An Internet Training to Reduce Assaults in Long-Term Care

Abstract

Physical and verbal assaults by residents on care staff are not uncommon in long-term residential care facilities (LTCs). This research evaluated an Internet training designed to teach Nurse Aides (NAs) strategies to work with aggressive resident behaviors. Six LTCs were randomized in an immediate treatment (IT) and delayed treatment (DT) design, and NAs were recruited in each (IT: n = 58; DT; n = 45). The treatment involved two weekly visits to the on-line training. Hard copy assessments collected participant responses at baseline (T1), 8 weeks (T2), and at 16 weeks (T3). The DT group viewed the program after T2. HLM models show significant group differences at T2 in knowledge and the levels were maintained at T3. The number of aggressive incidents reported per day by the IT group were non-significant at T2, but decreased significantly from T1 to T3 with a very large effect size. The program was well received by users. These results suggest that the Internet training was an effective tool to reduce assaults in LTCs, and training effects may improve over time as NAs gain experience using the techniques.

Use of a Dementia Training Designed for Nurse Aides to Train Other Staff

“…Trainee scores improved significantly on VST and psychosocial measures, with small-medium effect sizes. While comparisons across studies must be viewed cautiously, similar assessment batteries with VSTs and psychosocial instruments have shown positive results with NAs (Irvine et al, 2003; Irvine, Billow, Bourgeois, et al, 2012; Irvine et al, 2012a, 2012b; Irvine et al, 2007) and nursing staff (Irvine, Billow, Bourgeois, et al, 2012; Irvine, Billow, Eberhage, et al, 2012) and, in one study, was associated with a decrease in assaults by residents (Irvine et al, 2012a). …”

“…Furthermore, an Internet training approach would be compatible with the culture-change movement to improve residential care (Rahman & Schnelle, 2008) by diffusion of best practices to existing staff, and as part of new employee orientation to establish normative behaviors for the LTC (Hobday, Smith, & Gaugler, 2010; Irvine et al, 2012a). Culture change is reported to offer organizational benefits as well as competitive advantages in the market place (Crandall, White, Schuldheis, & Talerico, 2007; Doty, Koren, & Sturla, 2008), and we believe that improvements in care are well received by families of the residents.…”

“…It is recommended for orientation of new employees to establish normative staff behavior for the institution (Hobday et al, 2010; Irvine et al, 2012a; Irvine, Billow, Eberhage, et al, 2012). Online training for continuing education credits is readily available for nursing staff and might be appropriate for the training tested here if supplemental content (e.g., reading materials) were added to increase the intellectual rigor.…”

“…This approach has been used extensively to measure effects of Internet training programs for professional caregivers (Irvine et al, 2003; Irvine, Billow, Bourgeois, et al, 2012; Irvine et al, 2012a, 2012b; Irvine, Bourgeois, Billow, & Seeley, 2007; Irvine, Billow, Eberhage, et al, 2012; Irvine, Billow, McMahon, et al, 2012). VSTs approximate real-life behavior when in vitro observations are not practical.…”

Patient Aggression in Real Time on Geriatric Inpatient Units

“…Ahmed (2012) and Scott, Ryan, James, and Mitchell (2011) reported that nurses in Jordan who had been exposed to aggression had many of the similar symptoms as nurses exposed to aggression elsewhere. Several studies address the psychological trauma and fear for personal safety as a result of assault in dementia units (Bostrom, Squires, Mitchell, Sales, & Estabrooks, 2012;Graneheim et al, 2012;Irvine et al, 2012;Lanza, Rierdan, Forester, & Zeiss, 2009;Moylan et al, 2014;Vickland et al, 2012aVickland et al, , 2012bWharton & Ford, 2014).…”