Disruptive bEhavior manageMEnt ANd Prevention in Hospitalized Patients Using a behaviORal Intervention Team

Behavioral Problem Clinical Trial

— DEMEANOR  

Official title:

Disruptive bEhavior manageMEnt ANd Prevention in Hospitalized Patients Using a behaviORal Intervention Team: Study Protocol for a Pragmatic, Cluster, Cross-over Design

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03777241
• Other study ID #: 182229
• Status: Completed
• Phase: N/A
• Start date: March 1, 2019
• Est. completion date: May 11, 2020

Study information

• Verified date: September 2020
• Source: Vanderbilt University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of the proposed study is to evaluate the impact of a behavioral intervention team (BIT) on 2 adult units: a general medical (8N); a cardiac/medical stepdown (8S) at Vanderbilt University Medical Center (VUMC) with a higher proportion of patients with behavioral health comorbidities.

Description:

The BIT will provide a proactive psychiatric team that will screen all patients on admission, provide consultation to those meeting established criteria, and recommend interventions to the primary care team for consideration. BIT will also serve to model therapeutics tactics in communication and goal setting to the clinical staff.

Research Questions for the proposed study:

Considering that behavioral health co-morbidity is common among hospitalized medical inpatients and is associated with higher costs of care and staff dissatisfaction, we will ascertain whether the addition of dedicated, trained behavioral intervention team, compared to nursing staff training on trauma informed care and de-escalation techniques provides:

1. meaningful, measureable improvement in the prevention and management of disruptive behavior in the healthcare setting at VUMC, and

2. Improvement in staff perceptions of their ability to manage patients exhibiting disruptive, threatening or acting out behavior

Specifically, using a pragmatic, cluster cross-over trial design where the BIT crosses between 8N and 8S, we will test the hypothesis that presence of the BIT results in:

1. Improvement in the prevention and management of patients exhibiting disruptive, threatening or acting out behavior

2. Improvement in staff perceptions of their ability to manage patients exhibiting disruptive, threatening or acting out behavior

Recruitment information / eligibility

• Status: Completed
• Enrollment: 3800
• Est. completion date: May 11, 2020
• Est. primary completion date: February 9, 2020
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• All patients admitted to two adult medical surgical units (8N/8S) at Vanderbilt University Medical Center during the study period.

• All clinical nurses and staff on 8N/8S employed during the study period.

Exclusion Criteria:

• Patients admitted to the floor before the BIT team has begun the crossover period on the unit.

Related Conditions & MeSH terms

• Behavioral Problem
• Problem Behavior

Intervention

Behavioral:
• Behavioral Intervention Team
Multidisciplinary team to assist with actively identifying and managing mental illness and substance abuse disorders at their earliest possible time during hospitalization.
• Standard of care
Participants in this group will receive standard of care.

Locations

Country	Name	City	State
United States	Vanderbilt University Medical Center	Nashville	Tennessee

Sponsors (2)

Lead Sponsor	Collaborator
Vanderbilt University	Vanderbilt University Medical Center

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Percent of violence control measures utilized	By extracting medications, restraints, and sitters ordered from the electronic health records	6 months
Primary	Percent of patient injurious behaviors reported	By extracting reports of biting, kicking, throwing, etc. from the electronic medical record	6 months
Primary	Percent change in nurse comfort and confidence in their ability to manage patients exhibiting disruptive, threatening or acting out behavior	By administering surveys to participants	1 year
Secondary	Rate of unit nursing staff retention	By extracting rates from internal human resources records	1 year
Secondary	Patient length of stay	By extracting data from the electronic health record	6 months