Aggression in Healthcare - Coping - Evaluating The Effectiveness of Training

Evaluating The Effectiveness of Training

It remains that training is not universally or consistently offered to healthcare workers (Beech and Leather 2006). Beale et al. (1998) found that the levels of training offered ranged from nothing to high-level restraint/self-defense training. A report by the National Audit Office (NAO) in 2003 found that, within mental health trusts, a reactionary approach tends to prioritise over prevention. Although criticised by many; restraint, seclusion and medication are used (Wright 1999, Gudjonsson et al. 2004) (Duxbury and Whittington 2005). Breakaway techniques, restraint, rapid tranquilisation or isolation tend to be recommended when violence is instigated with a failure to prevent aggression (Duxbury and Whittington 2005). This correlates to the level of training offered, which dominates in these areas, however lacks in situation risk assessment and customer care (Beech and Leather 2006)–methods that are vital in a preventative approach to prevent escalation of the situation, causing for reactionary measures to be brought into play.

The study by Beale et al. (1998) therefore provides the following advice as to good practice (Beech and Leather 2006):

• Training should emphasise prevention, calming and negotiation skills as opposed to confrontation
• Training should be offered in modules, ranging initially from basic customer care and handling difficult patients to full control and restraint of patients.
• Material relating to the causes of aggression, how to reduce risks, anticipation of violence, resolving conflict and dealing with post-incident circumstances should be provided to staff.
• Physical breakaway skills should be taught–however an understanding as to situations in which such skills should be practiced must be appreciated.
• Staff should be taught to control their own feelings
• An understanding of normal/abnormal post-trauma reactions should be reached
• Staff should be familiar with local arrangements and policies