Content area
Full Text
Workplace violence is a topic with increased visibility both in discussion and in the literature. In 2018, The Joint Commission (TJC) addressed the topic of workplace violence in a sentinel alert. TJC has now published a "Quick Safety" article addressing de-escalation strategies that can be used in the health care arena, in addition to those described in the Sentinel Alert.
Overview
De-escalation strategies should be employed as the first line of defense when experiencing aggression and/or potential violence in the health care workplace. The increase in the number of instances in which nurses and nursing assistants are the victims of violence at the hands of patients and their family members gives rise to the need to be prepared. The areas reporting the greatest number of violence are the emergency department (ED), and geriatric and psychiatric settings. Even though there are no good data as to the efficacy of de-escalation, some studies have reported positive outcomes with de-escalation, including:
* "Preventing violent behavior.
* Avoiding the use of restraint.
* Reducing patient anger and frustration.
* Maintaining the safety of staff and patients.
* Improving staff-patient connections.
* Enabling patients to manage their own emotions and to regain personal control.
* Helping patients to develop feelings of hope, security and self-acceptance" (TJC, 2019, p. 1).
De-Escalation - What Is It and Why We Use it
Conflict resolution/management, defusing, talk down, and crisis resolution are terms with which many people are familiar and are actually forms of de-escalation. TJC (2019) describes de-escalation as "a combinaCopyright tion of strategies, techniques and methods intended to reduce a patient's agitation and aggression" (p. 1). Strategies used are intended to protect the patient and caregivers from harm through communication, assessment, actions, and self-regulation. Restraints and seclusion should be avoided due to the negative and even humiliating responses for the patient, and more importantly, the risk of serious injury and even death. Restraint use leading to unintended asphyxiation resulted in the death...