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Workplace Violence Training Using Simulation

Brown, Robin G., BSN, RN, CHEP; Anderson, Shauna, MSN, RN, NE-BC; Brunt, Barbara, MA, MN, RN-BC, NE-BC; Enos, Trish, BS, BSN, RN, CPHQ; Blough, Keith, MBA; Kropp, Denise, BS, CCRP

AJN The American Journal of Nursing: October 2018 - Volume 118 - Issue 10 - p 56–68
doi: 10.1097/01.NAJ.0000546382.12045.54
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Workplace violence in health care settings is increasing dramatically nationwide. In response, an interdisciplinary team at an Ohio health system developed and piloted a model of training to address workplace violence. The model included classroom learning, a code silver (person with a weapon or a hostage situation) simulation training, and hands-on self-defense techniques. Based on data collected in the pilot, the team revised the model to offer a more comprehensive approach; the new, revised training program is known as Violence: enABLE Yourself to Respond. The team designed four distinct five-minute simulation scenarios depicting a range of threats from “escalating behavior” to “active shooter” and enacted them with standardized participants (health care personnel trained to perform specific behaviors in educational scenarios). Immediately after each simulation, the instructors facilitated a debriefing of the participants. Participants' pre- and post-training program self-evaluations of how prepared they felt to react to violent situations, as well as experts' evaluations of the participants' performance in simulations, provided evidence of the effectiveness of the model. Analysis of the data demonstrated a statistically significant positive difference in both participants' perception of their preparedness and experts' evaluation of their performance. The combination of classroom learning and simulation training is an effective, evidence-based method to prepare employees to respond when a situation escalates to violence, including the use of a weapon. This approach was designed for acute care but can be adapted to other settings. Skills learned can be used in both personal and professional life.

This article describes how an interdisciplinary team at an Ohio health system developed and piloted a training program to address workplace violence, which included classroom learning, simulation training, and hands-on self-defense techniques.

Robin G. Brown is manager of environment of care safety and emergency preparedness; Shauna Anderson is a unit director of nursing; Trish Enos is system director of performance improvement and quality assurance; and Keith Blough is chief of protective services and police—all at Summa Health System, Akron, OH. Barbara Brunt is an education consultant with Brunt Consulting Services, also in Akron, and Denise Kropp is a research associate, family and community medicine, at Northeast Ohio Medical University, Rootstown. Contact author: Robin G. Brown, brownr@summahealth.org. The authors have disclosed no potential conflicts of interest, financial or otherwise.

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