Workplace violence is highly prevalent in emergency care settings.

De-escalation training boosts nurses’ confidence in managing aggression; it improves communication, empathy and preparedness.

Environmental and systemic factors often trigger workplace aggression especially in emergency care settings.

Organisational support enhances de-escalation training effectiveness in emergency care settings.

This integrative literature review aimed to examine the impact of de-escalation training on nurses’ ability to recognise and manage aggressive patient behaviour with a particular focus on emergency care settings.

An integrative review of the literature.

A comprehensive search was conducted across multiple databases including PubMed, CINAHL (EBSCO), and Scopus. Peer-reviewed articles published between 2013 and 2023 were considered. Search terms included “de-escalation techniques”, “workplace violence” and “emergency department staff”.

Nine studies met the inclusion criteria and were critically appraised using the Mixed Methods Appraisal Tool. Data were analysed thematically to identify recurring patterns and concepts.

Three main themes emerged: 1) the impact of de-escalation training on nurses’ confidence and clinical practice, 2) the effectiveness of de-escalation training in reducing the frequency and severity of violent incidents, and 3) the recurring factors contributing to the emergence of aggression in healthcare settings. De-escalation training was found to consistently improve nurses’ self-efficacy and patient-centred practices, though its direct impact on reducing violent incidents varied across contexts.

De-escalation training demonstrates strong potential to improve nurses’ responses to aggression in emergency care settings. However, its effectiveness is closely linked to contextual factors such as organisational support, environmental conditions, and staff resources. Future research should explore longitudinal impacts, optimal training modalities, and the integration of broader systemic strategies to support violence prevention in emergency departments.

Integrative review

Emergency department

Nurses

De-escalation techniques

De-escalation training

Aggression

Workplace violence

© 2026 The Authors. Published by Elsevier Ltd.