Nurses under threat: A comparison of content of 28 aggression management programs

Abstract

Staff who work in the health service are now recognized as a high-risk group for assault in the workplace. Recently, professional and industrial organizations have begun to suggest appropriate curricula for training staff in aggression management. However, there is currently a plethora of aggression management training programs (AMP) available, varying both in content and in duration. In this paper, 28 programs were evaluated against 13 major content areas derived from the recommendations made from key professional and industrial organizations, and what may be today considered appropriate/ideal content areas for AMP. Information on programs available in English was sought via standard databases, the Internet, program providers, and through networking with colleagues and professional organizations. The majority of the programs reviewed covered personal safety issues for staff and patients, together with legal issues. The use of restraint, pharmacological management of aggression and seclusion were features of programs specifically addressing the needs of health care staff in mental health settings. Most programs appeared not to address the psychological and organizational costs associated with aggression in the workplace. This is surprising since the literature suggests that the effects of violence are wide and varied, including increased absenteeism and sick leave, property damage, decreased productivity, security costs, litigation, workers' compensation, reduced job satisfaction together with recruitment and retention issues. Also, few programs were based on a systematic evaluation of their outcomes. Suggestions for program development and their teaching are discussed.

Workplace Violence Prevention Programs in Psychiatric Units and Facilities

“…ques for protection (Farrell and Cubit, 2005;Morrison & Love, 2003). The least common training components included review of policies, protocols, and the environment; pharmacological management of aggression; and the use of restraints.…”

Prevalence and Determinants of Workplace Violence of Health Care Workers in a Psychiatric Hospital in Taiwan

“…Active training of employees in high-risk groups, especially those with a moderate or high level of anxiety, may reduce workplace violence in psychiatric hospitals. Among many aggression management programs 29) , a training program of Nonviolent Crisis Intervention has been introduced to this hospital for all staff. It contains instruction on a series of skills for coping with assault situations including how to avoid kicking, hitting and how to escape when patients grasp hair or clothes.…”

Reducing aggressive behaviour and staff injuries: a multi-strategy approach

“…The focus of most studies has been on training staff to more effectively manage aggressive behaviour. 10,11 While the training of mental health staff has produced mixed outcomes, 12 it does seem to improve job satisfaction 13 and confidence in the management of violent individuals. 14 Providing support to victims of patient assault through a program of peer support has also been found to reduce the frequency of violence in mental health facilities.…”