24 hour behaviour monitoring record How to use

24 -hour behaviour monitoring record How to use this clinical record Education package, 2021 Record product code: NH 700562

ACI acknowledges the traditional owners of the land that we work on. We pay our respect to Elders past and present and extend that respect to other Aboriginal peoples present here today.

About this presentation The 24 -hour behaviour monitoring record was created for use in NSW Health facilities. The record documents: • changes in a patient’s behaviour or mental state • possible triggers of that change • effective intervention strategies to guide clinical practice This presentation covers how to: • complete the record • access an information sheet you can refer to if you need it

Why is a 24 -hour behaviour monitoring record important? Care of patients with challenging behaviours is a priority. The record is used to: • monitor changes in a patient’s behaviour or mental state, regardless of the cause • monitor sleep patterns and changes • provide cues for nonpharmacological intervention strategies • enable enhanced prompts for staff to document descriptions of behaviour/s and possible triggers • enable effective intervention strategies to guide clinical practice

Benefits of the 24 -hour behaviour monitoring record • Standardises care – removes the variation in clinical practice and documentation • Combines a 24 -hour behaviour monitoring scale with a behaviour management record • Quick and easy to use • Provides a picture of behaviours over a 24 -hour period • Guides clinical decisions – including non-pharmacological approaches and potential response according to the Clinical Emergency Response System (CERS)

Why a new tool? • There was no single template to capture this information • Completion of existing forms or tools was inconsistent • This record combines multiple tools into one consistent form Previous tools had: • limited descriptive information about behaviours, triggers and interventions • limited guides or prompts regarding non-pharmacological interventions • inconsistent documentation of correlating behaviours and interventions including medication administration

When to use the 24 -hour behaviour monitoring record Use this record for a patient experiencing: • • a new confusion or change in behaviour dementia or delirium with behaviour change hyperactive and hypoactive (fluctuating) behaviours a need for increased supervision Important! Continue documenting ‘vital sign observations’ on BTF chart and escalate, as per local CERS protocol

Page 1

How to complete page 1 • See the examples of behaviours at the bottom of the record. Note they may be in the white, yellow or red zone • Record date • Note time over 24 hours • Place a dot ● in the section relevant for the behaviour most consistently displayed over the time period • Complete the record at least hourly and more frequently as required • Place an S for when the patient is sleeping

Example of page 1 completed

Page 2

How to record behaviours on page 2 • Note date and time • Note where the behaviour occurred and what was happening at the time • Briefly describe the behaviour at that time – shouting, pacing, verbally aggressive • Note what could have been a trigger for the behaviour – the family has just left – needs to go to the toilet – too much noise in the room Tip! Think about what happened at the time or prior to the onset of the behaviour

How to record behaviours on page 2 (cont. ) • Interventions or strategies • Refer to the non-pharmacological management strategy codes (top of form) and note the strategies put in place (using letter code of interventions) • Note when PRN medication was administered • Record the outcome of the interventions or strategies – family member called to come or patient settled • Sign your initials on the record Note: An explanation of the behaviour may be required in the patient medical record progress notes to complement the 24 -hour behaviour monitoring record

Example of page 2 completed Make notes here when PRN medications are administered, or agitation or behaviour is marked in the yellow or red zone on page 1

Further information • An information sheet has been developed to complement this presentation. Go to the Aged Health Network Resources area on the ACI website • The 24 -hour behavior monitoring record can be ordered by NSW Health staff via Stream Solutions (a division of Toll). Product code: NH 700562 Acknowledgements We would like to acknowledge the Clinical Nurse Consultants from across NSW who assisted with the development of this education package, the Clinical Excellence Commission and the Agency for Clinical Innovation – Aged Health Network.

Thank you for your time 1 Reserve Rd St Leonards NSW 2065 T + 61 2 9464 4666 F + 61 2 9464 4728 aci-info@health. nsw. gov. au www. aci. health. nsw. gov. au SHPN (ACI) 210598 ISBN 978 -1 -76081 -829 -6 TRIM ACI/D 21/1534