National Survey on Pediatric Acute Agitation and Behavioral Escalation in Academic Inpatient Pediatric Care Settings

Malas, Nasuh; Spital, Linden; Fischer, Jason B.; Kawai, Yu; Cruz, David González; Keefer, Patricia

doi:10.1016/j.psym.2017.01.009

Cited by 23 publications

(14 citation statements)

References 14 publications

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“…Aggression demonstrated by patients in the acute paediatric hospital setting can result in serious self-injury and threaten the safety of their family, staff and other patients [1]. Clinical aggression episodes in child health facilities warranting a coordinated, systematic response are increasing [2][3][4][5][6]. Paediatric hospital staff, whilst required to regularly demonstrate competence in resuscitation and management of the deteriorating child, are often not trained nor tested in the management of clinical aggression [7][8][9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Simulation-based education to promote confidence in managing clinical aggression at a paediatric hospital

et al. 2020

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Background: An increasing number of incidents involving aggressive behaviour in acute care hospitals are being witnessed worldwide. Acute care hospital staff are often not trained or confident in managing aggression. Competent management of clinical aggression is important to maintain staff and patient safety. Training programmes for acute care staff are infrequently described in the literature and rarely reported for paediatric staff. Simulation training allows practice of skills without patient risk and may be more effective than traditional teaching formats for aggression management. Aim and design: The aim of this proof of concept study was to develop a simulation-based education session on aggression management for acute care paediatric staff based on best practice principles, to evaluate the acceptability of this training programme and to gain an understanding of the impact of the training on participants' perceived confidence in managing clinical aggression. Two separate simulation exercises were delivered as a 2-h component of a hospital management of clinical aggression (MOCA) training day. Participants completed a written survey immediately prior to, at completion of the simulation-based group training, and at 3-6 months following the simulation training. Findings: Nine training days were conducted in 2017 for nursing, medical, allied health, education and security staff with a total of 146 participants (83% were acute care nurses). Two thirds (68%) of participants had experienced clinical aggression as part of their routine work, with 51% overall reporting a lack of confidence managing these patients. Immediately following the simulation training, 80% of all participants reported feeling more confident in managing clinical aggression, 47% reported a 1-point increase in confidence, whilst 33% of participants reported a 2-or 3-point increase. At 3-6 months post-training, 66% of respondents (N = 44) reported continued confidence in managing aggression with 100% of participants stating they would recommend simulation training to colleagues.

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Section: Introductionmentioning

confidence: 99%

Simulation-based education to promote confidence in managing clinical aggression at a paediatric hospital

et al. 2020

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“…2 Youth commonly present to the emergency medicine department with agitation or become agitated during evaluation. 3 Behavioral interventions may not be successful in this setting, and rapid, effective approaches to protect the patient and others are a necessity. In these situations, restraints may be necessary, but these events often are emotionally charged and can be very distressing to patients, families, and medical staff.…”

mentioning

confidence: 99%

“…In these situations, restraints may be necessary, but these events often are emotionally charged and can be very distressing to patients, families, and medical staff. 3 Unfortunately, there are gaps in the literature regarding high-quality evidence comparing the efficacy of various pharmacologic and nonpharmacologic approaches with managing agitation in youth.…”

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confidence: 99%

Benchmarking and Optimizing Pharmacologic Restraint for Agitated Youth in the Emergency Medicine Department

Voort

Croarkin

2021

The Journal of Pediatrics

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“…Agitation and aggression in children and adolescents in the emergency department (ED) can be dangerous and distressing for patients, families and staff 1. Agitation and aggression can disrupt care, cause injury, or necessitate use of physical restraint.…”

Section: Introductionmentioning

confidence: 99%

Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the Emergency Department: Consensus Statement of the American Association for Emergency Psychiatry

Gerson

Malas

Feuer

et al. 2019

WestJEM

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Introduction Agitation in children and adolescents in the emergency department (ED) can be dangerous and distressing for patients, family and staff. We present consensus guidelines for management of agitation among pediatric patients in the ED, including non-pharmacologic methods and the use of immediate and as-needed medications. Methods Using the Delphi method of consensus, a workgroup comprised of 17 experts in emergency child and adolescent psychiatry and psychopharmacology from the the American Association for Emergency Psychiatry and the American Academy of Child and Adolescent Psychiatry Emergency Child Psychiatry Committee sought to create consensus guidelines for the management of acute agitation in children and adolescents in the ED. Results Consensus found that there should be a multimodal approach to managing agitation in the ED, and that etiology of agitation should drive choice of treatment. We describe general and specific recommendations for medication use. Conclusion These guidelines describing child and adolescent psychiatry expert consensus for the management of agitation in the ED may be of use to pediatricians and emergency physicians who are without immediate access to psychiatry consultation.

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National Survey on Pediatric Acute Agitation and Behavioral Escalation in Academic Inpatient Pediatric Care Settings

Cited by 23 publications

References 14 publications

Simulation-based education to promote confidence in managing clinical aggression at a paediatric hospital

Simulation-based education to promote confidence in managing clinical aggression at a paediatric hospital

Benchmarking and Optimizing Pharmacologic Restraint for Agitated Youth in the Emergency Medicine Department

Best Practices for Evaluation and Treatment of Agitated Children and Adolescents (BETA) in the Emergency Department: Consensus Statement of the American Association for Emergency Psychiatry

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