Nursing Communication Strategies to Reduce Aggressive Behaviour in Patients in ED

Running head: RESEARCH IN NURSING
Research in nursing
Name of the student:
Name of the University:
Author’s note

1RESEARCH IN NURSING
Abstract:
As aggression and violence is a common occurrence in ED, the main aim of the research
paper was to conduct a literature review to understand whether nursing communication strategies
can reduce aggressive behaviour in patients in ED or not. By the use of specific search terms in
relation to the research question and searching for articles in CINAHL, PubMED and
PyschINFO database, the study revealed de-escalation and effective communication skills
training as a widely used strategy to control violence in ED setting. However, limitations and
gaps in research methodology such as lack of direct patient related outcomes and no observation
based studies points out to the need to conduct future research in these areas.

2RESEARCH IN NURSING
Table of Contents
Research topic: Nursing management of aggressive patients in emergency department................3
Introduction (Background and research question):..........................................................................3
Problem analysis/literature review:.................................................................................................4
Objectives:.......................................................................................................................................5
Hypotheses:......................................................................................................................................5
Methodology and methods:.............................................................................................................5
Results:............................................................................................................................................6
Conclusion:......................................................................................................................................9
References:....................................................................................................................................10

3RESEARCH IN NURSING
Research topic: Nursing management of aggressive patients in emergency department
Introduction (Background and research question):
Violence and aggression is a common occurrence in the emergency department (ED). It is
a high risk area that increases the likelihood of aggression and Tan, Lopez and Cleary (2015)
reports that majority of nurse experience physical injuries because of aggression in the ED.
There are a number of factors that increases risk of aggression in the ED. Firstly, many patient
related factors such as age, gender and exposure to alcohol and substance abuse is strongly
associated with violent behaviours. Secondly, environmental factors like poor staffing levels,
overcrowding, increased waiting time and poor security increases the chance of violence and
aggression in the ED. Another possible cause of high risk of violent episodes in the ED includes
exposure to lack of communication between patient and nursing staff and demanding behaviour
or attitude of patients and their family members (Angland, Dowling and Case 2014). Hence,
addressing these risk factors might be a solution to control aggressive events and manage
aggressive patients in the ED.
The review of study regarding nurse’s perception regarding violence in ED suggest that
nurses are psychological affected by the event as they experience physical injuries as well as
stress and burnout due to such experience. Nurses were found to be frustrated while delivering
patient care in overcrowded areas. In case of nurse-patient related factors, poor interpersonal
communication is identified as one of the factors contributing to violence in the ED. However,
Swain and Gale (2014) improving communication skills and implementing good communication
strategies can be an approach to avoid violence and manage aggressive patients in the ED.