Teaching staff to respond effectively to cognitively impaired residents who display self-protective behaviors.

A randomized controlled trial (RCT) was implemented to evaluate the effectiveness of a 7 1/2 hour educational program designed to provide staff with the knowledge, skill, and confidence to manage physical self-protective behaviors of cognitively impaired long-term care residents. This RCT using a pretest/post-test design was conducted using consenting staff members (n = 40) who were randomly allocated to either a control or experimental group. The main outcome measure was a skills lab that evaluated participants 'responses to simulated patients. Both groups participated in the skills lab prior to training, and six weeks after the experimental group completed the program. Pre- and post-training and skills lab observational field notes were subjected to thematic content analysis. Twenty-eight staff members completed both pre- and post-training assessment measurements. Descriptive statistics and paired t-test analyses yielded statistically significant differences in change scores for performance indicators in three simulation scenarios. Analysis of the qualitative data support the finding that, once trained, staff felt better prepared to manage self-protective behaviors. The results suggest that an initiative to educate staff will enhance knowledge, improve performance, and provide the confidence necessary for staff to respond positively to overt physical behaviors in cognitively impaired elders.