Management of Aggressive Patient Situations
Aggression perpetrated by patient and family situations is a serious, growing threat in health care worldwide and a widely recognized problem. In 2019, the U.S. House of Representatives passed the Workplace Violence Prevention for Health Care and Social Service Workers Act, requiring employers to implement comprehensive plans to protect health care providers from workplace violence, therefore creating the need for health care-focused training. Therefore, members of the College of Nursing faculty created the Managing Aggressive Patient Situations (MAPS) Train the Trainer Program to meet the specific needs of health care providers and supported by a grant from Tennessee Hospital Association.
Because workplace violence incidents are more common in health care than private industries, programs implemented in health care institutions should be tailored for the unique needs of health care providers and patients. MAPS was designed by clinical and mental health experts and integrates verbal strategies for de-escalation, communication skills, and simulation experiences in clinical settings. Other leading programs that teach de-escalation of aggressive behavior are designed for a broad audience and are not health care and patient focused. Since 2022, more than 140 nurses across Tennessee have been trained using this strategy.
MAPS Train the Trainer Program certifies health care providers to teach MAPS to employees within their institution. All trainers upon certification will receive a MAPS Teaching Packet which includes a power point presentation, handouts, learning activities, and a teaching guide. In addition, they will receive simulation videos developed based on examples of real-life hospital scenarios involving agitated patients. Each video depicts a patient in one of the three stages of conflict: anxiety, verbal aggression and confrontation, and physical aggression. Debriefing questions are included for discussion after viewing each video. The certified trainers will be able to use these materials within their institution to teach classes. The materials can be adapted for a course ranging from 2 to 8 hours depending on time available within their institution.
MAPS Learning Objectives
- Gain awareness of the current state of health care violence in the U.S.
- Understand how cultural awareness affects one’s view of the world and influences the clinician/patient relationship
- Understand the role of self-awareness and self-reflection in managing aggressive patients
- Identify cultural norms in response to anxiety
- Use self-reflection to understand factors that contribute to feeling threatened
- Differentiate between verbal and nonverbal communication
- Identify common body languages used to communicate
- Gain proficiency in use of therapeutic communication strategies
- Differentiate between threatening and nonthreatening communication approaches
- Gain proficiency in the use of strategies to reduce emotional confrontation
- Understand the three stages of conflict (anxiety, verbal aggression, and physical aggression) with an emphasis on patients and their families
- Implement appropriate strategies for diffusing aggressive behavior based on identified stage of conflict
- Learn how to help the patient manage their emotions and maintain control of his behavior.
- MAPS is free of charge to health care providers in Tennessee. To schedule a training session, please email maps@uthsc.edu.