Revisiting Therapeutic Communication as an Evidence-Based Intervention to Decrease Violence by Patients Against Staff on Psychiatric Wards-A Quality Improvement Project.

Abstract

Background: Violence against healthcare workers continues to be a widespread problem and adversely impacts both healthcare providers and consumers.

Objectives: To evaluate the effectiveness of a staff education and training program in therapeutic communications in decreasing violence by patients against staff in an acute inpatient behavioral hospital. Further, the project measured the effect of the training on the self-efficacy and knowledge level of the 15 recruited staff in the use of therapeutic communications, and its overall impact on the participants' reaction, learning, behavior and observed results at the hospital.

Methods: This study used a pretest and posttest design.

Results: There was a decrease (73%) in violence incidents which correlated with the staff training and education sessions compared with violence occurrence incidents during the 12 weeks preceding the implementation. There was also a significant increase in the staff's self-efficacy, {t(-11.4), df = 114, p < 0.001}, and knowledge level {t(-10.40), df = 14, p < 0.001)} in the use of therapeutic communications, and an overall positive impact on staff's reaction, learning, behavior and observed effects as a result of the training program.

Conclusion: Staff training in effective therapeutic communications had a multidimensional effect, the most important was its effect on decreasing violence. These findings underscore the need to revisit and emphasize therapeutic communications in promoting a safety culture in behavioral health settings.