De-escalation training for pyschiatric/mental health nurse practitioner students

Abstract

Workplace violence towards nurses is occurring at alarming rates throughout Montana and the United States. Verbal de-escalation is recommended for the prevention and management of aggressive patients in health care settings. However, de-escalation training is not required to be provided in nursing education programs. The purpose of this project was to develop, implement, and evaluate simulation-based verbal de-escalation training for psychiatric/mental health graduate nursing students on the prevention and management of aggressive patient behavior. The de-escalation training included an education module and simulated scenario using a simulated patient behaving as an agitated psychiatric patient. Confidence levels before and after the training were measured with the Confidence in Coping with Patient Aggression (CCWPA) scale and de-escalation techniques were assess with the English Modified De-escalating Aggressive Behavior scale (EMDABS). Strengths and weakness of the de-escalation techniques used in the simulation were identified and discussed. Overall scores on the CCWPA increased after the training. All participants received EMDABS scores representing acceptable de-escalation techniques. Identified strengths include use of a calm demeanor and maintaining a safe distance. Weakness include use of emotional suppression, limited use of inference, and lack of confidence. De-escalation training can positively affect nurses' confidence levels for coping with patient aggression. Use of a simulated patient scenario can provide a high-fidelity mental health experience that is effective for practicing de-escalation techniques. Participants reported that they felt the training was beneficial to their education and recommended that de-escalation training with a simulated patient be required in all nursing education.