Behavioral Emergency Response Team

Purpose:
To develop and implement an effective structure and process to provide timely consultative and intervention services to assist in de-escalation of patients with psychiatric diagnoses that are hospitalized on non-psychiatric acute care units. The Behavioral Emergency Response Team (BERT)was created.

Significance:
BERT is a consultative resource, practively implemented when a patient shows psychiatric behaviors in nonpsychiatric setting. Patients with psychiatric diagnoses can present obstacles to nurses not accustomed to dealing with these behaviors and may hinder delivery of care that these patients need.

Strategy and Implementation:
When a patient on an inpatient floor exhibits dramatic signs of physiological decline, the Rapid Response Team is called for quick, effective evaluation and consultation. This model for treating medically distressed patients led the way for developing the behavioral health rapid response team. Team members on our acute care units were voicing the need for a response team for behavioral health emergencies. In response to this need, a team of psychiatric nurses and interdisciplinary team members assembled and formalized BERT. BERT is comprised of psychiatric nurses, trained mental health technician and licensed clinical social worker. The team is extremely knowledgeable about psychiatric issues and understands how to build a therapeutic environment that may prevent behavioral excalation. Forms were developed to assist the team to collect data for continued process improvement An education plan was created and dissminated to the acute care nursing teams to explain the BERT process.

Evaluation:
Since implementation of BERT in late 2010, fifty two BERT codes have been initiated. The BERT members all maintain competences in descalation strategies and the management of agressive behaviors. Top reasons for activating the BERT team have been increasing agitation and threatening actions.

Implications for Practice:
Based on the patient behaviors presented during a BERT code, securty staff have been added to BERT team. Ongoing educational inservices on dealing with difficult patient behavors has been held on the acute care units. Nursing staff are rotating through a Non Violent Crisis Intervention training.