Heather Block
Project Manager – SA Health

Heather is currently Project Manager and Principal Investigator for a project conducted across SA’s acute trauma hospitals “Standardising the management of behaviours of concern in the acute phase of TBI”. She has a background as a Clinical Lead Occupational Therapist and has extensive experience in acute stroke and acquired brain injury.

Presentation Title
Standardising the Management of Behaviours of Concern in the Acute Phase of Traumatic Brain Injury

Short Abstract
Across South Australia’s acute trauma hospitals, there have been inconsistent approaches for identification and management challenging behaviours, such as variable use of physical restraints, variable use of medications and doses to sedate patients, and frequent security incidents (code blacks). This project, funded by the Lifetime Support Authority, aims to develop and implement a standardised, best practice protocol to identify and manage behaviours of concern in patients with TBI across South Australia’s acute trauma hospitals.Evidence was examined through a systematic review of literature, in addition to interstate benchmarking visits. Local working parties consisting of experts in the field of acute and subacute TBI were then formed to develop best practice recommendations for standardised identification and management of behaviours of concern in acute TBI.A specific assessment tool and protocol was developed to identify and manage TBI behaviours of concern which has been implemented across SA’s acute trauma hospitals. The TBI Behaviour Scale and Record provides an objective, TBI specific assessment and recording tool for severity of behaviours of concern. The TBI – Management of Behaviours of Concern protocol provides a standardised approach to non-pharmacological and pharmacological interventions based on assessment of behaviours using the TBI Behaviour Scale and Record. Additionally, an Individualised TBI Behaviour Support Plan has been developed to identify patient’s lifestyle factors, routines, supports, and can be used to track patient’s behaviour triggers, warning signs and individualised management strategies.Evaluation of the TBI protocol, TBI Behaviour Scale and Record and Individualised TBI Behaviour Support Plan will commence over the next 6 months. Additionally, a state-wide online staff training module will be developed and plans for a state-wide TBI database to measure longitudinal change and guide future research.