WEBB FELLOW: A Scoping Review of Educational Programs Aimed at the Management of Acute Agitation in Non-Delirious Patients

Friday, November 11, 2022

11:00 AM – 12:30 PM

Location: Room 217

Presenting Author(s)

Artin Mahdanian, MD, MSc, FRCPC

Consultant Psychiatrist
McGill University
Columbia, Maryland

PDF

Co-Author(s)

Idris Leppla, MD

Assistant Professor, Co-Director of CL Psychiatry Program
Johns Hopkins Bayview Medical Center
Baltimore, Maryland
SP

Sanam Patel

Researcher
Johns Hopkins University
Baltimore, Maryland
WT

William Tobolowsky, MD

Psychiatry Resident
Johns Hopkins University
Baltimore, Maryland
KL

Katie Lobner, MLIS

Librarian
Johns Hopkins University
Baltimore, Maryland
CC

Christine Caufield-Noll

NA
NA
Baltimore, Maryland
LP

Lucia Ponor, MD

Attending Physician
Johns Hopkins University
Baltimore, Maryland
Durga Roy, MD, FACLP

Associate Professor
Johns Hopkins University School of Medicine
Baltimore, Maryland

Abstract:

Background: Agitation is one of the most common reasons for a psychiatric consultation in general hospitals. Acute agitation is associated with higher health care costs, patient distress, and longer lengths of stay. The purpose of this scoping review is to broadly explore the subject to not only find what exists but also what is lacking in the literature.

Methods: We searched several databases (MEDLINE via PubMed, Embase, The Cochrane Library, PsycInfo, and CINAHL via EbscoHost, and Web of Science via Clarivate) using relevant keywords and controlled vocabulary to identify articles focusing on the curricula about agitation management. Other inclusion criteria were applied: full text only, English-only articles, adult patients >18, and a target audience of healthcare professionals. Eligible articles were identified through a title/abstract scan and confirmed through a full-text review. Two reviewers independently reviewed each title/abstract and then full-text article and extracted the data.

Results: The search yielded a total of 3250 articles. After removing duplicates and reviewing procedures, we included 55 articles. Data extraction captured article type and details; educational program information (staff training, web modules, instructor-led seminar); target learner population; target patient population; target setting. The curricula were categorized into designed/described only (6 articles), implemented only (2 articles), and implemented AND evaluated (47 articles). The learner’s outcomes included increased staff comfort, increased staff confidence, and improved knowledge, and patient outcomes were decreased violence, decreased PRN medication use, and decreased restraint use.

Discussions: This review has identified that the literature is limited in studies that focus on curricula on agitation that describe, implement and evaluate outcomes both from a patient perspective and learner perspective across inpatient settings. More studies are required for the future.