The effect of aggression management training programmes for nursing staff and students working in an acute hospital setting : A narrative review of current literature.

Background
Patient aggression is a longstanding problem in general hospital nursing. Staff training is recommended to tackle workplace aggression originating from patients or visitors, yet evidence on training effects is scarce.

Aims
To review and collate current research evidence on the effect of aggression management training for nurses and nursing students working in general hospitals, and to derive recommendations for further research.

Design
Systematic, narrative review.

Data Sources
Embase, MEDLINE, the Cochrane library, CINAHL, PsycINFO, pubmed, psycArticles, Psychology and Behavioural Sciences Collection were searched for articles evaluating training programs for staff and students in acute hospital adult nursing in a ‘before/after’ design. Studies published between January 2000 and September 2011 in English, French or German were eligible of inclusion.

Review Methods
The methodological quality of included studies was assessed with the ‘Quality Assessment Tool for Quantitative Studies’. Main outcomes i.e. attitudes, confidence, skills and knowledge were collated.

Results
Nine studies were included. Two had a weak, six a moderate, and one a strong study design. All studies reported increased confidence, improved attitude, skills, and knowledge about risk factors post training. There was no significant change in incidence of patient aggression.

Conclusion
Our findings corroborate findings of reviews on training in mental health care, which point to a lack of high quality research. Training does not reduce the incidence of aggressive acts. Aggression needs to be tackled at an organizational level.