Abstract
Objectives
Workplace disruptive behavior incidents can be costly for organizations, employees,
and customers. Persons with dementia living in long-term care settings have a high
risk of exhibiting distressed behaviors. We examined whether a resident-centered,
behavioral intervention for residents with dementia led to a reduction in reported
workplace disruptive behaviors and staff injury rate due to assault. Impactful interventions
are important for quality of care.
Design
We examined whether a team-based behavioral program in community living centers (CLCs),
where a nurse champion and behavioral coordinator were trained to work with the clinical
team to understand and manage distressed behaviors commonly associated with dementia,
was associated with reductions in behavior incidents.
Setting and Participants
The setting was Veterans Health Administration CLCs. The sample consisted of 120 aggregated
CLCs operating between 2012 and 2017 with 62 completing training. CLCs were distributed
across the United States.
Methods
Outcomes included CLC-level rates of staff injury and number of workplace disruptive
behavior incidents. Outcomes were regressed on measures of intervention completion,
time since intervention, and several CLC characteristics.
Results
The intervention was significantly associated with lower incidence of assault with
staff injury rates overall, particularly following the first year of training, but
not with other reported workplace disruptive behavior incident rates.
Conclusions and Implications
A team-based behavioral intervention was associated with reduction of employee assaults,
a critical repercussion of distressed behavior in dementia. Given rapid growth in
patients with dementia in nursing homes, effective treatment practices, such as interdisciplinary
behavioral management approaches may be impactful and valuable to implement.
Keywords
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Article info
Publication history
Published online: August 30, 2021
Footnotes
This material is based upon work supported by the Department of Veterans Affairs, Veterans Health Administration Office of Research and Development, QUERI project award PEC 16-353 and Health Services Research and Development, IIR 17-046.
An earlier version of this paper was part of a panel presentation at the Gerontological Society of American 2019 annual meeting.
The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.
The sponsor provided funding but did not have a role in the design, methods, recruitment, data collection, analysis or preparation of the paper.
The authors declare no conflicts of interest.
Identification
Copyright
Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
