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Impact of Behavior Management Training on Nurses' Confidence in Managing Patient Aggression

de la Fuente, Margarita, DNP, RN, RN-BC, NE-BC; Schoenfisch, Ashley, PhD, MSPH; Wadsworth, Barbara, DNP, RN, FACHE, FAAN, NEA-BC; Foresman-Capuzzi, Joyce, MSN, RN, APRN, CEN, CCRN

JONA: The Journal of Nursing Administration: February 2019 - Volume 49 - Issue 2 - p 73–78
doi: 10.1097/NNA.0000000000000713

OBJECTIVE The aim of this study was to evaluate the impact of behavior management training on nurses' confidence in managing aggressive patients.

BACKGROUND Nurses are at a high risk of experiencing violence directed toward them by patients.

METHODS This quality improvement project used a pre-and-post study design. A survey was administered within 1 month before behavior management training and 1 month after training, capturing participants' demographic and work characteristics, as well as their experiences with patient/visitor-perpetrated violence. Confidence was measured using the Confidence in Coping with Patient Aggression Instrument. Open-ended questions sought participants' thoughts on workplace violence prevention initiatives.

RESULTS Thirty-eight confidence scores were assessed. Nurses' confidence in coping with patient aggression was significantly higher after behavior management training. Nurse participants described the training as “timely,” “helpful,” and “beneficial.”

CONCLUSION With an increased understanding of violent behavior stages and warning signs, a nurse is better able to manage a potentially violent situation.

Author Affiliations: DNP Student (Dr de la Fuente) and Assistant Professor (Dr Schoenfisch), Duke University, School of Nursing; and Senior Vice President and Chief Nursing Officer (Dr Wadsworth) and Clinical Nurse Educator (Ms Foresman-Capuzzi), Main Line Health, Bryn Mawr, Pennsylvania.

The authors declare no conflicts of interest.

Correspondence: Dr de la Fuente, Main Line Health, 130 S Bryn Mawr Ave, Bryn Mawr, PA 19010 (

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