abstract

BACKGROUND

Staff members working on our nonmental health (non-MH) units (i.e., medical-surgical [MS] units) were not educated in recognizing or deescalating behavioral emergencies. Published evidence suggests a behavioral emergency response team (BERT) composed of MH experts who assist with deescalating behavioral emergencies may be beneficial in these situations. Therefore, we sought to implement a BERT on the inpatient non-MH units at our military treatment facility.

AIMS

The objectives of this evidence-based practice process improvement project were to determine how implementation of a BERT affects staff and patient safety and to examine nursing staffs' level of knowledge, confidence, and support in caring for psychiatric patients and patients exhibiting behavioral emergencies.

METHODS

A BERT was piloted on one MS unit for 5 months and expanded to two additional units for 3 months. Pre- and postimplementation staff surveys were conducted, and the number of staff assaults and injuries, restraint usage, and security intervention were compared.

RESULTS

The BERT responded to 17 behavioral emergencies. The number of assaults decreased from 10 (pre) to 1 (post); security intervention decreased from 14 to 1; and restraint use decreased from 8 to 1. MS staffs' level of BERT knowledge and rating of support between MH staff and their staff significantly increased. Both MS and MH nurses rated the BERT as supportive and effective.

LINKING EVIDENCE TO ACTION

A BERT can assist with deescalating behavioral emergencies, and improve staff collaboration and patient and staff safety.

摘要

背景

在我们非精神卫生(非MH)科室(即内科-外科[MS]科室)工作的工作人员未接受过识别或缓解行为紧急情况的培训。已发表的证据表明,由精神卫生专家组成的行为紧急情况应对小组(BERT)在这些情况下协助缓解行为紧急情况可能会有所帮助。因此,我们试图在我们的军事治疗机构的住院非MH科室实施BERT。

目的

这个基于证据的实践过程改进项目的目标是确定实施BERT如何影响工作人员和患者安全,并检查护理人员在护理精神病患者和出现行为紧急情况的患者时的知识水平、信心和支持程度。

方法

在一个MS科室对BERT进行了为期5个月的试点,并扩展到另外两个科室,为期3个月。实施前后进行了工作人员调查,并比较了工作人员受到攻击和受伤的次数、约束措施的使用情况以及安全干预情况。

结果

BERT应对了17起行为紧急情况。攻击次数从10次(实施前)降至1次(实施后);安全干预从14次降至1次;约束措施的使用从8次降至1次。MS科室工作人员对BERT的了解程度以及对精神卫生科室工作人员与他们科室工作人员之间支持程度的评分显著提高。MS科室和精神卫生科室的护士都认为BERT有帮助且有效。

将证据与行动联系起来

BERT可以协助缓解行为紧急情况,并改善工作人员之间的协作以及患者和工作人员的安全。

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