Staff Training to Manage Aggressive Resident Behaviors

描述（由申请人提供）：拟议的项目将为长期护理机构中经常遭受老年人攻击行为的专业护理人员开发一个交互式多媒体培训计划（LTCs; Gates, Fitzwater, & Succop, 2005）。需要对工作人员进行培训，以遵守职业安全与卫生管理局保护工人不受工作场所暴力侵害的准则，以及OBRA关于心理健康和社会服务方面护理助理教育的条例。课程模块将介绍1)处理攻击的预防方法，2)当住院医生激动或具有攻击性时使用的特定沟通和管理技术，3)当住院医生的攻击对其他住院医生或工作人员的安全构成威胁时，个人和团队为基础的策略，4)事件发生后护理人员情绪自我护理的技术，5)痴呆症护理和相关问题的一般信息。为管理员提供的额外密码保护模块将解释有效培训和促进以人为本的护理理念以防止问题行为的组织文化的成本效益。交互式多媒体格式特别适合这种类型的员工培训，因为它已被证明是有效的（Irvine, Bourgeois, & Ary, 2003），而且它的实施不需要员工密集。用户将按照自己的节奏完成程序，这对于受教育程度或阅读能力有限的人来说是一个有益的功能。以技能为基础的教学设计将包括交互式教程。以能力为基础的教学设计，建立在真实的视频片段中，当用户理解材料时，将促进用户，并将自动复习最初未掌握的内容。将向用户提供项目内容摘要打印件，并向主管提供培训进度文件。第一阶段的原型项目在互联网上的随机试验中显示出显著的效果。第二阶段的产品将以互联网和唯读光碟/DVD-ROM格式开发，并备有工作手册，方便个人和团体使用。将通过一项大型随机试验（n=300）对其进行评估。长期护理机构的专业护理人员经常受到工作场所暴力的侵害，表现为居民的攻击性行为。拟议的计划将赋予护理人员识别和预防经常导致攻击行为的症状的技能。工作人员还将获得处理侵犯行为的技能，以最大限度地保障居民和护理人员的安全。

DESCRIPTION (provided by applicant): The proposed project will develop an interactive multi-media training program for professional caregivers who are regularly subjected to aggressive behaviors by older adults in long term care facilities (LTCs; Gates, Fitzwater, & Succop, 2005). Staff training is needed to comply both with OSHA guidelines to protect workers from workplace violence, and OBRA regulations governing nursing assistant education in mental health and social services. Program modules will present 1) a prevention approach for dealing with aggression, 2) specific communication and management techniques for use when a resident is agitated or aggressive, 3) individual and team-based strategies for situations where resident aggression is a threat to the safety of other residents or to staff, 4) techniques for caregiver emotional self-care after an incident has occurred, 5) general information on dementia-care and related issues. An additional password protected module for administrators will explain the cost benefits of effective training and of an organizational culture that promotes a person centered care philosophy to prevent problem behaviors. The interactive multimedia format is particularly well-suited for staff training of this type because it has been shown to be effective (Irvine, Bourgeois, & Ary, 2003), and it is not staff-intensive to implement. Users will move through the program at their own pace, which is a beneficial feature for individuals with limited education or reading ability. The skill-based instructional design will include interactive tutorials. The competency-based instructional design, built around modeling in realistic video vignettes, will advance users when the material is understood, and will automatically review content not initially mastered. Summary printouts of program content for users and documentation of training progress for supervisors will be supplied. The Phase I prototype program showed significant effects in a randomized trial on the Internet. The Phase II product will be developed in Internet and CD-ROM/DVD-ROM formats with a workbook available to facilitate both individual and group usage. It will be evaluated with a large randomized trial (n=300). Professional caregivers in long term care facility are regularly subjected to workplace violence in the form of aggressive resident behaviors. The proposed program will give caregiving staff the skills to recognize and prevent symptoms that often lead to aggressive behaviors. Staff will also gain skills to deal with aggression that does occur in ways to maximize safety of both the resident and the caregiver.