Disruptive behavior may take the form of:
(1) verbal abuse or hostility
(2) physical actions - throwing things, inappropriate physical contact
(3) passive-aggressive behaviors (withholding of participation, delays, failures, etc.)
(4) emotional lability or aberrant behaviors
The behavior becomes significant when it negatively impacts or has the potential to impact an organization or patient care.
Reasons for disruptive behavior:
(1) immaturity
(2) manipulative behavior
(3) substance abuse
(4) emotional problems such as depression and anger
(5) serious psychiatric problems
(6) stress from overwork or exhaustion
(7) physical illness (pain, insomnia, other)
Pattern of disruptive behavior:
(1) predictable, repetitive
(2) episodic (brief periods separated by absence of long periods)
(3) single instance
False positives diagnosis of disruptive behavior:
(1) Criticism offered in good faith with the aim of improving patient care.
(2) Legitimate anger at failures by a healthcare organization to provide appropriate equipment, supplies or services.
Requirements for an organization:
(1) There should be policies that define disruptive behaviors and the procedures for reporting it.
(2) There should be methods for investigation and due process.
(3) Affected providers should be referred for corrective action.
(4) There should be ongoing monitoring to document the effectiveness of any intervention.
(5) People reporting disruptive behavior in good faith should be protected.
(6) There should be safeguards in place to prevent abuse in the system.
