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St. Catherine of Siena Nursing and Rehabilitation Care Center innovates behavioral health management

Psychoactive medications as an intervention for geriatric behavioral health management, while effective, can lead to undesired side effects, including a reduced quality of life. In 2016, St. Catherine of Siena Nursing and Rehabilitation Care Center initiated a program to reduce the use of psychoactive medications while emphasizing non-pharmacological alternatives for managing the behavioral health of their residents.

In 2013, St. Catherine of Siena participated in a Lean Six Sigma Project focusing on antipsychotic medication reduction. The facility successfully reduced antipsychotic usage from 24.6% to 2.8% using non-pharmacological alternatives for behavioral management.

However, the facility recognized that the rate of other psychoactive medications was another area in need of improvement. A focused review of the residents receiving antipsychotic medications revealed behaviors that were based in uncertainty, nervousness, fear and sleeplessness rather than physical and verbal agitation and aggression. The team began to research alternate non-pharmacological approaches that would provide a sense of comfort, improve focus, reduce fear and uncertainty and facilitate positive sleep patterns. During implementation, staff found that individualized review and close management of residents’ environment and medication regimen were essential to the initiative’s success and the comfort of the residents.

Through the program, sedative/anti-anxiety medication usage decreased from 28% to a current rate of 14.6%. Newly identified non-pharmacological interventions for the management of residents with anxiety-related behaviors decreased sedative/anti-anxiety medication usage by 48%. The reduction of psychoactive medication usage resulted in a 24% reduction in falls. 

For more information, contact Erin Bourguignon, RN, MSN, director, nursing, at (631) 862-3900 or erin.bourguignon@chsli.org.