Reducing Patient Aggression Through a Nonviolent Patient De-escalation Program: A Descriptive Quality Improvement...

Area of Science:

• Healthcare Safety
• Clinical Practice Improvement
• Emergency Response Systems

Background:

• Patient aggression poses significant risks to nursing staff and healthcare institutions globally.
• Effective systems are crucial for managing and mitigating aggressive patient behaviors in clinical settings.

Purpose of the Study:

• To implement and evaluate a Behavioral Emergency Response Team (BERT) program in acute care settings to enhance clinical practice safety.
• To provide healthcare teams with a structured system for reporting and de-escalating aggressive patient encounters.

Main Methods:

• A descriptive quality improvement project utilizing simulation-based training, patient safety rounds, and a BERT activation system.
• Data collection involved pre- and post-intervention surveys, aggression reports, safety rounds documentation, and BERT activation records.
• Analysis included descriptive statistics and the Wilcoxon signed-rank test on data from nursing personnel, dispatchers, and BERT responders.

Main Results:

• Successful design and implementation of an evidence-based BERT program mitigated patient aggression episodes.
• Nursing staff reported increased confidence and capability in managing aggressive patient behaviors.
• A partnership between security and nursing identified and intervened with 41 potentially aggressive patients, reducing harm risk. Reported aggression did not increase, possibly due to early detection or under-reporting.

Conclusions:

• Healthcare organizations require robust systems to manage aggressive patient encounters effectively.
• Comprehensive strategies, including simulation training, BERT responders, and nursing-security partnerships, are vital for managing patient aggression.