Prepare for the Worst

De-escalation Training Arms Hospitalists With Measures to Calm Agitated Patients

Karen Appold


The Hospitalist. 2015;19(3):30-31. 

In This Article

What's Required of Hospital Administration?

Under its Environment of Care standards, The Joint Commission requires accredited healthcare facilities to address workplace violence risk. The requirements mandate facilities to maintain a written plan describing how the security of patients, staff, and facility visitors will be ensured, to conduct proactive risk assessments considering the potential for workplace violence, and to determine a means for identifying individuals on their premises and controlling access to and egress from security-sensitive areas.[1]

The standard states that "staff are trained in the use of nonphysical intervention skills," says Cynthia Leslie, APRN, BC, MSN, associate director of the Standards Interpretation Group at The Joint Commission, which is based in Oakbrook Terrace, Ill. "These skills may assist the patient in calming down and prevent the use of restraints and/or seclusion."

In addition, staff must be trained before they participate in a restraint or seclusion episode and must have periodic training thereafter. Anyone who wants de-escalation training can contact a company like CPI directly or establish in-house training teams (CPI offers an Instructor Certification Program). "This allows a costeffective way [approximately $10 per person] to cascade training to others within the hospital who are part of care teams," Schubert says.