Innovative Behaviour Support Role in the ED

Included in the photo are Dr. Adam Nicholson, Chief & Medical Director of Emergency Services; Mikyla Lennard, Clinical Manager of ED; Norielynn Baldoza, Behaviour Support RN in the ED; Mélissa Laroche, Advanced Practice Nurse in Geriatrics; and other QCH ED nurses.

Being hospitalized can be stressful for anyone. For people living with a cognitive impairment, being in a new environment with unfamiliar people – like an Emergency Department – can lead to escalated and unpredictable behaviour.

Caring for these patients requires specialized knowledge, which is not always covered in standard university education for clinical staff. To fill this gap, Queensway Carleton Hospital, in collaboration with the Center for Aging and Brain Health Innovation (CABHI), created a Behaviour Support Registered Nurse role in the Emergency Department.

This new role offers coaching to our frontline ED staff, empowering them with the skills and knowledge to provide appropriate care for patients in behavioral emergencies, specifically in the ED setting. The approach involves early identification of patients living with dementia who are at risk of having behavioural escalations. Geriatric assessments are conducted, and the team offers support to caregivers.

“Having a role in the Emergency Department that is dedicated to providing behavioural support provides our ED team with a better understanding of potential triggers and interventions to mitigate, reduce, and manage these behaviours safely and effectively,” says Mélissa Laroche, Advanced Practice Nurse in Geriatrics at QCH, who lead the project.

“Not only does the role enhance patient care, but it minimizes safety risks for our teams and for our patients living with dementia.”