Abstract
BackgroundThe high incidence of workplace violence (WPV) in clinical mental health settings has caused a series of negative impacts on nurses, which has subsequently increased public concern. De-escalation (DE) is recommended as a training program which aims at providing nurses with skills and strategies to more effectively respond and manage WPV. Very few studies have examined the effectiveness of DE training, with current studies possessing various limitations due to their design and small sample sizes. By using a cluster randomized controlled design, the proposed study aims to evaluate the effectiveness of a CRCSE-based DE training programs among psychiatric nurses.MethodA cluster randomized controlled trial, with a 6-month follow-up period after the end of the intervention, will be conducted among psychiatric hospitals in Guangdong, China. The randomization unit is each involved psychiatric hospital. Participants in the control group will be assigned to routine WPV management training, participants of the intervention group will undergo the same training while additionally receiving DE training. The DE training will include the following five modules: communication, response, solution, care, and environment (CRSCE). Primary outcomes are objective clinical indicators, which will be extracted from the information systems of the enrolled hospitals. These include the incidence of WPV, injuries caused by WPV, and the use of coercion (physical restraint and seclusion) by nurses. Secondary outcomes, aims at evaluating the effects of DE training on nurses, include the capacity of DE, DE confidence, level of job burnout, and professional quality of life. Data will be collected at baseline (T0), at 3 months (T1, intervention completed), and at 6 months after intervention (T2, follow-up).DiscussionThis study will offer trial-based evidence of the efficacy of a DE training program targeted at WPV among psychiatric nurses. DE training is expected to reduce both the total incidence and negative impacts of WPV, with additional improvements in psychiatric nurses’ coping skills.Trial registrationChinese Clinical Trial Registry, ChiCTR1900022211. Prospectively registered on 30 March 2019.
Highlights
The high incidence of workplace violence (WPV) in clinical mental health settings has caused a series of negative impacts on nurses, which has subsequently increased public concern
This study will offer trial-based evidence of the efficacy of a DE training program targeted at WPV among psychiatric nurses
The aim of this study is to evaluate the effectiveness of a DE training program using the CRSCE core components among Chinese psychiatric nurses
Summary
The high incidence of workplace violence (WPV) in clinical mental health settings has caused a series of negative impacts on nurses, which has subsequently increased public concern. De-escalation (DE) is recommended as a training program which aims at providing nurses with skills and strategies to more effectively respond and manage WPV. By using a cluster randomized controlled design, the proposed study aims to evaluate the effectiveness of a CRCSE-based DE training programs among psychiatric nurses. Other studies reported that approximately 56.1 to 70% of psychiatric nurses expressed experiences of being physically assaulted by patients at the workplace [6, 7]. In China, WPV-related issues have become increasingly serious, with approximately 82.4 to 94.6% of Chinese psychiatric nurses reporting that they had suffered from at least one type of WPV in the last year, with the incidences of verbal abuse, physical assaults, and sexual harassment being 78.6 to 92.1%, 61.5 to 81.9%, and 18.6 to 42.9%, respectively [8, 9]
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