De-escalation Training for Obstetric/Neonatal Health Care Workers to Improve Confidence in Managing Workplace Violence.

Objective: To improve the confidence level of obstetric/neonatal health care staff in managing episodes of workplace violence.

Design: Quality improvement project with a pretest/posttest survey design.

Setting/local problem: A large, urban, academic medical center where an increase in episodes of workplace violence was observed in the obstetric/neonatal department.

Participants: Eighty-seven staff members from the interdisciplinary health care team in the obstetric/neonatal department participated in the quality improvement initiative.

Intervention/measurements: Crisis Prevention Institute de-escalation training was customized with scenarios commonly seen in obstetric/neonatal settings. Fourteen training sessions were offered to obstetric/neonatal staff during a 4-month period. Measurable outcomes included participant satisfaction, number of security calls to the obstetric/neonatal units, and clinician confidence in coping with patient aggression at baseline, 2 weeks posttraining, and 3 months postintervention.

Results: In the obstetric/neonatal department there was an increase in rates of completion of Crisis Prevention Institute de-escalation training from 1.7% to 19% during the study period. Scores for overall clinician confidence in coping with patient aggression significantly improved from baseline at 2 weeks posttraining (from 43.51 to 68.50 [p < .001]) and at 3 months posttraining (from 43.51 to 71.54 [p < .001]).

Conclusion: Customized de-escalation training sessions can contribute to active participation in de-escalation training and improvement in clinician confidence in coping with patient aggression.