Branden, Morgan, BSN, RN

Cosgrove, Peter J, BSN, RN

Devitis, Van T, BSN, RN

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksPatient Care Services / NursingDiversionary Activities for Behavioral HealthPatients in the Emergency DepartmentMorgan Branden BSN, RNLehigh Valley Health Network, Morgan.Branden@lvhn.orgVan T. Devitis BSN, RNLehigh Valley Health Network, Van.Devitis@lvhn.orgPeter J. Cosgrove BSN, RNLehigh Valley Health Network, Peter_J.Cosgrove@lvhn.orgFollow this and additional works at: https://scholarlyworks.lvhn.org/patient-care-services-nursingThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtBranden, M. Devitis, V. Cosgrove, P. (2018, November 30th). Diversionary Activities for Behavioral Health Patients in the EmergencyDepartment. Poster presented at: LVHN Vizient/AACN Nurse Residency Program Graduation, Lehigh Valley Health Network,Allentown, PA.© 2014 Lehigh Valley Health NetworkLehigh Valley Health Network, Allentown, PennsylvaniaDiversionary Activities for Behavioral Health Patients in the Emergency DepartmentProject Purpose• Education to staff on diversionary activities for Behavioral Health (BH) patients in the Emergency Department (ED)• To provide ED staff education on the use of diversional activities for Behavior Health patients.Due to: • Consumption of time and safety concerns for both staff, family, and other patients.• Lack of education/availability on diversionary activitiesImplementation Method• Nurse residents passed out a survey to collect information regarding knowledge and potential usage of a BH box containing diversional activities in the unit• The survey asked participants of the awareness of using a BH box to prevent behavioral exacerbations. Education was then given during survey implementation, with follow-up questions asked regarding future likeliness of the participant to use the BH box.Outcome• Current RNs, TPs, and POAs LVH-ED Cedar Crest will have awareness of a BH box and opportunities to utilize it based on patient needWill ED nurses change their care for BH patients in the after receiving education on diversionary activities versus no education at all?P- Emergency Department NursesI - Education of diversionary activities C- Current state- No educationO- Educated staff, with knowledge base of diversionary activities and increased comfort level for utilizationMorgan Branden, BSN, RN, Van DeVitis, BSN, RN, Peter Cosgrove, BSN, RNBackgroundPICOImplementation Plan/MethodsResultsResults / Future Goals• Lehigh Valley Cedar Crest Policy and Procedures (2018). Behavioral Health Evaluation Process - Emergency Medicine Policy. • Bowman, S. & Jones, R. (2016). Sensory Interventions for Psychiatric Crisis in Emergency Departments-A New Paradigm. Journal of Psychiatry Mental Health. doi: http://dx.doi.org/10 16966/2474-7769.103 • Green, C. (2018, July 19). Behavioral Health in the ED [Personal interview]• Giarelli, Ellen EdD, RN, CRNP; Nocera, Romy PhD; Turchi, Renee MD,  MPH; Hardie, Thomas L. EdD; Pagano, Rachel BSN; Yuan, Ce BS. Sensory Stimuli as Obstacles to Emergency Care for Children With Autism Spectrum Disorder. Advanced Emergency Nursing Journal. April/June 2014 , Volume 36(2), 145–163. doi: 10.1097/TME. 0000000000000013• Yakov, S., Birur, B., Bearden, M. F., Aguilar, B., Ghelani, K. J., & Fargason, R. E. (2018). Sensory Reduction on the General Milieu of a High-Acuity Inpatient Psychiatric Unit to Prevent Use of Physical Restraints: A Successful Open Quality Improvement Trial. Journal of the American Psychiatric Nurses Association, 24(2), 133–144. doi: https://doi.org/10.1177/10783903 17736136ReferencesTotal Number of participants: 51 (RN: 42 | TP: 7 | POA: 2)• Among those who participated in our survey, less than half of participants had prior knowledge on the use of diversionary activities for BH patients at LVHN. (Not educated = 6, Somewhat Educated= 29, Educated= 16). • Use of diversionary activities were used in the past (Yes= 36, No= 15). • A majority of those interviewed would use diversionary activities and the BH box in their practice at LVH- CC ED (Not likely= 2, Somewhat likely= 19, Very Likely= 30).Future Goals• Advocate for use of activities such as BH box (currently being used at BH-Muhlenburg)• Bring BH box to/implement use at CC-ED• Follow-up survey and data collection regarding usage of BH box Evidence1) What is your role in the Emergency Department?2) What is your knowledge of diversionary activities for behavioral health patients  and when it is acceptable to use them? (Ex: puzzles, music, scent cards, coloring)3) Have you ever used diversionary activities with behavioral health patients in the emergency department or at a previous job? 4) If yes, did you find them helpful?5) Are you aware of what activities are available for use with patient who are displaying behaviors?6) Examples of diversionary activities available include: Music therapy, aromatherapy or “Scent cards”, puzzles, coloring books, card games, stress balls  etc. If these items were more readily available how likely would you be to use them in your practice?7) Not all patients are candidates to use these activities. Of the following which are examples of patients you would allow to utilize diversionary activities?• There is sensory defensiveness with light and sound intensity in common ED locations. The differences in description of light and sound patterns support the need to monitor sensory defensiveness in people with ASD (Giarelli et al, 2014).• De-escalation tactics and sensory modulation tactics were implemented at an Australian ED. Objects included a massage chair, rocking chair, beanbag, faux-fur blankets, weighted blankets, weighted soft toys, ‘stress’ balls, and portable audio players with relaxing sounds. Findings indicated that the sensory intervention facilitated a calm state, enhanced interpersonal connection and supported self-management in consumers who were acutely unwell (Yakov et al, 2018).• An ED explored use of sensory reduction interventions on a high-acuity inpatient milieu to reduce high assault/restraint rates. Restraint rates dropped immediately following light and sound reduction interventions and by 72% at 11 months post-implementation (Bowman & Jones, 2016).

Diversionary Activities for Behavioral Health Patients in the Emergency Department

https://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=2055&context=patient-care-services-nursing

Diversionary Activities for Behavioral Health Patients in the Emergency Department

Abstract

Similar works

Full text

Available Versions

Lehigh Valley Health Network: LVHN Scholarly Works