Behavioral Intervention Team (BIT), Yale New Haven Hospital, New Haven, Connecticut (Ms Tommasini); and Yale University School of Nursing, Orange, Connecticut (Dr Iennaco).
Nurs Adm Q. 2022;46(1):37-44. doi: 10.1097/NAQ.0000000000000501.
Medically hospitalized individuals have high rates of comorbid psychiatric, substance abuse, and behavioral disorders. Disruptive and sometimes aggressive behaviors may arise when mental health needs of patients go unrecognized or are inadequately addressed. Health care workers experience the most workplace violence compared with other professions, with nurses and nursing aides at highest risk. A Behavioral Emergency Support Team (BEST) model can be an effective approach to providing a customized response to a patient's agitation through identification of underlying clinical and environmental contributors to the onset of aggression as well as to provide behavioral education and support of nursing staff. Results from 2 years of BEST model use resulted in 124 events among 96 patients of whom 19 had repeated events. The most common reasons for codes were aggression (79%) and elopement threat/attempt (45%), and the most frequent patient diagnosis was cognitive impairment (54%). Development of a BEST model provides support to nurses that is not otherwise available for events that are disruptive to care in inpatient medical settings and help minimize the occurrence of workplace violence.
住院患者合并有较高比例的精神疾病、药物滥用和行为障碍。当患者的心理健康需求未得到识别或未得到充分解决时，可能会出现破坏性行为，甚至出现攻击行为。与其他职业相比，医护人员经历的工作场所暴力最多，护士和护理助理面临的风险最高。行为紧急支持小组（BEST）模式是一种通过确定导致攻击行为发生的潜在临床和环境因素来为患者的激动提供个性化反应的有效方法，还可以为护理人员提供行为教育和支持。2 年来使用 BEST 模型的结果显示，在 96 名患者的 124 次事件中，有 19 人重复发生。代码最常见的原因是攻击（79%）和逃跑威胁/企图（45%），最常见的患者诊断是认知障碍（54%）。BEST 模式的开发为护士提供了支持，否则在住院医疗环境中，护理受到干扰的情况下，无法获得这种支持，有助于最大程度地减少工作场所暴力的发生。
