Improving De-escalation Techniques in Primary Care: A Quality Improvement Project

Background: Workplace violence is increasing in the primary care setting. Interventions are necessary to de-escalate aggression and maintain workplace safety. This quality improvement project implemented a de-escalation training program to equip healthcare workers with confidence in de-escalating agitated, aggressive, and violent behavior in the primary care setting. Methods: This project employed a pretest-posttest design and was implemented at a family and a pediatric primary care clinic. Twenty healthcare workers participated in the de-escalation training program implemented over 13 days utilizing three sequential elements: 1) verbal and nonverbal de-escalation skills training, 2) simulation exercise, and 3) debriefing session. The Confidence in Coping with Patient Aggression Instrument measured healthcare workers’ confidence in coping with aggression pre-and post-intervention. The Satisfaction with Simulation Experience Scale measured healthcare workers’ satisfaction level with the simulation exercise and debriefing session. Descriptive statistics analyzed participants’ confidence levels and satisfaction with the training program. Paired t-tests analyzed participants’ changes in confidence level of coping with aggression pre-and-post de-escalation training program. Results: Participants’ confidence levels significantly increased from baseline (M = 54.1, SD = 24.5) to post de-escalation training program (M = 77.5, SD = 18.0) (t = - 4.84, p < .0001). Participants demonstrated substantial satisfaction with the simulation exercise and debriefing session (M = 81.3, SD = 12.4). Conclusion: The de-escalation training is a promising intervention to promote management of workplace violence. This training program may be implemented in other primary care settings to reduce workplace violence. Keywords: workplace violence, primary healthcare, de-escalation techniques, simulation, healthcare workers

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Work Title Improving De-escalation Techniques in Primary Care: A Quality Improvement Project
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Penn State
Creators
  1. Julie LaRue
Keyword
  1. DNP Project
License In Copyright (Rights Reserved)
Work Type Project
Acknowledgments
  1. Doctor of Nursing Practice committee members: Kelly A. Wolgast, DNP, RN, FACHE, FAAN; Ying-Ling Jao, PhD, RN; Diane Berish, PhD, MA
Publication Date April 30, 2021
DOI doi:10.26207/8s2b-dr97
Deposited April 30, 2021

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    • Doctor of Nursing Practice committee members: Kelly A. Wolgast, DNP, RN, FACHE, FAAN; Ying-Ling Jao, PhD, RN; Diane Berish, PhD, MA
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