Preventing and managing challenging behaviour
Intended for healthcare professionals
CPD Previous     Next

Preventing and managing challenging behaviour

Nutmeg Hallett @dr_nutmeg Lecturer in mental health nursing, School of Nursing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, England

Patients exhibiting challenging behaviour, which includes any non-verbal, verbal or physical behaviour, is a significant issue in healthcare settings. Preventing such behaviour and the harm it can cause is important for healthcare organisations and individuals, and involves following a public health model comprised of three tiers: primary, secondary and tertiary prevention. Primary prevention aims to reduce the risk of challenging behaviour occurring in the first instance; secondary prevention involves reducing the risk associated with imminent challenging behaviour and its potential escalation; and tertiary prevention focuses on minimising the physical and emotional harm caused by challenging behaviours, during and after an event. De-escalation should be the first-line response to challenging behaviour, and healthcare staff should use a range of techniques – maintaining safety, self-regulation, effective communication, and assessment and actions – to reduce the incidence of challenging behaviour. In some situations, physical interventions may be required to protect the safety of the individual, healthcare staff and other individuals involved, and healthcare staff should be aware of local policies and procedures for this. Following a serious incident, where there was potential or actual harm to patients and healthcare staff, healthcare organisations should use post-incident reviews to learn from the situation, while healthcare staff should be offered the opportunity for debriefing. Positive responses to challenging behaviour at an organisational and individual level can lead to improved work environments for healthcare staff and optimal patient care and outcomes.

Nursing Standard. 32, 26, 51-63. doi: 10.7748/ns.2018.e10969

Correspondence

n.n.hallett@bham.ac.uk

Peer review

This article has been subject to external double-blind peer review and checked for plagiarism using automated software

Conflict of interest

None declared

Revalidation

Prepare for revalidation: read this CPD article, answer the questionnaire and write a reflective account: rcni.com/revalidation

To write a CPD article

Please email tanya.fernandes@rcni.com. Guidelines on writing for publication are available at: rcni.com/writeforus

Received: 30 July 2017

Accepted: 25 January 2018

Want to read more?

RCNi-Plus
Already have access? Log in

or

3-month trial offer for £5.25/month

Subscribe today and save 50% on your first three months
RCNi Plus users have full access to the following benefits:
  • Unlimited access to all 10 RCNi Journals
  • RCNi Learning featuring over 175 modules to easily earn CPD time
  • NMC-compliant RCNi Revalidation Portfolio to stay on track with your progress
  • Personalised newsletters tailored to your interests
  • A customisable dashboard with over 200 topics
Subscribe

Alternatively, you can purchase access to this article for the next seven days. Buy now


Are you a student? Our student subscription has content especially for you.
Find out more