Managing aggression in a psychiatric hospital using a behaviour plan: a case study

• Published in: Journal of psychiatric and mental health nursing Vol. 13; no. 5; pp. 515 - 521
• Main Authors: BISCONER, S. W., GREEN, M., MALLON-CZAJKA, J., JOHNSON, J. S.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.10.2006
• Subjects: Adult; aggression; Aggression - psychology; Avoidance Learning; Behavior Therapy - organization & administration; behaviour plan; Bipolar Disorder - complications; Bipolar Disorder - prevention & control; Bipolar Disorder - psychology; Clinical Nursing Research; Communication; Cooperative Behavior; Hospitals, Psychiatric; Humans; intellectual disabilities; Intellectual Disability - complications; Intellectual Disability - psychology; Male; mental illness; Nurse Clinicians - organization & administration; Nurse Clinicians - psychology; Nurse's Role - psychology; Nurse-Patient Relations; Nursing Assessment; Patient Care Planning - organization & administration; Patient Care Team - organization & administration; Peer Group; psychiatric hospitals; psychiatric nursing; Psychiatric Nursing - organization & administration; Risk Reduction Behavior; Safety Management - organization & administration; Self-Injurious Behavior - complications; Self-Injurious Behavior - prevention & control; Self-Injurious Behavior - psychology; Treatment Outcome
• ISSN: 1351-0126; 1365-2850
• DOI: 10.1111/j.1365-2850.2006.00973.x

This paper focuses on the critical role of nursing in implementing a behaviour plan in a psychiatric hospital. The plan was implemented with a 40‐year‐old man with a long history of aggression towards others and self. The study used a single‐subject research design with baseline and intervention phases (AB Design). Data were collected on (1) frequency of incidents of aggression towards others and self; (2) use of restrictive interventions to manage aggression (i.e. restraints, pro re nata medication, 1:1 special observation); and (3) frequency of staff injury. The data show a decrease in frequency of aggression towards others and self, a concurrent reduction in the use of restrictive interventions to manage aggression, and a decrease in incidents of staff injury. The behaviour plan helped staff maintain a safe and therapeutic milieu. The behaviour plan has given the patient an opportunity to learn positive replacement behaviours and skills, and the opportunity eventually to leave the hospital to live in a less restrictive community home.