Alec M. Bernstein, PhD, BCBA-D, Emory University School of Medicine, Atlanta, GA, USA; Marcus Autism Center, Atlanta, GA, USA.
Seth B. Clark, MA, BCBA, Children's Healthcare of Atlanta, Atlanta, GA, USA; Marcus Autism Center, Atlanta, GA, USA.
J Am Psychiatr Nurses Assoc. 2024 Apr;30(2):424-433. doi: 10.1177/10783903221093578. Epub 2022 May 9.
Behavioral crises are increasingly prevalent in health care settings. Existing programs, however, include procedures that lack adaptability, omit critical components, and deviate from clinical best-practice recommendations. Health care employees also continue to report lacking confidence for safely managing behavioral crises.
We described the development and acceptability of a comprehensive crisis prevention program and its modification for a large pediatric health care system to help remediate the limitations of existing programs.
Chi-square analyses evaluated the acceptability of the crisis prevention program pre- versus post-training and at 3- and 6-month follow-up times. For insignificant outcomes, logistical regressions identify whether responses differed between emergency-department and nonemergency-department employees.
Chi-square analyses were significant for 10 of 15 questions suggesting that employees were more confident in managing and communicating during behavioral crises post-training, and that this confidence was maintained. Logistic regressions found that emergency-department employees differed in some responses to the acceptability questionnaire than nonemergency-department employees over time.
The present crisis prevention program is adaptable to various settings and patients, and it is well received overall by employees. The safety of patients and employees is integral to the delivery of quality care and improving patient-provider relations.
行为危机在医疗环境中越来越普遍。然而，现有的方案包括缺乏适应性、遗漏关键部分和偏离临床最佳实践建议的程序。医疗保健员工也继续报告缺乏安全管理行为危机的信心。
我们描述了一个全面的危机预防计划的开发和可接受性，以及为帮助弥补现有计划的局限性而对其进行的修改，该计划适用于大型儿科医疗保健系统。
卡方分析评估了危机预防计划在培训前后以及 3 个月和 6 个月随访时的可接受性。对于不显著的结果，逻辑回归确定了急诊部门和非急诊部门员工的反应是否存在差异。
卡方分析对 15 个问题中的 10 个问题具有统计学意义，表明员工在行为危机期间的管理和沟通方面更有信心，并且这种信心得到了保持。逻辑回归发现，随着时间的推移，急诊部门员工对可接受性问卷的某些回答与非急诊部门员工不同。
目前的危机预防计划具有适应性，可以应用于各种环境和患者，并且总体上受到员工的欢迎。患者和员工的安全是提供优质护理和改善医患关系的关键。
