Selection of employee personal protective equipment based on aggressive behavior in pediatric neuropsychiatry

ABSTRACT

Purpose: Hospitalized patients with a developmental or intellectual disability and a psychiatric disorder (dual-diagnosis) often pose a risk to themselves or others leading to high injury rates for their providers. Therefore, evidence-based strategies to reduce employee injuries resulting from interactions are necessary. Methods: To reduce injuries resulting from interactions with dual-diagnosis patients, the Initial Behavioural Assessment (IBA) and Protective Equipment Decision Key (PEDK) were used in inpatient neuropsychiatry. The IBA-PEDK identify patients’ aggressive behaviors to provide employees with personal protective equipment (PPE). Inter-rater reliability, validity, and adherence were examined. Results: Injuries significantly decreased after implementing the IBA-PEDK. The average kappa coefficient was 0.64 with a 90.6% agreement. Ninety-three percent of respondents reported wearing PPE at the time of injury. Conclusions: A quick, user-friendly tool that provides a standardized method for determining PPE based on patient-specific behavior can significantly reduce aggression-related injuries.

KEYWORDS:

• Autistic disorder
• developmental disabilities
• occupational health
• personal protective equipment
• safety management

Acknowledgments

We would like to thank the staff in the pediatric neuropsychiatry unit for participating in the study, their time and assistance was invaluable. We would also like to thank our research assistants Seth Connolly and Joshua Myers for their efforts in creating the IBA-PEDK repository.

Declaration of interest

The authors report no declarations of interest.