Evaluation of Training in De-escalation

Effects of a Brief De-escalation Training Program on Student Nurses' Skills and Confidence Level in Coping With Patient Aggression: a Cluster Randomized Controlled Study

The purpose of the study is to evaluate one of the chapters in the new national Norwegian training manual (MAP). The chapter that is selected to be evaluated is the chapter on de-escalation. Effective training in this topic should not only lead to changes in the level of knowledge and attitudes, but also changes in behavior and skills. Experiencing better preparedness does not necessarily entail a change in behavior. This study wants to test whether training in de-escalation changes the participants' skills and experience of self-confidence, security and coping in threatening situations.

Study Overview

• Status: Completed
• Conditions: De-escalation Skills
• Intervention / Treatment: Behavioral: Training in de-escalation

Detailed Description

The theme is:

• Evaluation of the training program of de-escalation for third-year nursing students

Underlying research questions will be:

• Will the intervention provide increased de-escalation skills?
• Will training in de-escalation provide increased confidence in coping with patient aggression?

The design used to answer the research questions is a cluster-randomized controlled study with an intervention group and a control group.

The two study groups with nursing students will be exposed to two different scenarios (A and B) with simulated patient situations. Students will conduct simulation A before the intervention and simulation B the same day after the intervention. A control group will also be included which will review scenarios A and B without intervention. The purpose of this is to see if the scenarios in isolation give any effect on the pre- and post-measurements.

Participants will also be asked to complete a questionnaire (Thackreys, 1987) related to experienced coping security related to aggression management at four different times.

The scenarios will be recorded on video. Following all video data collection, 2 de-escalation experts will independently review the video data and quantify it using the EMDABS instrument. They will be blinded and not aware of whether the video was recorded before or after the intervention. The data that this generates will then be statistically examined.

The selection of participants will be made from three classes with third year nursing students. The classes consist of about 50 students. Participation is voluntary.

It is uncertain how many will participate, but on the basis of practical limits there is an upper limit of 15 participants per class for the intervention group (the selection is recruited from two classes), and 30 participants from the control group (the selection is recruited from a class). A total of n = 30 is desired in both the intervention group and the control group.

The following two outcomes will be analyzed; de-escalating behavior (EMDABS, Mavandadi et al., 2016) and confidence in coping with patient aggression (Thackrey, 1987).

• Study Type: Interventional
• Enrollment (Actual): 45
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Norway
  • Bergen, Norway
    • Bergen University College

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 60 years (ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Third year nursing student

Exclusion Criteria:

• Has to talk and understand Norwegian

Study Plan

How is the study designed?

Design Details

• Primary Purpose: PREVENTION
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: SINGLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Third year nursing students - intervention; Third year nursing students will receive the intervention in de-escalation training	Behavioral: Training in de-escalation; Will receive one hour of de-escalation training
NO_INTERVENTION: Third year nursing students - control; Third year nursing students will receive no training in de-escalation

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in de-escalation skills: Baseline	Instrument: "English Modified De-escalating Aggressive Behaviour Scale" (Mavandadi & Bieling, 2016)	Immediately before and immediately after intervention (single day, baseline)
Changes in de-escalation skills	Instrument: "English Modified De-escalating Aggressive Behaviour Scale" (Mavandadi & Bieling, 2016)	Immediately before and immediately after intervention (single day, 6 months post-baseline)
Changes in de-escalation skills	Instrument: "English Modified De-escalating Aggressive Behaviour Scale" (Mavandadi & Bieling, 2016)	Immediately before and immediately after intervention (single day, 9 months post-baseline)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in coping and confidence	Instrument: "Clinicians confidence in coping with patient aggression" (Thackreys, 1987)	Immediately before and immediately after intervention (single day, baseline)
Changes in coping and confidence	Instrument: "Clinicians confidence in coping with patient aggression" (Thackreys, 1987)	Immediately before and immediately after intervention (single day, 6 months post-baseline)
Changes in coping and confidence	Instrument: "Clinicians confidence in coping with patient aggression" (Thackreys, 1987)	Immediately before and immediately after intervention (single day, 9 months post-baseline)

Collaborators and Investigators

• Sponsor: Bergen University College
• Collaborators: Helse-Bergen HF
• Investigators: Study Chair: Kjersti Alsaker, PhD, Bergen University College

Study record dates

Study Major Dates

• Study Start (ACTUAL): February 18, 2019
• Primary Completion (ACTUAL): November 26, 2019
• Study Completion (ACTUAL): June 30, 2020

Study Registration Dates

• First Submitted: April 10, 2019
• First Submitted That Met QC Criteria: April 22, 2019
• First Posted (ACTUAL): April 23, 2019

Study Record Updates

• Last Update Posted (ACTUAL): August 5, 2020
• Last Update Submitted That Met QC Criteria: August 3, 2020
• Last Verified: August 1, 2020

More Information

Terms related to this study

• Keywords: Aggression; De-escalation; Violence prevention
• Additional Relevant MeSH Terms: Behavioral Symptoms; Aggression
• Other Study ID Numbers: 716537

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No