Nurses Help Create Plan to Address Pediatric Patient Aggression

A safe hospital experience for pediatric patients and staff is an important goal of Golisano Children’s Hospital. Some children who are admitted to the hospital have issues with behavior or communication that exist prior to admission. Needing to be cared for in the hospital due to illness or for management of chronic conditions is stressful and may cause worsening behavior that can cause self-harm or injury to others including the staff caring for them.

Over the past several years 8 South has implemented steps to help reduce the risk of serious injury. A behavioral screening tool is now done on admission of children over two to help identify those at risk, and a behavioral care plan is developed to put in place things that can be done to help that child cope to the best of their ability.

Awareness is heightened. If a screened patient is at risk for aggressive behavior, a bee icon is placed outside of their room to alert other care providers and services.Behaviors are documented and protective equipment may be recommended for those entering the room. All documentation is entered into eRecord.

“We found that physical Injury from aggressive patient behavior was the number one cause of employee safety events at Golisano Children’s Hospital,” said Amy Keller, BSN, nurse manager, 8 South. “That’s why we put a multidisciplinary team together to find out why this was happening and what we could do to mitigate it.”

“This information gives us a clearer picture of the patient and if there is risk of aggression,” said Rebecca Kanaley, RN, MS, CNL, senior clinical nurse leader. “Aggression is not something you normally think about in pediatrics but it happens and there is a real need to address it for the safety of all.”

Pediatric aggression is not unique to Golisano Children's Hospital. In fact, the hospital is sharing information with hospitals across the country that are looking at ways to address the issue in their own facilities.

These steps have helped develop a better reporting system that is giving a better picture of the issues and incidents. Staff are feeling more supported and prepared, and parents are appreciative that staff work in partnership with them. "I am proud that 8 South wanted to do this as a unit project,” said Keller. “As nurse manager my job is to make sure everyone stays safe -- physically, emotionally, and mentally. We owe it to our patients, families, and staff to be the best we can be.”

In addition to Keller and Kanaley the team includes: Megan Harding, RN, Dr. Sasha Massachi, Dr. Mike Scharf, Rachel Steffen, RN, Dr. Taylor Starr, Bonnie Strollo, DNP and Dayla Terp, RN.