Overview of Project BETA: Best Practices in Evaluation and Treatment of Agitation

Holloman, Garland H.; Zeller, Scott L.

doi:10.5811/westjem.2011.9.6865

Cited by 153 publications

(101 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The participants were scored on 11 categories including obtaining information from nursing staff, maintaining personal safety, assessing the patient, attitude, empathy, selection and timing of oral medications offered, response to escalation, when to call security, when to order a restraint, and intramuscular medication selection. These categories were determined by consensus discussion among a panel of experts and are consistent with published guidelines on best practices in the management of agitation [12][13][14][15][16][17]. In each category, participants were scored between 0 and 5 with specific behavioral anchors.…”

Section: Simulation Descriptionmentioning

confidence: 99%

“…The participants had the opportunity to practice a number of skills, including obtaining key clinical information from the nurse, attending to safety, performing a focused interview of the patient, employing appropriate verbal deescalation techniques, deciding when to call for security, offering oral medications, and ultimately ordering a physical restraint with intramuscular medications. Consensus guidelines were used to determine the appropriate steps in the assessment and management of an agitated patient [12][13][14][15][16][17].…”

Section: Simulation Descriptionmentioning

confidence: 99%

See 1 more Smart Citation

Simulation-Based Training for Residents in the Management of Acute Agitation: A Cluster Randomized Controlled Trial

et al. 2016

View full text Add to dashboard Cite

In this study, simulation-based training appeared to be more effective at teaching knowledge and skills necessary for the management of acutely agitated patients, as compared to didactic-based instruction alone. Subjective evaluations of confidence in these skills did not improve significantly compared to controls, corroborating the need for using objective outcome measures when assessing simulation-based training.

show abstract

Section: Simulation Descriptionmentioning

confidence: 99%

Section: Simulation Descriptionmentioning

confidence: 99%

Simulation-Based Training for Residents in the Management of Acute Agitation: A Cluster Randomized Controlled Trial

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Several consensus guidelines have been published to direct physicians in the management of agitation in the acute setting [3, 24], with the most recent being that of the American Association for Emergency Psychiatry (AAEP) which covers all interventional aspects on the evaluation and treatment of agitation and has improved the consistency and safety in the management of patients [25]. Recently, a panel of 24 international experts have published a consensus on the assessment and treatment decisions for psychiatric agitation has that provides some useful recommendations for daily clinical practice based on the current knowledge of agitation [26].…”

Section: Introductionmentioning

confidence: 99%

State of Acute Agitation at Psychiatric Emergencies in Europe: The STAGE Study

San¹,

Marksteiner²,

Zwanzger³

et al. 2016

CPEMH

View full text Add to dashboard Cite

Background:Agitation is an array of syndromes and types of behaviors that are common in patients with psychiatric disorders. In Europe, the estimation of prevalence of agitation has been difficult due to the lack of standard studies or systematic data collection done on this syndrome.Objective:An observational, cross-sectional, multicenter study aimed to assess the prevalence of agitation episodes in psychiatric emergencies in different European countries.Method:For 1 week, all episodes of acute agitation that were attended to at the psychiatric emergency room (ER) or Acute Inpatient Unit (AIU) in the 27 participating centers were registered. The clinical characteristics and management of the agitation episode were also described. A descriptive analysis was performed.Results:A total of 334 agitation episodes out of 7295 psychiatric emergencies were recorded, giving a prevalence rate of 4.6% (95% CI: 4.12-5.08). Of them, 172 [9.4% (95% CI: 8.2-10.9)] were attended at the ER and 162 [2.8% (95% CI: 2.4-3.3)] at AIU. Only data from 165 episodes of agitation (those with a signed informed consent form) was registered and described in this report. The most common psychiatric conditions associated with agitation were schizophrenia, bipolar disorder and personality disorder. The management of agitation included from non-invasive to more coercive measures (mechanical, physical restraint or seclusion) that were unavoidable in more than half of the agitation episodes (59.5%).Conclusion:The results show that agitation is a common symptom in the clinical practice, both in emergency and inpatient psychiatric departments. Further studies are warranted to better recognize (using a standardized definition) and characterize agitation episodes.

show abstract

“…Fortunately, acute treatment options for the management of agitation are plentiful and generally efficacious [50]. Published are a set of guidelines created by the American Association for Emergency Psychiatry titled BBest practices in Evaluation and Treatment of Agitation^(BETA) [51].…”

Section: Tertiary Preventionmentioning

confidence: 99%

Preventing Violence in Patients with Schizophrenia

Citrome

Volavka

2015

Curr Treat Options Psych

View full text Add to dashboard Cite

Opinion statementViolence in patients with schizophrenia has garnered substantial public attention in the lay press. Although schizophrenia is associated with a modestly elevated risk for violent behavior, which is further increased by comorbid substance use disorders, most patients with schizophrenia are not violent and most violent individuals do not have schizophrenia. At present, primary prevention efforts are of theoretical interest and include attention being placed on childhood maltreatment. Research into secondary prevention, defined as the prevention of occurrence of violent behavior in persons already diagnosed with schizophrenia, has identified several risk factors including substance use and nonadherence to medication treatment. A specific antiaggressive effect of clozapine has been identified and should be considered as a treatment option for persons with schizophrenia and persistent aggressive behavior. A potential alternative to clozapine is olanzapine, based on a randomized controlled trial where although olanzapine was less efficacious than clozapine in aggression outcomes, olanzapine was more efficacious than haloperidol, and the choice of olanzapine is further supported by evidence from two large effectiveness studies, the Clinical Antipsychotic Trials of Intervention Effectiveness and the European First-Episode Schizophrenia study. Tertiary prevention, defined as the acute management of agitated and aggressive behavior, is accomplished with the use of psychological and behavioral interventions such as verbal de-escalation techniques, in combination with pharmacological agents. For persons with schizophrenia, antipsychotics are preferred. Although rapidly acting intramuscular formulations have been the mainstay for this type of treatment, oral agents such as inhaled loxapine and sublingual asenapine can be considered.

show abstract

Overview of Project BETA: Best Practices in Evaluation and Treatment of Agitation

Cited by 153 publications

References 5 publications

Simulation-Based Training for Residents in the Management of Acute Agitation: A Cluster Randomized Controlled Trial

Simulation-Based Training for Residents in the Management of Acute Agitation: A Cluster Randomized Controlled Trial

State of Acute Agitation at Psychiatric Emergencies in Europe: The STAGE Study

Preventing Violence in Patients with Schizophrenia

Contact Info

Product

Resources

About