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OBJECTIVES

Understand the rationale for the Behavioural Support Plan.

Add a tool to support non-pharmacological interventions.

Develop an uncontrollable urge to develop a BSP.

WHY ANOTHER PLAN ?

Needed a resident centered, plain language plan for RCAs.

Wanted a stand alone document that could incorporate information from PIECES, BPSD Algorithm, staff and family.

Needed a plan that ensured consistent actions by all care staff dealing with responsive and/or acting out behaviours.

WHY ANOTHER PLAN (CONT’D)

No other plan provided a “Care recipe” that increased the safety of casual staff and students unfamiliar with the resident.

Wanted a format that enabled quick and easy ongoingediting by staff with only basic computer skills.

HOW DO WE DEVELOP THE BSP?

Staff identify resident behaviours that are negativelyimpacting their health and/or the health and safety of otherresidents/visitors/ and staff.

Do a PIECES assessment and address the treatable issues first to avoid creating a BSP based on assumptions rather than accurate data.

HOW DO WE DEVELOP THE BSP (CONT’D)

Gather clinical data using assessment tools from PIECES/ BPSD Algorithm and/or the facility mandated tools.

Care staff share strategies that have been successful; aswell as their actions that increase the resident’s distress.

Staff that are not available are to provide their input so that the BSP is more comprehensive and has staff buy-in.

HOW DO WE DEVELOP THE BSP (CONT’D) ?

The BSP returns to the basic format all staff learned; Resident issue or Focus/ Goal/ Interventions/ Review date.

Using the template, choose the behaviour needing urgent

attention (3 issues max.) and write it from resident’s

perspective: “ I will strike out at staff that wake me up in the morning.” !

HOW DO WE TO MAKE THE BSP (CON’T)

Goals are set that are resident centered, realistic and achievable.

Interventions reflect best practice guidelines and there are natural consequences for intentional behaviours.

* Some staff may be uncomfortable with Personality Disorder boundaries and may not follow the BSP.

HOW DO WE TO MAKE THE BSP (CON’T)

Review date is flexible as it is dependent on the goal.

Resident and/or Representative review the BSP.

Staff read and sign the BSP indicating they understand and will follow it.

BSP is located where care staff can easily access the binder.

REMEMBER

Consistency and staff compliance are mandatory for BSP to succeed.

The input of everyone who knows the resident has equal value.

The BSP is not meant to replace other mandated plans.

PLAN YOUR WORK-WORK YOUR PLAN

“ United we stand - divided we fall”

Date

Focus Goal Intervention E-Date

 June 19/14

 I don’t like people touching me for any reason.

 Reduce striking out during care by 25% in the first month.

 All staff providing Morning care will do the following:Nurse will give HO her before care medication 30 minutes prior to staff entering resident’s room for morning care (ideally 10 A.M.)  Wake HO slowly and put light on in room- drapes shut. Morning care provided by 2 staff at approx.10:30 AM One staff distracts with conversation and informs HO step by step what they will be doing.Second staff provides the care and is responding to both her partner’s direction and HO’S response to touch. Roll HO on to clean pad and put her into the sling for her wash.NOTE: One roll only- HO holds on to sling straps. Peri-care done in the air-too late when seated.Complete care and dress in her chair. HO picks her clothes-loose on her neck-OPEN BACK * No pants-wrap legs up in a blanket as not mobile. Open drapes and take to dining room.

 July 29/14

QUESTIONS ?