%0 Journal Article
%T Implementation of Modified Positive Behavioral Interventions and Supports in a youth psychiatric partial hospital program
%A Carisa Parrish
%A Elizabeth K Reynolds
%A Jessica C Hankinson
%A Marco A Grados
%A Nancy Praglowski
%A Rick Ostrander
%J Journal of Patient Safety and Risk Management
%@ 2516-0443
%D 2019
%R 10.1177/2516043518811758
%X Seclusion and restraint are procedures utilized in youth psychiatric settings. While a number of agencies have called for a reduction and ultimate elimination of the use of these practices, there has been limited research on behavioral programs to reduce seclusion/restraint. This is particularly true for research on behavioral programming in youth psychiatric partial hospital settings. As such, the current study sought to examine the effectiveness of a modified version of Positive Behavioral Interventions and Supports (M-PBIS) implemented on a youth psychiatric partial hospital service to reduce seclusion/restraint. This naturalistic, prospective study covered a 26-month period and utilized a pre¨Cpost design. M-PBIS features include a defined set of positive behavioral expectations, a system to teach behavioral expectations, reinforcement of appropriate behaviors, data collection/evidence-based decision making, individual support for those not responding to the unit-wide system, active support by all stakeholders (including all staff members agreeing to the program), and positive recognition among staff. With a sample of 442 admissions, there were meaningful reductions in the percent of patients who were in seclusion/restraint (from 47.6 to 6.7%) as well as the overall seclusion/restraint rate (from 3.56 (SD£¿=£¿1.94) to 0.48 (SD£¿=£¿0.64)). Furthermore, there was a significant reduction in the use of Pro Re Nata (PRN) medication for agitation/aggression (percent of patient who received a PRN decreased from 33.3 to 12.9%). This naturalistic study suggests that M-PBIS is a promising intervention for use in youth psychiatric partial hospital services to reduce seclusion/restraint and PRN medication for agitation/aggression. Reduction and ultimate elimination of seclusion/restraint is a critical objective in improving the quality and safety of acute mental health services for youth
%K Seclusion
%K restraint
%K youth
%K psychiatric
%K positive behavior
%U https://journals.sagepub.com/doi/full/10.1177/2516043518811758