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Description

Hospitalized children diagnosed with autism spectrum disorder (ASD), with intellectual disability, are a challenge for nursing and safety assistant staff. A large, metropolitan, pediatric hospital recently struggled while caring for a developmentally delayed, non-verbal teenager with ASD that was hospitalized for a year. Although staff are provided yearly education related to high-risk behavioral health patients, autism-directed education was minimal. A literature search for interventions to execute was unsuccessful due to the lack of articles related to the prolonged medical hospitalization of ASD teens. In response to repeated events related to staff injuries and patient behavioral escalations, a workgroup was formed to address the care provided. A multidisciplinary team offered creative solutions to meet the needs of this long-term hospitalization. Sensory items were introduced. Safety was increased with the implementation of two safety assistants. A psychotropic medication plan was readily available. Although successes were made, others were discarded based on inconclusive results. Permanent outcomes included the creation of a specialized patient care technician with additional training for patients with autism, a behavioral health banner to share information about the patient’s care with all disciplines, and a full-time psychiatric resource registered nurse. The new modalities proved effective as the patient did not require as needed medication during the last three months of hospitalization. Lessons learned were the early identification of patients with ASD that prove difficult to place, and the prompt initiation of interventions to lessen the number of Behavioral Emergency Response Team events.

Publication Date

2023

Shining a Light on Autism Interventions During a Long-Term Medical Hospitalization: A Case Study

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