Occupational violence: can training pack a punch? A review of the effectiveness of the MOCA-REDI program in an acute general health setting

Workplace violence is internationally recognized as a major issue for many organizations and employees however the issue is more prominent in healthcare settings (Oostrom and Mierlo 2008). The Department of Health, Victoria requires that all levels of healthcare staff be educated about how to prevent, manage and report violence and aggression in the workplace. Education should be actively and openly supported by senior management and should be part of the induction program for all new staff in operational healthcare. Witnessing the success of the Management of Clinical Aggression - Rapid Emergency Department Intervention (MOCA-REDI) at one of the facilities that took part in the initial MOCA-REDI trail sites in the Emergency Department (ED); it was considered that a widened approach to multiple settings within the healthcare sector would be more beneficial for staff and the organisation in managing clinical aggression and violence. This project used an experimental, pre-test post-test survey design to examine the relationship between acute general healthcare nurses' attitude to aggression and the management of aggression. A validated measurement tool, The Management of Aggression and Violence Attitude Scale (MAVAS) was utilised in this study. This project sought to evaluate whether the introduction of the MOCA-REDI has the potential to affect general acute healthcare nurses' attitudes towards reasons for patient aggression and management of patients' aggression in an acute general health care setting. Fifty-three acute care general nurses completed the survey pre-test and post-test intervention. There were statistically significant shifts on fourteen of the twenty seven items (Wilcoxon Signed Ranked Test: p :5 0.001). There was concurrence from all participants that the training raised awareness about the environmental (external subscale) concerns in relation to violence and aggression within the workplace. There was near concurrence with the interactions between patients and staff (situational subscale) with all bar one item providing a statistically significant shift. There is evidence to demonstrate that the MOCAREDI program significantly modified general nursing staffs' attitudes towards the prevention of patient aggression using the Management of Aggression and Violence Attitude Scale.