• Article
  • September 30, 2019

Educating Hospital Staff on De-Escalation Strategies with the Behaviorally Challenged

Hospital uses online courses to maintain a safe environment, answer staff questions, and meet onboarding and training needs

By Kaitie Marolf

Keeping patients and staff safe is a top priority for hospitals, and de-escalation skills are vital. Cook Children's Hospital utilized several Pediatric Learning Solutions (PLS) courses to reach their goals for education and reducing the risk of harm.

“I don’t have the resources or the time to create all of the education we need, or provide personalized education,” Stephen Sims, psychiatry department education coordinator, said. “I have a resource list that I have put together that has a lot of PLS courses on there. When staff have questions about certain topics, one of the computer-based trainings could meet that need.”

The education staff at Cook Children’s has leveraged several courses from the Pediatric Behavioral and Mental Health Library to maintain a safe environment, answer staff questions, and meet onboarding and training needs. Sims shared how the hospital is using three of these courses specifically.

Pediatric Restraints and Seclusion

Restraints and seclusion education for staff is part of The Joint Commission’ (TJC) standards. Assigning this course helps the hospital reach this requirement when it comes time for audits.

This course emphasizes the importance of knowledge and competence in this area, as while these measures are sometimes necessary, they also can pose very serious risk. In addition to TJC standards and practice guidelines, the course also encompasses those of the Centers for Medicare and Medicaid Services (CMS). Learners work through information about the different types of restraints and alternative ways to create a safe environment.

Autism Spectrum Disorder (ASD)

While the psychology department sees patients with many diagnoses, two out of the 15 beds in on their unit are dedicated to the autism patient population. Sims bases much of the education he provides to his learners from an annual needs assessment, and ASD is a frequently requested topic on the assessment. The Autism Spectrum Disorder course is assigned to all new hires on the unit. 

“Staff are always looking for better ways to care for the patients and so we front-load them with that information,” Sims said. “We have a few staff who are fairly specialized with that population who also found that information to be very helpful.”

On his unit specifically, Sims took advantage of a resource linked in the course, the National Professional Development Center on Autism Spectrum Disorder's 27 evidence-based interventions, by assigning staff to each do a deeper dive into one of the interventions listed. 

Crisis Prevention Through Verbal and Non-Verbal De-escalation Strategies 

The ASD population, among others, pose a higher risk for disturbances than non-behaviorally challenged patients. As the hospital strived to create the safest environment possible, they assigned the Crisis Prevention Through Verbal and Non-Verbal De-escalation Strategies course and related annual competency to targeted staff, mostly bedside registered nurses, hospital-wide.

Sims said that de-escalation and crisis prevention are major areas of interest among staff, and many have asked about taking Crisis Prevention Institute (CPI) training. But these live trainings require an on-site instructor, so seats for staff to access it are limited.

“Initially my response to those requests had to be, ‘we have a couple of classes available, but you have to get on the waitlist. If CPI is not required for your role, it’s not guaranteed,’” Sims said. “So I was excited to provide the course as an option, and I think a lot of the educators were as well.”