Reviewing the evidence base for de-escalation training: a rapid evidence assessment
Aug 7, 2019
RAND Europe conducted a rapid evidence assessment of the de-escalation training literature and found that training may help staff manage patient violence and aggression but de-escalation training may not in itself reduce the number of violent or aggressive incidents. Also, de-escalation training contributes to a significant reduction in lost workdays, improved staff retention, reduced complaints, and reduced overall expenditure.
A Rapid Evidence Assessment
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Violence in the workplace is a major issue for healthcare providers. As a way to help staff manage, reduce or prevent violence from occurring, NHS Improvement asked RAND Europe to conduct an analysis of de-escalation training to support the development of this type of training within health settings.
The study focused on individual skills-based training to help reduce workplace violence and assessed whether de-escalation training is effective in managing violence towards NHS staff, benefits and key methods used to provide training, key types of training and its content, and factors of success in deploying training.
To answer the research questions the research team conducted a rapid evidence assessment (REA) of de-escalation training literature. Given the availability of existing reviews evaluating the efficacy of de-escalation training in healthcare settings, our approach was to perform a review of existing de-escalation training reviews and other individual skills-based approaches to aggression management within the last 10 years (2009–2019).
The study found that training may help staff manage patient violence and aggression although de-escalation training may not in itself reduce the number of violent or aggressive incidents. Additionally, evidence shows de-escalation training contributes to a significant reduction in lost workdays, improved staff retention, reduced complaints, and reduced overall expenditure. Given these limitations, using comprehensive approaches to managing violence in the NHS may be more effective than de-escalation training alone. The quality of available evidence on de-escalation training is limited. Any efforts towards implementing de-escalation training would benefit from the inclusion of evaluation in their design.
Background and context
Study design and methods
The effectiveness (or otherwise) of de-escalation training in healthcare and other settings
The research described in this report was prepared for NHS Improvement and conducted by RAND Europe.
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