Abstract
Background: In pediatric settings, there has been an increase in patients with mental health problems, who experience aggressive and threatening behavior toward the clinical care staff. Without proper policies, education, and means to identify patient triggers for aggressive behavior, nurses are unable to safely care for these children and are at risk of being injured during aggressive outbursts. The objective of this project was to promote evidence-based practices regarding the prevention and management of aggression in hospitalized pediatric patients in medical-surgical units.
Methods: Using the JBI Evidence Implementation framework, this project sought to optimize compliance with best practices for early identification and management of aggressive behaviors in pediatric inpatient units. Three barriers to best practice were identified after a baseline chart audit including the lack of an organizational policy to prevent and manage aggressive behavior, the lack of identification of triggers that precipitate aggressive behavior, and the lack of utilization of an aggression prevention care plan. To address these barriers the team created a unit protocol for prevention and management of aggression, an easy way to document triggers, and a general pediatric aggression care plan.
Lessons Learned: Continuing education and ongoing refreshers can affect the quality of patient care and outcomes by offering occasions to improve or strengthen knowledge. There is still much work to be done at an organizational level to develop a policy, adopt more formal tools/resources, and provide formal training.
Conclusions: A new care plan was created and is helpful for nursing staff in caring for aggressive patients. Shared knowledge of triggers can be profound in preventing aggressive outbursts and staff injuries. However, formal training and risk assessment tools need to be adopted to truly support evidence-based practices. Continued nursing education is essential and should continue to be supported, utilized, and encouraged by the entire organization.
Notes
References:
Advisory Board. (2024). Workplace violence against nurses, in 3 charts. Retrieved from https://www.advisory.com/daily-briefing/2024/02/08/nnu-survey#:~:text=Overall%2C%2081.6%25%20of%20nurses%20said,they%20had%20been%20physically%20threatened.
American Nurses Association. (n.d.). End nurse abuse. Available from: https://www.nursingworld.org/practice-policy/work-environment/end-nurse-abuse/
Porritt, K., McArthur, A., Lockwood, C., & Munn, Z. (2020). JBI handbook for evidence implementation. Adelaide, Australia: JBI. Available from: https://implementationmanual.jbi.globalhttps;//doi.org.10.46658/JBIMEI-20-01
Stephenson, M. (2022). Evidence Summary. Aggression in hospital and mental health unit: Prevention. The JBI EBP Database. JBI-ES-138-3.
Sigma Membership
Non-member
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Translational Research/Evidence-based Practice
Keywords:
Policy and Advocacy, Incivility, Acute Care, Pediatrics, Workplace Violence Against Nurses, Pediatric Aggression Care Plan
Recommended Citation
Riddick, Johnna C., "Preventing Aggression in a Pediatric Inpatient Unit: A Best Practice Implementation Project" (2025). Biennial Convention (CONV). 13.
https://www.sigmarepository.org/convention/2025/presentations_2025/13
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-11-17
Preventing Aggression in a Pediatric Inpatient Unit: A Best Practice Implementation Project
Indianapolis, Indiana, USA
Background: In pediatric settings, there has been an increase in patients with mental health problems, who experience aggressive and threatening behavior toward the clinical care staff. Without proper policies, education, and means to identify patient triggers for aggressive behavior, nurses are unable to safely care for these children and are at risk of being injured during aggressive outbursts. The objective of this project was to promote evidence-based practices regarding the prevention and management of aggression in hospitalized pediatric patients in medical-surgical units.
Methods: Using the JBI Evidence Implementation framework, this project sought to optimize compliance with best practices for early identification and management of aggressive behaviors in pediatric inpatient units. Three barriers to best practice were identified after a baseline chart audit including the lack of an organizational policy to prevent and manage aggressive behavior, the lack of identification of triggers that precipitate aggressive behavior, and the lack of utilization of an aggression prevention care plan. To address these barriers the team created a unit protocol for prevention and management of aggression, an easy way to document triggers, and a general pediatric aggression care plan.
Lessons Learned: Continuing education and ongoing refreshers can affect the quality of patient care and outcomes by offering occasions to improve or strengthen knowledge. There is still much work to be done at an organizational level to develop a policy, adopt more formal tools/resources, and provide formal training.
Conclusions: A new care plan was created and is helpful for nursing staff in caring for aggressive patients. Shared knowledge of triggers can be profound in preventing aggressive outbursts and staff injuries. However, formal training and risk assessment tools need to be adopted to truly support evidence-based practices. Continued nursing education is essential and should continue to be supported, utilized, and encouraged by the entire organization.
Description
This project examined best practices for preventing aggression among inpatient pediatrics patients. Compliance with best practices was audited on a general pediatric unit and changes were implemented. Post-implementation audits were conducted. Several lessons were learned about ways to prevent aggression among this patient population.