Use Of De-Escalation Techniques Reduce Workplace Violence Use Of De-Escalation Techniques Reduce Workplace Violence Research: Literature Synthesis: Patient Aggr

Use Of De-Escalation Techniques Reduce Workplace Violence

Use Of De-Escalation Techniques Reduce Workplace Violence

Research: Literature Synthesis: Patient Aggression Risk Assessment Tools in the Emergency Department
Non-research: Ensuring Workplace Safety: Evidence Supporting Interventions for Nurse Administrators.

 

Only use template provided (APA format)

not including cover page, 4-5pgs

 

 

Must include.

Recommended Practice Change

· Be sure you include your recommendation for your practice change, using your EBP question (remove the comparison)

· Next, State how the research article supports this practice change recommendation, then include the in-text citation at the end of the statement

Example: The research article demonstrated use of Pilates increased strength, balance, and reduced falls among participants (Smith, 2020).

· Finally, state how the non-research articles supports this practice change recommendation, then include the in-text citation at the end of the statement

· All of these elements must be included for this section to pass

5. Key Stakeholders

· State 3 stakeholders (by their position- wound nurse, nurse educator, nurse administrator, etc) and state their role in helping get the practice change started. They each need a different role (job)

based risk management should be emphasized to assess and reduce violent behavior, but there appears to be a noticeable lack of assessment tools and interventions available.2 In addition, few programs are based on a systematic evaluation of outcomes, and there is little information available to support health care providers in choosing one program over another.3

The purpose of this systematic review of the literature was to evaluate the use of aggression risk assessment tools regarding workplace violence (WPV) in the emergency department and the reduction of the future risk of violence toward ED health care staff. The research question addressed in this systematic review was as follows: Does the use of an aggression risk assessment tool reduce the future risk of violence toward the health care worker? The focus was on reduction of potential violence toward staff in the ED setting. Use Of De-Escalation Techniques Reduce Workplace Violence

Methods

Evaluation of the evidence was completed using a 7-step systematic review method.4 The 7 steps are formulating a research question, developing a research protocol, com- mencing a literature search, performing data extraction, conducting a quality appraisal, performing data analysis and reviewing the results of the included studies, and interpret- ing the results.4

The initial search inquiry used 3 electronic databases: CINAHL (Cumulative Index to Nursing and Allied Health Literature) Plus with Full Text, Medline, and PsycINFO. Limitations were set to include only research conducted in the period from January 2009 through September 2014, English-language studies, and research published in peer- reviewed journals. In an effort to gain the greatest depth of knowledge, the following search terms were used in multiple combinations: WPV, violence, patient aggression, patient assault, aggression risk assessment tool, violence risk assessment tool, predicting violent behavior, nursing, and emergency department. The initial search using the combination of search terms yielded 589 research journal

WWW.JENONLINE.ORG 19

 

 

CLINICAL/Calow et al

articles. Internet searches of government Web sites and professional organizations were also conducted, producing position statements, toolkits, and discussion papers regarding WPV in the emergency department. In addition, references of articles were scanned to identify additional relevant articles. A preliminary review of the literature for inclusion was conducted by reviewing the title of the article for relevancy (N = 589). A further review of the literature for inclusion was conducted by reviewing the abstract of the article (N = 56). Our final review of the literature for inclusion was conducted by a full review of the article (N = 13).

INCLUSION AND EXCLUSION CRITERIA

Articles included in the synthesis of the literature were original research studies of any research design, written in the English language, published between the years 2009 and 2014, and published in peer-reviewed journals. Articles were also chosen based on answering the research question specifically addressing WPV in the ED setting and use of an aggression risk assessment tool. Because of the limited amount of research in the literature specific to violence risk assessment tools in the emergency department, the search was expanded to include violence risk assessment tools in the inpatient setting, including psychiatric and medical-surgical units.

Because the nature of this synthesis of the literature was to apply findings specifically to clinical practice in the ED and inpatient setting, research conducted in outpatient and extended-care facilities was excluded. Although multiple articles were available related to WPV in the ED setting, articles were excluded if they did not discuss the specific use of a tool to assess the risk of violent behavior from a patient toward a health care worker.

An exception to the inclusion criteria was the use of articles published in 2007 specific to the Staring, Tone and volume of voice, Anxiety, Mumbling, and Pacing (STAMP) violence risk assessment framework.5 Several studies following the 2007 publication of research related to the STAMP violence risk assessment framework have cited STAMP as foundational work regarding violence risk assessment specific to the emergency department. Use Of De-Escalation Techniques Reduce Workplace Violence

LITERATURE SYNTHESIS

The literature showed that violence risk assessment tools have been implemented in various health care settings (Appendix Table). In total, the use of 9 different violence risk assessment tools emerged from the literature across the various settings, 3 in emergency departments, 4 in psychiatric settings, and 2 in medical-surgical inpatient units. Although one specific violence risk assessment tool

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was not consistently implemented across the literature, variations of the STAMP violence assessment framework emerged in 3 articles specific to the emergency depart- ment,5–7 variations of the Brøset Violence Checklist (BVC) emerged in 2 articles specific to psychiatric units,8,9 and a variation of the M55 Violence Risk Assessment Tool emerged in 2 studies in medical-surgical areas.10,11

ED SETTING

Three violence risk assessment tools implemented in the ED setting emerged from the literature: (1) STAMP violence assessment framework5–7; (2) Assessment, Behavioral indicators, and Conversation (ABC) of violence risk assessment at triage12; and (3) five attributes of caring to avert violence (being safe, being available, being respectful, being supportive, and being responsive).13

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