Nurses: Responding to Patients' Needs Through Collaboration

Many times, hospital stays for children trigger fear, stress or memories of trauma. This can result in escalations of behavior, which quickly becomes a dangerous environment for the patients and employees. Lisa Farmer, BSN, RN-BC, LMSW, Director of Psychiatry Services and a Cook Children’s employee for 17 years, has seen the need emerge for a dedicated team to respond to these urgent situations as they arise.

“A few years ago, our team started lobbying for a solution,” Lisa said.

The hospital has seen a large increase of high-risk behavioral patients including an over 40% increase in suicide attempt patients on non-psychiatric floors. Since the pandemic began, there has also been an uptick in children presenting with disruptive and aggressive behaviors, as well as those with autism or delays, whose families have been in crisis mode and could no longer manage these symptoms at home.

Additional employees were hired and the program specialists, who are direct caregivers on the psychiatry unit, became the responders to these behavioral events. Nurse residents completed a project with extensive research on the effectiveness of a group of staff members trained to react to escalations. This planning team utilized this research to understand Cook Children’s needs, in order to develop the response team and policy. The BERT team was then created.

Jennifer Horn, MSN, RN, CPN, CPPS, Quality Improvement Coordinator in Clinical Collaborative, works with Solutions for Patient Safety, a clinical collaborative of 145 pediatric hospitals which focuses on patient safety initiatives and reducing harm. Since 2018, Jennifer has worked closely with Occupational Health, which tracks employee injuries as a result of patient actions, such as kicking, hitting or biting.

“Our first planning meeting came just in the nick of time because we saw a big influx of high-acuity behavioral patients,” Jennifer said.