Agitation/safety management

  1. Hello,

    I work on a locked acute inpatient rehab brain injury unit.

    I am interested in improving safety/quality on the unit.

    Our staff is trained how to interact with a patient with a brain injury at a Rancho level 4 (confused and agitated), but our family members come to us without this knowledge. So, there is a gap of increased risk until that education is completed. (Problem #1) Occasionally there are those family members or partners who do not benefit from education. (Problem #2) These individuals can be overstimulating and create a distrust in the patient when complaining about care, policies, or staff in front of their cognitively impaired loved one. In the more extreme cases family/partner dissatisfaction can be expressed with high stress and raised voices and can be a pattern for how they express themselves.

    Do any of you work in facilities that have protocols or algorithms for managing these situations? Are they successful? Are they evidence based?

    Thank you for your time.

    Kathy Warehime, RN, CRRN, CBIS

    Sent from my iPhone
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    Joined: Jul '13; Posts: 9; Likes: 16


  3. by   Here.I.Stand
    I would get an interdisciplinary care conference set up. This would provide a united front to the family, show them that the entire care team is on the same page in their approach to the pt.

    If that doesn't work, a behavioral contract might be warranted. Care teams make them with a&o patients all the time, so it stands to reason that it could be done with others who are on the property and interfering with care.
  4. by   Here.I.Stand
    ** to clarify, overstimulation and undermining trust in the team, to a TBI pt is interfering with care.