If you are familiar with the Rubik’s puzzle cube, then you may have a head start in understanding how behavioral analysis works in nursing homes. Nursing home behavior management is basically a search through the multiple layers of nursing home life for the behavior management solution hiding within. With the right information at your fingertips, a little detective work can turn up helpful insights that save time for the care plan team or nursing supervisor.
The analysis begins with the person, place, time, and the “with whom” of the problem behavior. In its most simple form, this matrix-type analysis involves the slicing and dicing of the 24-hour care schedule and floor plan geography to identify the important characteristics of a problem behavior. For starters, the analysis looks at layers including the shift breakdown, a weekday-weekend breakdown, a staff breakdown and the routine of the resident.
The important questions to ask ourselves in the analysis are, " Where and when does it happen?" and "Where and when does it not happen?" This line of investigation will almost always point to a reasonable, efficient solution to what might otherwise appear to be an unsolvable puzzle of patient distress, risky behavior, and facility disruption.
One of the dividends of a behavioral analysis is that is it cost-controlling. It is a rare case where doing more actually costs less. It's only vulnerability is that the results of the analysis are only as good as the accuracy of records and the reliability of observer reports that are used in the analysis. In general, the deeper the behavior analysis goes, the less expensive the solution is likely to be.
The pleasant surprise is that the problem behavior most often turns out to be far more limited in its scope than was initially anticipated on the basis of informal staff reports. An intervention strategy that is limited to one or two prevention steps lasting less than an hour each day is far more manageable and less costly than a continuous, 24-hour intervention such as one-to-one monitoring at the facility or the additional disruption of a psychiatric admission.
What is a "behavior event?"
It is the behavior observed plus
the information about the where, when, who context of the behavior.
If it turns out that an analysis is needed later,
then the information about the event
is described in the chart.
With practice and training, social workers and nurses can become skilled at searching their facility's unique behavioral complex for behavioral management solutions. With industry regulators pushing for fewer medications and more in-house behavioral management, staff with behavioral skills may find themselves in a unique and valued position in this rapidly evolving field of nursing care.