EXECUTIVE SUMMARY
Background: A progressive decline in acute psychiatric facility beds has led to a steadily increasing number of pediatric psychiatric patients hospitalized on acute care medical-surgical units. Clinical nurses in this environment feel ill-equipped to provide quality behavioral health care.
Aims/objectives: This project aimed to improve continuity of care as well as staff and patient safety in pediatric acute and transitional care units. The specific objectives related to implementation of a resource allocation algorithm for staffing behavioral health admissions and consistent use of an interdisciplinary psychiatric huddle.
Methods: This project used the Joanna Briggs Institute's Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) audit tool for promoting health practice change. A baseline medical record audit was conducted which was followed by charge nurse education on the resource allocation algorithm and huddle initiation. Three follow-up audits measured compliance with best practice criteria for assessing and managing care of behavioral pediatric patients.
Results: Compliance with comprehensively assessing children with challenging behaviors who were hospitalized in acute care units achieved 100% for the first three months following algorithm implementation. Nurses reached 100% compliance with initiating psychiatric huddles. All audits for individualized care plans, which included family or carer involvement, were fully compliant.
Conclusions: Use of a resource allocation algorithm for individualizing care of pediatric behavioral patients enhanced quality of care through a standardized process which enabled acute care nurses to better meet the safety needs of this patient population. Early signs of sustaining improvements were promising for hard-wiring workflows. Future plans include adoption of the algorithm and huddle by all in-patient areas in the children's hospital.