Citation

Eisenstein M, Chung J, Domaleski V, Lantz S. J. Nurs. Meas. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Springer Publishing)

DOI

10.1891/JNM-2021-0068

PMID

37558252

Abstract

Background and Purpose: The prevention of aggressive behavior in child and adolescent inpatient settings is essential. However, it can be difficult to prompt a quick appropriate intervention without an early warning scale for the prevention and management of behavioral emergencies in a psychiatric inpatient adolescent unit. Behavioral emergencies often result in restraint/seclusion and/or administration of psychotropic medications. The objectives are to develop and evaluate the Pediatric Behavioral Early Warning Scale (Pedi-BEWS) as a screening tool to prompt quick appropriate interventions and to decrease incidents of restraint/seclusion and/or administration of psychotropic medications.

METHODS: A two-phase methodological design was applied. A total of 447 inpatients and 21 nurses were used to test internal consistency reliability and validity.

RESULTS: Receiver operating characteristic curve areas for the developed instrument were calculated to be 0.890 (Cognition), 0.959 (affect), and 0.951 (behavior). The overall Pedi-BEWS indicated high reliability (Cronbach's alpha =.98).

CONCLUSIONS: The Pedi-BEWS shows high internal consistency and validity. The use of the newly developed tool may reduce or eliminate episodes of seclusion and restraint for pediatric patients with a behavioral problem. In addition, the tool has the potential to enhance psychiatric nurses' assessment skills and competencies. The use of the newly-developed Pedi-BEWS can promote an appropriate and timely nursing assessment and intervention before the deterioration in psychiatric nursing practice.

Language: en

Keywords

instrument development; clinical; measurement/statistical methods, adolescent health