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Neurological Rehabilitation

Implementing behavior management education in inpatient rehab: staff survey and case reports.

Saturday, October 25, 2025
8:00 AM - 9:15 AM MT
Location: Kiosk 5
Disclosure(s):
Tyler Christensen, MS, CCC-SLP: No financial relationships to disclose
Liz Follis, PP-OTD: No financial relationships to disclose
Derrick Allred, MD: No financial relationships to disclose
Case Diagnosis: Case 1: a 20 y/o male admitted for self-inflicted GSW to head s/p bifrontal craniectomies in December 2021; Case 2: 44 y/o male with PMH polysubstance use admitted for moderate TBI following fall in February 2025

Case Description or Program Description: We investigated the feasibility and effectiveness of a behavior management training for nursing staff to identify agitation, understand neurological causes, improve communication, and implement techniques for de-escalation. We used pre- and post-intervention surveys of self-reported learning, tallied number of meetings completed weekly, and Agitated Behavior Scale (ABS), Orientation Log, and use of PRN medications for agitation were analyzed.

Setting: 25-bed inpatient neurorehabilitation unit specializing in brain injury care

Assessment/Results: Surveys indicated self-reported knowledge increased for all learners [t (119) = -7.36, p <.001], and the size of this improvement did not differ between RNs and HCAs [F(1,76) = 27.33, p<.001]. Weekly huddles with nursing staff decreased considerably from case study 1 (2021) to case study 2 (2025), while both showed improved ABS, improved Orientation log, and decreased use of PRN medications.

Discussion (relevance): Acquired brain injuries can cause cognitive and behavioral challenges for which many staff may lack the experience and training to appropriately address. This can lead to poor patient outcomes and staff injuries. A 60 minute training provided at onboarding can be effective to educate nursing staff and increase their engagement in neurorehabilitation. These changes may lead to improved patient outcomes, patient and staff safety, which can be maintained across years, and may result in the need for fewer patient-specific meetings and huddles to address behavior issues.

Conclusions: Further high-quality research is needed in the area of staff education and behavior management in brain injury populations. The case studies and staff surveys presented show that quality improvement projects like this can be feasible and effective, and serve as a basis for further investigation.