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性行为的专业照顾者开发一个交互式多媒体培训计划(LTCS；Gates，Fitzwater，&Succope，2005)。需要对工作人员进行培训，以遵守OSHA保护工人免受工作场所暴力的指导方针，以及Obra关于心理健康和社会服务方面的护理助理教育的规定。计划模块将提供1)处理攻击性的预防方法，2)当居民情绪激动或攻击性时使用的特定沟通和管理技术，3)针对居民攻击性对其他居民或工作人员的安全构成威胁的情况下的基于个人和团队的策略，4)事件发生后照顾者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。针对管理员的附加密码保护模块将解释有效培训和组织文化的成本效益，该组织文化促进以人为中心的关怀哲学，以防止问题行为。交互式多媒体格式特别适合于这种类型的工作人员培训，因为它已被证明是有效的(欧文、布尔乔瓦和艾里，2003)，而且它的实施不需要工作人员的密集。用户将按照自己的节奏浏览该程序，这对教育或阅读能力有限的个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互动教程。基于能力的教学设计围绕逼真视频片段中的建模而构建，当用户理解材料时，它将使用户进步，并将自动审查最初未掌握的内容。将提供面向用户的计划内容摘要打印输出和面向主管的培训进度文档。第一阶段的原型程序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因特网和CD-ROM/DVD-ROM格式开发，并提供工作簿，以方便个人和团体使用。它将通过一项大型随机试验(n=300)进行评估。长期护理机构中的专业照顾者经常受到工作场所暴力行为的侵略性居民行为的影响。拟议的计划将为护理人员提供识别和预防经常导致攻击性行为的症状的技能。工作人员还将获得应对侵犯行为的技能，以最大限度地提高居民和照顾者的安全。

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.