Effectiveness of De-Escalation Training to Medical-Surgical Nurses

Nurses are the most common victims of workplace violence and typically are not equipped deliver appropriate prevention interventions. Although most violent episodes occur in the emergency department and mental health units, violence towards nurses on the medicalsurgical units is on the rise. Patient perpetrated aggression and violence is positively correlated with poor patient outcomes and length of stay. In addition to the physical effects on the nurse, there are psychological effects that can impact their career and personal life. The direct and indirect cost for an organization includes decreased productivity, increased absenteeism, and turnover. In potentially violent situations, nurses must be able to recognize escalating behavior, respond in ways that will de-escalate the behavior and gain cooperation of the patient. Nurses should have the knowledge of psychological risk factors for patient aggression, skills to recognize the signs of agitation and possess verbal skills and physical techniques to deal with the situation. Evidence supports educating acute care nurses on de-escalation techniques will increase their confidence and utilization of the techniques when faced with an agitated patient thus preventing a violent event. This quality improvement project provided acute care medicalsurgical nurses with knowledge of psychological risk factors for violence, a tool to assess patient behavior for signs of agitation and techniques to use to de-escalate and gain cooperation of the patient. A pre and post-test design was used to measure the confidence level of acute care nurses when coping with patient aggression prior to the educational sessions and at two-weeks and fourweeks post educational sessions