College of Nursing and Health Sciences DNP Defense - David Heeps, BS, ADN, RN
Title: An Evidence-Based Training Program to Improve Communication and De-escalation Skills in Medical-Surgical Nurses
Student: David Heeps, BS, ADN, RN
Faculty Mentor: Mark Adelung, PhD, RN, CPH
Committee Member: Michelle Glowny, PhD, RN, CNE
Clinical Site Mentor: Carolyn Harding, DNP, RN
Date: April 29, 2026
Time: 10:00AM
Zoom: Please contact dhoffman@umassd.edu for link.
Abstract
Background: Medical-surgical nurses frequently care for patients with mental health conditions yet often feel unprepared to manage escalating behaviors, which can contribute to decreased confidence, increased workplace violence, and poorer patient outcomes. The purpose of this Doctor of Nursing Practice (DNP) project was to implement and evaluate a brief, evidence-based educational intervention focused on communication and verbal de-escalation skills to improve nurses’ mental health knowledge and perceived competence in managing escalating behavioral health events.
Methods: This project used a quantitative, quasi-experimental one-group pretest–posttest design with a qualitative component. Medical-surgical nurses (N = 11) participated in an online, asynchronous, narrated PowerPoint training module. Outcomes were measured using the validated Behavioral Health Care Competency (BHCC) survey before and after the intervention. Data were analyzed using paired samples t-tests and effect sizes.
Results: Results demonstrated a statistically significant improvement in overall BHCC scores, with a 16.7% increase from pretest to posttest (p = .005) and a large effect size (d = 1.10). Significant improvements were also observed across all four subscales, with the greatest improvement in practice/intervention competency (d = 1.24). Qualitative feedback supported these findings, with participants reporting increased confidence, improved ability to recognize early signs of agitation, and greater use of de-escalation strategies. Participants also identified ongoing educational needs, particularly related to psychotropic medications and managing delirium.
Conclusions: Despite limitations such as a small sample size, single-site design, and short-term evaluation, findings suggest that a brief educational intervention can meaningfully improve nurses’ behavioral health knowledge and confidence. This project supports integrating structured communication and de-escalation training into orientation and ongoing education for medical-surgical nurses to support safer patient care and reduce workplace risk.
Zoom
Deanna Hoffman
dhoffman@umassd.edu