- De-escalation training and resilience support enhance nurses' communication, situational response and psychological preparedness for workplace violence.
- Organisational climate, leadership engagement and reporting systems critically determine training usefulness and sustained application in acute care.
- Sustainable prevention needs mandatory competency embedding, structured post-incident psychological support and improved interdisciplinary coordination to address staffing and practice barriers.
Worldviews Evid Based Nurs. 2026 Aug;23(4):e70170. doi: 10.1111/wvn.70170.
ABSTRACT
SIGNIFICANCE/BACKGROUND: Workplace violence is a persistent threat to nurses’ safety, well-being, and retention, particularly in acute care settings where patient acuity, time pressure, and emotionally charged interactions can heighten the risk of aggression. De-escalation training is increasingly recommended as a workplace violence prevention strategy, while resilience-oriented support may help nurses cope with the psychological consequences of exposure. However, less is known about how nurses experience these forms of training in routine acute care practice and what contextual factors influence their uptake and usefulness.
AIMS: To explore nurses’ experiences with de-escalation training and resilience support in the context of workplace violence prevention and to identify factors influencing their perceived usefulness and sustained application in acute care settings.
METHODS: A qualitative study guided by interpretive description and informed by the Consolidated Framework for Implementation Research was conducted in acute care facilities in the Al-Ahsa region, Saudi Arabia. Purposive sampling was used to recruit 20 registered nurses from emergency, medical-surgical, and critical care units who had participated in workplace violence-related training within the previous 12 months. Data were collected through semi-structured interviews and analyzed using reflexive thematic analysis.
RESULTS/FINDINGS: Four themes were identified: (1) training as a foundation for confidence and psychological preparedness, (2) organizational climate as a determinant of training usefulness, (3) barriers to translating training into practice, and (4) the need for system-level integration for sustainable workplace violence prevention. Participants viewed de-escalation training as strengthening communication and situational response skills, while resilience support was perceived as helping nurses manage stress reactions and recover after difficult incidents. However, staffing pressures, inconsistent reporting pathways, and variable leadership support limited sustained application.
LINKING EVIDENCE TO ACTION: Effective workplace violence prevention requires more than staff education alone. Healthcare organizations should embed de-escalation training within mandatory competency development, pair it with structured psychological support after incidents, and strengthen leadership engagement, reporting systems, and interdisciplinary coordination to promote safer acute care environments.
PMID:42548034 | DOI:10.1111/wvn.70170
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