Evaluating the Impact of a Modified AVADE Program on Health Care Workers’ Confidence in Managing Patient Agitation

BackgroundIn the United States, it is estimated that 75% of healthcare workers report encountering workplace violence. Assaults on healthcare workers are associated with increased turnover rates, job dissatisfaction, trauma, and an inability to complete job tasks.AimsThe purpose of this quality improvement project was to evaluate the effectiveness of an education program to increase healthcare workers' knowledge and confidence in managing agitation and violence.MethodsThe project used a single group, pre- and post-test design to evaluate an educational intervention, a modified Awareness, Vigilance, Avoidance, Defense, and Escape/Environment (AVADE) program, using the Confidence in Coping with Patient Aggression Instrument (CCPAI), a 30-day post-intervention follow-up, and a post-violent incident follow-up. Quantitative data were analyzed using descriptive statistics and paired <i>t</i>-tests, and qualitative data were analyzed using content analysis of an open-response question on the post-violence and 30-day follow-up surveys.ResultsThackery's CCPAI was completed by 130 participants, across 20 different departments, and 13 job titles. The modified AVADE program was found to increase confidence among healthcare workers when coping with patient aggression.ConclusionAn educational intervention emphasizing de-escalation techniques, situational awareness, self-defense, appropriate restraint use, legal considerations, and case studies increased healthcare workers' confidence in managing patient aggression. According to a 30-day follow-up survey, staff members applied at least one of the strategies taught during the course to handle violent incidents within a month of completing the training.