Utilizing cognitive behavioral therapy, token economy technique to positively impact boarding of pediatric psychiatric patients
Author DetailsCrystal Crider, BSN, RN, CEN; Luna Sanchez Rivera, MD; Beth Beaver, MS, CCLS; Sarah O'Rourke, PhD; GenaLynne C. Mooneyham, MD, MS, FAAP, FABPN; Ann White, MSN, APRN, CCNS, CEN CPEN
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Recent US data estimates 5% to 7% of pediatric ED visits are related to mental health. The most common mental disorders diagnosed in childhood are Tourette syndrome, attention-deficit/hyperactivity (ADHD), behavior, mood, anxiety, autism spectrum (AS), and substance use disorders (SUD). Between 2011 and 2015, psychiatric ED visits per 1000 youth increased by 28%. Disposition is the major issue; the wait for outpatient psychiatry is long and inpatient psychiatric beds are a limited resource. This negatively impacts patient behavior, overall ED throughput and patient/family/staff satisfaction. This ED sought to develop an evidence based, proactive, consistent approach to improving pediatric patient behavior management during prolonged boarding.