1 Southern Adelaide Local Health, SA Health
Behaviours of concern in acute traumatic brain injury (TBI) present risks including harm to patients, equipment destruction, and workplace violence. This study aimed to determine if implementing a clinically pragmatic behaviour management approach for behaviours of concern in acute TBI reduces use of restraints, security incidences, acute length of stay admission and cost, thereby improving progress to rehabilitation. The intervention group (n = 23) consisted of acute TBI patients exhibiting behaviours of concern who received a behaviour management approach at two acute hospitals in South Australia, compared with a historical control group from both sites (n = 74). Fidelity results demonstrated high level of adherence to the implemented behaviour management approach. Intervention group had significant lower use of mechanical restraints (p = 0.03), and significantly lower acute admission costs (p = 0.034). Trends in lower pharmacological restraint usage, lower acute hospital length of stay and time from admission to rehabilitation acceptance were recorded. These pilot results contribute to improving quality of health care. Future studies are required to investigate evidence-based behaviour management interventions for acute TBI patients using rigorous knowledge translation implementation designs.