An education program to reduce violence against emergency department nurses
Michael Zielinski II, DNP, MSN, RN, APN, CEN, EMT
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Session A presented Thursday, September 14, 2017
Purpose: An Evidence-Based Practice (EBP) change project was designed to educate nurses in the ED on how to recognize, de-escalate, and mitigate violence encountered while working. This will enhance their daily practice, make the workplace environment safer, and improve patient outcomes. The financial benefit to the institution is intended to increase job satisfaction, decrease staff injuries, call outs and staff turnover. Educating nurses to maintain a safe and secure work environment is beneficial to all; the nurses, their patients, patient families and visitors.
Design: The EBP change project consisted of the implementation of five educational modules on “What is Violence?”, “How to Recognize Violent Behaviors”, “How to De-Escalate Violent Behaviors”, “How to Mitigate Violent Behaviors” and “Bringing It All Together”. Pre and post surveys were used. The results of the surveys were analyzed to determine if an education program helped to increase knowledge on the recognition, de-escalation and mitigation of violent behavior.
Setting: The project setting was a large suburban healthcare system with three campuses in South Jersey. Each ED is equipped with state of the art equipment and each ED is divided into two centers for patient care, one for acute care and the other for sub-acute care. Each of the three EDs have private treatment rooms, a reception area, with separate children's wait area, private rooms for consultation, and helipad. Only one location offers 24 hour Pediatric Emergency Care.
Participants/Subjects: Population for the EBP change project were ED RNs in the suburban hospital's three EDs. ED RNs were 18 years of age or older, of both genders, including all ethnicities. ED RNs were licensed to practice in New Jersey and qualified to work within the ED setting of the targeted project sites.
Methods: Each of the five learning modules had an independent survey to assess knowledge gained specific to the defined module. All module surveys were scored and evaluated in a consistent manner. Each module knowledge survey was comprised of five multiple choice statements. The knowledge survey tool was self-developed by the author. Regarding each survey, the scores for individual surveys were calculated as a percentage based on the number of questions answered correctly (# answered correct / 5x 100 = % score). Respondent scores could range from “0” (no correct responses) to “100” (all correct responses).
Results/Outcomes: There were 69 participants. Not all participants completed a pre and post survey. An item analysis of the questions for each education module showed that there was an increase in knowledge from pre to survey.
Implications: Implications of this EBP change project indicate that an on-going and realistic education program on how to recognize, de-escalate and mitigate violent behaviors has been an effective method to reduce violence against nurses. This will allow ED registered nurses to provide excellent care to their patients while enjoying a safe work environment.
ENA 2017: Education, Networking, Advocacy. Held at America's Center Convention Center, St. Louis, Missouri, USA
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