Tennessee Nurse - May 2021

May, June, July 2021 Tennessee Nurse Page 17
Workplace Violence De-Escalation Training
Lisa D. Beasley DNP, APRN, NP-C, RN
Introduction
According to the Occupational Safety and Health
Administration (2016), violence against nurses in the workplace
has been increasing in alarming numbers, with recent research
indicating the rise has spiked as much as 110%. Half of all
workplace violence is committed against healthcare workers.
In a health risk appraisal conducted by the American Nurses
Association, 1 in 4 nurses reported physical assault by a patient
or patient family member (2016). What makes this even more
disturbing is that these assaults go greatly underreported.
A surveillance report conducted by the Emergency Nurses
Association discovered that the majority of the 7,000 Lisa D. Beasley
emergency room nurses surveyed indicated assault by a
patient or patient family member and did not report the incident (2011). This growing
rate of assaults has sparked legislation on both national and state levels, including
the Workplace Violence Prevention for Health Care and Social Service Workers Act
which passed the United States House of Representatives in November of 2019. While
legislation has been implemented or proposed at the state level across the country,
many believe the penalties are not harsh enough.
Answering the Call
The University of Tennessee Health Science Center College of Nursing (UTHSC
CON) is taking action to empower nurses and other healthcare workers in recognizing
and de-escalating potential hostile situations. Dr. Sara Day, Professor and Assistant
Dean for Community and Global
Partnerships, leads the Management
of Aggressive Patient Situations (MAPS)
program through a grant obtained by the
Tennessee Hospital Association (THA).
The team includes Dr. Randy Johnson,
Associate Professor; Dr. Jacqueline Sharp,
Assistant Professor; Dr. Diana Dedmon,
Assistant Professor; Dr. Gabrielle Jackson;
and Dr. Lisa Beasley, Assistant Professor.
MAPS consists of a two-day program
that emphasizes active learning through
a variety of learning strategies for adult
LtoR: Dr. Nicole Knox, Christian
Brothers University participant,
engaging with Dr. Jacqueline (Jackie)
Sharp on de-escalation techniques.
learners. “MAPS is a ‘train the trainer’
program that certifies the trainer and
provides the necessary tools for trainers
to, in-turn, teach the program to nurses
and other healthcare professionals,” said
Dr. Day.
The Curriculum and Training
The curriculum was developed by faculty who completed the Management of
Aggressive Behavior instructor certification course through MOAB® International.
Commercial programs have limitations as they are designed for a general audience
and are expensive; however, MAPS is unique because it was designed by nurses to
meet the specific needs of healthcare providers and is offered without cost throughout
Tennessee. The current UTHSC CON MAPS team members present the original
curriculum and discuss the topics relevant to gaining the skills necessary to recognize
and subvert aggressive patient situations. Concepts for the learning outcomes
include cultural awareness, self-awareness and self-reflection, verbal and non-verbal
communication, strategies in therapeutic communication and emotional confrontation,
stages of conflict, and strategies to diffuse conflict in various stages. Real life situation
videos with standardized patients and healthcare providers were created to stress deescalation
techniques with patients in varying stages of conflict. “Our team has really
worked hard to engage participants and encourage discussion,” said Dr. Day, who also
commented that the teach-back method is incorporated into the training as part of
the certification requirement. The current team has trained nurse educators at Maury
Regional Medical Center in Columbia and faculty at Christian Brothers University
in Memphis with upcoming sessions scheduled with Vanderbilt Behavioral Health
and Jackson-Madison County General Hospital. MAPS training is well suited for any
healthcare facility employing nurses and for implementation into the curriculum of
nursing schools and colleges.
More information on violence against nurses in the workplace can be found on the
American Nurses Association website in the resource guide, “A Nurse’s Call to Action!”
at https://www.nursingworld.org/practice-policy/work-environment/end-nurse-abuse/.
The cost of MAPS training is paid for by the grant. To schedule the MAPS training
program for your institution, please contact Dr. Sara Day by email at sday5@uthsc.edu
or telephone at 901-930-8007.
About the author: Dr. Lisa Beasley is an assistant professor at the University of
Tennessee Health Science Center College of Nursing, Department of Health Promotion
and Disease Prevention in Memphis. Dr. Beasley is also the president of TNA District 1.
References:
ANA’s New Health Risk Appraisal Evaluates Nurses’ Health, Wellness, Safety. (2014). Georgia Nursing,
74(1), 1–2.
Emergency Department Violence Surveillance Report. (2011).https://www.ena.org/docs/defaultsource/resource-library/practice-resources/workplace-violence/2011-epdf?sfvrsn=5as81911_6
Occupational Safety and Health Administration. (2016). Workplace Violence in Healthcare
Understanding the Challenge. https://www.osha.gov/Publications/OSHA3826.pdf
Dr. Sara Day providing teach-back instructions to the Christian
Brother’s University participants.
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