| Primary Author: | Deirdre O. Rea, MSN, RN |
| Co-Principal Investigators/Collaborators: | Natasha Obrist, BSN, RN |
| Organization: | Carilion Clinic |
Abstract
Purpose
The purpose of this study is to examine the effect of Non-Violent Crisis Intervention Training (CPI) on nursing personnel’s perceived confidence and skills in managing aggression.
Background
Assault and violence rank among the nation’s leading causes of occupational injuries. Violence in healthcare is growing with frontline nursing personnel three times more likely than other occupations to be victims of patient and family aggression. National organizations identify a lack of staff training as a precursor to violence. Violence is most prevalent in the emergency department and on psychiatric units, but medical-surgical floors also encounter violence. At our hospital, a Code Secure is called when a patient becomes aggressive and staff feel there is a threat to safety. In 2012, medical units called 573 Codes Secures.
Materials & Methods
A convenience sample of 29 medical-surgical nursing personnel completed a six-hour de-escalation training and a pre and post-intervention survey, the Confidence in Coping with Patient Aggression instrument. This validated survey consists of 10 questions, with a response scale ranging from very uncomfortable to very comfortable. Participants were asked about previous experiences with work-related violence and trainings regarding violence prevention.
Results
Of study participants, 96.15% reported verbal aggression from patients in the past 12 months, 82.1% had experienced physical assault, 77.8% identified aggression as a problem on their unit, and 75% reported no prior education in managing aggression. Crisis Intervention Training had a significant effect on nursing personnel’s perceived sense of confidence and skills in managing aggression in all areas measured. (2.86748E-09; p= 0.0). There was a 1.735 point increase in confidence in managing aggression.
Conclusion
The results indicate that focused training increases nursing personnel’s perceived confidence and skills in managing aggression. Findings also indicate that violence in the healthcare setting is a real issue for staff who need education in how to assist patients and families manage the stresses often associated with illness and hospitalization.
Bibliography
- Centers for Disease Control and Prevention/NIOSH. (2002). Violence: Occupational hazards in hospitals (No. 2002-101): National Institute for Occupational Safety and Health.
- Colling, R. & York, T. (2010). Chapter 19: Preventing and managing healthcare conflict and violence, Hospital and healthcare security (5th ed., pp. 483-504). Doi: 10.1016/B978-1-85617-613-2.00019-7.
- McPhaul, K. & Lipscomb, J. (2004). “Workplace Violence in health Care: Recognized but not regulated.” Online Journal of Issues in Nursing, (9)3.
- Occupational Safety and Health Administration (OSHA). (2004). Guidelines for preventing workplace violence for healthcare and social service workers (No, OSHA 3148-01R). Washington, DC: U.S. Department of Labor & OSHA.
- Thackrey, M. (1987). Clinician confidence in coping with patient aggression: Assessment and enhancement. Professional Psychology: Research and Practice, (18)1, 57-60.
© Improvement Science Research Network, 2012
The ISRN published this as received and with permission from the author(s).