Enhancing staff competence in managing autism spectrum disorder: a quality improvement project in inpatient psychiatric care

Purpose Autism spectrum disorder (ASD) presents unique challenges in inpatient psychiatric settings due to frequent emotional dysregulation and aggressive behaviors, compounded by a lack of specialized staff training. This quality improvement project aims to evaluate the impact of Applied Behavior Analysis (ABA)-based training on staff knowledge, comfort and patient care in a psychiatric hospital. Design/methodology/approach Conducted at a facility managed by the Department of State Health Services, the project involved 35 staff members from the children and adolescent unit, with 25 participating in a mandatory two-day workshop led by an experienced ABA specialist. Pre- and posttraining questionnaires assessed staff knowledge of ASD and their comfort in handling challenging situations, alongside data on the frequency of holds, restraints and emergency medication usage for patients with ASD over two six-month periods. Findings Results showed significant improvements in staff knowledge and comfort, with posttraining scores higher than pretraining scores (p = 0.006). In addition, the use of mechanical restraints decreased from 61 to 29 instances, while personal holds increased from 36 to 67 instances, indicating a shift toward less invasive interventions. The frequency of emergency medication administration also decreased from 66 to 39 instances (d = 0.36). Originality/value These findings highlight the effectiveness of ABA-based training in enhancing staff competence and reducing reliance on restrictive measures, advocating for broader implementation of such training programs to improve outcomes for patients with ASD in psychiatric settings.