Simulation-based education for teaching aggression management skills to healthcare providers in acute healthcare settings: A systematic review.

Autor: Mitchell M; Department of Paediatrics, Monash University, Clayton, Melbourne, Australia; Royal Children's Hospital, Parkville, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia; Monash Children's Hospital, Clayton, Melbourne, Australia. Electronic address: marijke.mitchell@monash.edu., Newall F; Royal Children's Hospital, Parkville, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia; Murdoch Children's Research Institute, Parkville, Melbourne, Australia., Bernie C; Department of Paediatrics, Monash University, Clayton, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia; Murdoch Children's Research Institute, Parkville, Melbourne, Australia; Southern Cross University, Bilinga, Queensland, Australia., Brignell A; Department of Paediatrics, Monash University, Clayton, Melbourne, Australia; Murdoch Children's Research Institute, Parkville, Melbourne, Australia; Monash Children's Hospital, Clayton, Melbourne, Australia., Williams K; Department of Paediatrics, Monash University, Clayton, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Melbourne, Australia; Murdoch Children's Research Institute, Parkville, Melbourne, Australia; Monash Children's Hospital, Clayton, Melbourne, Australia.
Jazyk: angličtina
Zdroj: International journal of nursing studies [Int J Nurs Stud] 2024 Oct; Vol. 158, pp. 104842. Date of Electronic Publication: 2024 Jun 15.
DOI: 10.1016/j.ijnurstu.2024.104842
Abstrakt: Background: Behavioural emergencies involving aggression in acute care hospitals are increasing globally. Acute care staff are often not trained or confident in their prevention or management. Of available training options simulation-based education is superior for clinical medical education and is gaining acceptance for teaching clinical aggression management skills.
Objective: The aim of this study was to conduct a systematic review of the effectiveness of simulation-based education for teaching aggression management skills for health professionals working in acute healthcare settings.
Methods: The study protocol was prepared in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) statement, registered (27/02/2020) and published. We included randomised controlled trials, non-randomised controlled trials, quasi-experimental studies, and observational studies involving healthcare professionals in acute hospital settings or trainee health professionals who received simulation-based training on managing patient aggression. Comprehensive searches were conducted in PubMed, Ovid MEDLINE, PsycINFO, CINAHL and The Cochrane Library. Two reviewers independently screened all records, extracted data and assessed risk of bias. The primary outcomes included patient outcomes, quality of care, and adverse effects. Secondary outcomes included workplace resource use, healthcare provider related outcomes, knowledge (de-escalation techniques), performance, attitudes, and satisfaction. A narrative synthesis of included studies was performed because substantial variation of interventions and outcome measures precluded meta-analyses.
Results: Twenty-five studies were included with 2790 participants, 2585 (93 %) acute care hospital staff and 205 (7 %) undergraduate university students. Twenty-two studies combined simulation-based education with at least one other training modality. Three studies were randomised controlled trials, one was a pilot and feasibility cluster randomised controlled trial, one was a three-group post-test design and twenty were pre-/post-test design. Twenty-four studies were deemed to be high/critical or serious risk of bias. Four studies collected primary outcome data, all using different methods and with inconsistent findings. Twenty-one studies assessed performance in the test situation, seven studies provided objective ratings of performance and eighteen provided self-report data. Twenty-three studies reported objective or subjective improvements in secondary outcomes.
Conclusions: Acute healthcare staff who completed simulation-based education on managing clinical aggression showed statistically significant improvements in knowledge and self-reported confidence. However, there is a lack of evidence about the magnitude of these improvements and impact on patient outcomes.
Registration: PROSPERO Registration Number CRD42020151002.
Tweetable Abstract: Simulation-based education improved acute healthcare clinician knowledge and confidence in managing aggression.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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