Abstract
Background: Over the last decade, emergency departments (ED) have seen an increase in workplace violence (WPV) enacted by patients and visitors against healthcare workers, affecting healthcare organizations worldwide and posing significant consequences for patients, employees and employers (Gillespie et.al, 2014; Kowalenko et.al, 2013; Berlanda et.al, 2019).|Objective: The project purpose was to implement a de-escalation education and training for ED nurses designed to increase staff knowledge of behavior cues for escalating patient behavior, increase staff confidence in coping with escalating patient behavior, and decrease WPV events.|Methods: This pre-and-post study design project was conducted at a large Midwest Academic Medical facility. The Confidence in Coping with Patient Aggression (CCWPA) tool was used to measure changes in nurses’ confidence levels and a paired t-test was used to analyze the data.|Results: Five nurses completed the pre/post CCWPA and de-escalation training. The average total score on the post CCWPA tool was 72.4 (sd = 14.3) compared to a pre CCWPA score of 62.8 (sd = 11.5). The results were not statistically significant, p = .12, 95% CI (-3.6, 22.8), however, the CCWPA scores did increase from pre to post in 80% of participants.|Conclusion: ED staff are often victims of workplace violence which leads to increased stress and burnout. Further education and training on the early identification and intervention prior to escalating patient behavior may increase nurses’ confidence in caring for patients and reducing WPV.|Keywords: Workplace violence, aggressive patients, Confidence in Coping with Patient Aggression, violence risk assessment, and de-escalation training.