Abstract
This study describes the development of the Disruptive Behavior Impact Assessment (DBIA) designed to measure three aspects of severity of 44 disruptive behaviors: (1) the resources used to address DBs (e.g. increased patient care time), (2) the physical impact of DBs (e.g. injury to the patient or others), and (3) the psychological impact of DBs on staff. Data were collected prospectively for 21 consecutive shifts on each of 240 institutionalized subjects diagnosed with cognitive impairment, psychiatric, and mixed diagnoses. The contexts and impacts of 894 episodes of disruptive behavior are described. Although 25% of all disruptive behaviors required no intervention, those receiving intervention required 24 minutes to manage the 'average' disruption, the majority of which was spent on direct care. Physical impact included injuries to others (0.8%) and physical damage to the environment (0.9%). The average caregiver reported minimal emotional adverse affect from DBs.
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