Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-12-2023

Graduate Advisor

Pearson, Stacy

Committee

Loyd, Vanessa

Schaller, Elise

Largent, Cheyanne

Abstract

Introduction: Patients with behavioral health diagnoses are among the highest risk for
aggression. For pediatric patients with behavioral health needs, urgent treatment is
needed for aggressive behavior, due to the potential unwanted outcomes. The purpose of this Quality Improvement (QI) pilot project was to implement an Acute Agitation Intervention Tool that uses the Broset Violence Checklist (BVC) to guide
pharmacological intervention for mild and moderate to severe agitation in pediatric
patients with behavioral health needs ages 8 to 18 to decrease the number of medications that patients are getting per agitation event over a 12-week period.

Methods: This QI included a retrospective analysis of PRN medications pre (Oct. 2022-Dec. 2022) and post (Jan 2023-Mar 2023) implementation of the Acute Agitation
Intervention Tool using the BVC to inform pharmacological intervention. The Iowa
Model Revised: Evidence-Based Practice to Promote Excellence in Health Care was the framework.

Results: A (N=337) agitation occurred when combining the pre and post-implementation periods. Pre-Implementation (n=237) Post Implementation (n=100). A
decrease in the number of medications utilized per agitation event by 6.6% was found. A two-tailed independent sample t-test was performed.

Implication for practice: Continued utilization of the Acute Agitation Intervention Tool,
modifying the tool to self-injurious behaviors, continual support, and audits of those
administering the medication of the order set will be completed. There will continue to be areas of opportunity for improvement in aggression assessment and PRN medication practices

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