An evaluation of four programs for the management of aggression in psychiatric settings.

Regulatory agencies are encouraging health care facilities to address the problem of violence to employees. In response to this pressure, most psychiatric facilities now require and implement formal education for the nursing staff on a yearly or biannual basis in the management of aggressive behavior (MAB). Although some of the programs are good, not all are based on sound professional and clinical principles and very little is publicly known about the results of scientific study of these programs. Our goal with this report is to evaluate several commonly used programs for the management of aggressive behavior using a set of predetermined criteria. Hopefully, this discussion will stimulate a debate over the effectiveness of these programs, and others, that dot the landscape and foster clinical research that examines staff injury rates as well as other common and clinically important patient outcomes, such as violence.