Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


33rd Annual Convention; San Diego, CA; 2007

Event Details

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Symposium #353
Improving Healthcare Behaviors and Outcomes with Applied Behavior Analysis
Monday, May 28, 2007
10:00 AM–10:50 AM
Emma AB
Area: OBM/CSE; Domain: Applied Research
Chair: Timothy D. Ludwig (Appalachian State University)

Healthcare safety continues to be a major issue in the public forum, and behavior analysts continue to address various aspects of healthcare delivery. This symposium includes three papers from three different universities, all focusing on improving the safety of healthcare. One paper focuses on improving employee health by increasing the safety of patient handling routines in a hospital. Another paper systematically studies methods for increasing the efficiency of staff response times in a nursing home. The third paper will discuss the successes and failures of attempting to affect large-scale change among physicians working in two hospitals by motivating them to adopt technological changes in the medication-ordering process. Following these data-based presentations, the results and implications of the research will be discussed by a leader in the field of teaching behavioral methods.

Differential Staffing Reinforcement in a Nursing Home Reduced Response Latency to Call Bells.
K. R. GRAVINESE (Appalachian State University), Timothy D. Ludwig (Appalachian State University)
Abstract: An ABC analysis (Daniels & Daniels, 2004) was used to pinpoint Certified Nursing Assistant (CNA) behaviors that compete with call bell response time. Observations of CNA response time to call bells were conducted on two separate residential wings of the nursing home. A staffing intervention was implemented in which a single CNA was reinforced for only answering call bells, ultimately removing all competing behaviors for that CNA. Other CNA's were then able to attend only to the competing tasks. The intervention was implemented on Wing 1, using Wing 2 as a control comparison. Following this intervention, a reversal was conducted counterbalancing the design. Response time to call bells was decreased from an average baseline of 330.5 seconds to 51.5 during the intervention.
Overcoming Barriers to Behavioral Intervention with Medical Practitioners: A Two-Way Process.
THOMAS R. CUNNINGHAM (Virginia Polytechnic Institute and State University), Steven W. Clarke (Virginia Polytechnic Institute and State University), Remmie LeRoy Arnold (Virginia Polytechnic Institute and State University), David Michael Harris (Virginia Polytechnic Institute and State University), E. Scott Geller (Virginia Polytechnic Institute and State University)
Abstract: Distress about medical errors continues to grow in the realm of public concern. The Institute of Medicine’s shocking estimate of medical errors occurring in the United States has prompted leaders in the healthcare profession to declare the mission statement of saving 100,000 lives through preventive actions to curtail risk of medication error (Berwick, Calkins, McCannon, & Hackbarth, 2006). One of their stated objectives, to improve patient safety with technology adoption, has been the focus of current research efforts. Increasing physician use of Computerized Physician Order Entry (CPOE) at two major medical centers was the target of an intervention package, as well as the pilot demonstration of a NIH grant application that was rejected following highly disparate reviews. Ineffective initial intervention strategies are being revised with direct input from medical professionals, and results will be discussed using physician CPOE usage data, reported medical incidents, average length of patient stay, as well as content analyses from researcher-physician communications.
Patient Handling Safety for Nursing Staff.
DON K. NIELSEN (Western Michigan University), John Austin (Western Michigan University)
Abstract: The effectiveness of video scoring and feedback about the scoring of the components of safe patient transfers was observed among eight nursing staff members in a skilled nursing department within an acute care hospital. An ABCA, multiple baseline across groups design was utilized in the study. The dependent variable under investigation was the percentage of safe lifting components. Following baseline measures, nursing staff participated in an information phase during which they reviewed and discussed components of safe patient transfers. A video scoring phase was introduced, during which, participants viewed and scored a model video of a patient transfer. Video scoring was not as effective in improving the safety of patient transfers for two of the participants during the video-scoring phase as it had been for the other participants and a feedback phase was added for these two participants. Finally, a withdrawal phase was implemented for all participants to determine the long-term effects of the study. The current study suggests that video scoring and feedback are effective in increasing safe behaviors related to patient transfers and reducing the possibility of back injuries among health care workers in a skilled nursing facility.



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