Improvement of Patient- and Family-Specific Care for Children with Special Behavioral Needs in the Emergency Setting: A Behavioral Needs Education

Published:September 03, 2016DOI:


      Improvements in staff training, identification, and treatment planning for children with special health care needs who have behavioral issues are routinely recommended, but a literature review revealed no coherent plans targeted specifically toward pediatric ED staff.


      An educational module was delivered to emergency staff along with a survey before and after and 1 month after the intervention to examine comfort in working with children with behavioral special needs and the ability to deliver specialized care. Child life consultations in the pediatric emergency department were measured 3 months before and 3 months after the education was provided.


      A total of 122 staff participated and reported clinically significant improvements across all areas of care that were maintained at 1 month.

      Implications for practice

      To the best of our knowledge, this project represents the first quality improvement project offering behavioral needs education to emergency staff at a large pediatric hospital with an examination of its impact on staff competence, comfort, and outcomes. A large-scale educational module is a practical option for improvement in pediatric ED staff competence in caring for patients with behavioral special needs.

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      Nicole Brynes is DNP graduate of the University of Pittsburgh School of Nursing, and former Senior Professional Staff Nurse, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA.


      Heeyoung Lee is Assistant Professor in the Department of Health & Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA.


      Dianxu Ren is Associate Professor in the Department of Health & Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA.


      Michael Beach is Assistant Professor in the Department of Acute & Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, PA.