Simulation-based education for behavioural emergencies in children and young people

This project utilises an innovative solution to a major health care problem. Behavioural emergencies, such as aggression and self-harm, are increasing in frequency in acute health care settings. As well as a physical threat to the safety of children, other patients and health care staff, there are negative consequences for the immediate and ongoing physical and mental health of children, families and clinicians. High-risk behaviours and aggression are often the child’s attempt to communicate fear and frustration which can be magnified in the hospital setting. Children with more complex needs, including autism, are at increased risk for prolonged or abandoned investigations or treatments, poorer health outcomes and psychological trauma from hospital management processes. Acute care paediatric staff report a lack of confidence managing aggression in children, especially those with complex neurodevelopmental or mental health needs. A complex problem which requires a confident, well-trained workforce: In order for children at high-risk for behavioural emergencies to be treated safely and with dignity in hospital, staff need to understand risk-factors and employ individualised communication techniques that are suitable for the developmental level of each child. A comprehensive training program providing practice of skills and reflection on performance is needed. This training program uses simulation to replicate the clinical experience via multidisciplinary team training providing repetitive practice of de-escalation and restraint skills without patient or staff risk. We are currently delivering and evaluating the effect this training has on staff confidence and performance in preventing and managing behavioural emergencies.