IN THE LINE OF FIRE: ONE HOSPITAL'S JOURNEY TO A SAFER ENVIRONMENT

Purpose:
Patient and visitor aggression is an occupational hazard and the source of significant role dissatisfaction for nurses. We will describe the implementation of a multidisciplinary improvement initiative to provide support and education when aggressive or disruptive behavior occurs.

Significance:
These incidents can happen throughout the healthcare system and, according to the United States Bureau of Labor Statistics, nurses are the most frequently attacked group in Healthcare settings. This impacts their health and well-being. Some nurses choose to change careers as a result.

Strategy and Implementation:
Based on the successful Rapid Response Team Model, the Behavioral Response Team (BRT) works with the staff involved in the activation to understand the background and assess the patient, assist in stabilizing the situation, collaborate with the care team in planning/implementing behavioral intervention(s), and document & gather data. Information will be provided on each of the stages of BRT development, including needs' assessment, planning, education, development of strategies to operationalize the plan and implementation. The materials created for staff education will be shared including the Algorithm which the staff nurses use to determine when to call for help from the BRT. The results of an exporatory study of all incidents will be presented.

Evaluation:
Thorough chart review was performed by a group of 4 medical students under the direction of this presenter. They incorporated the patient safety net information and the record keeping by the responders as well. Surveyed nurses before and after implementation of the Behavioral Response Team.

Implications for Practice:
Discovered need for an Evidence Based Nursing Care Project to improve our early recognition of delirium and EBN interventions for the patient suffering with delirium. The BRT will continue to be utilized, patients and nurses are kept safer and injury rates have reduced.