Employing a positive behaviour support approach on a neuro-behavioural ward: A service evaluation

Background:Outcomes from neuro-behavioural wards can be overlooked due to the complex and varied presentations and difficulty in establishing the ingredients contributing to functional improvements. Methods:A service evaluation was conducted on an adult Neuro-behavioural Rehabilitation Unit (NRU) at the Royal Hospital for Neuro-disability (RHN) (2015-2022). Primary aims were to examine demographic characteristics and assess the functional benefits of admission to a setting that utilises a positive behaviour support (PBS) approach as indicated by the Functional Independence Measure and Functional Assessment Measure (FIM+FAM) and Swansea Neurobehavioural Outcome Scale (SASNOS) scores. Results:The FIM+FAMs of 53 patients (38% female; mean age 44) were included. The majority of patients were White British (60%). Most patients were admitted to the NRU following a traumatic brain injury (TBI; 41%), and admission was, on average, seven months after their injury. The results show that the mean FIM+FAM score revealed significant statistical improvement from admission to discharge. Improvement is also seen in all domains and almost all sub-domains of the SASNOS. Conclusion:The findings support an association between admission to a neuro-behavioural rehabilitation setting providing PBS and improvements over time. Careful selection of outcome measures and consistent completion is necessary to support successful funding applications for neuro-behavioural rehabilitation services.