Increasing Competence of health care providers: Application of newly Learned non-pharmacological Methods in the ER: the CALM(ER) study.

Pain, fear and agitation are not unfamiliar in Emergency Department (ED) patients. To reduce these uncomfortable sensations, pharmacological agents are often administered, despite common disadvantages like adverse effects, prolonged stay in the ED and necessary intensive monitoring.
Non-pharmacological interventions, including particular communication skills and distraction techniques, have been shown to be effective to reduce pain, anxiety and discomfort in patients undergoing invasive treatment or painful procedures outside the ED. We believe that these interventions could also be of great value in causes of pain, fear and agitation in ED patients. Furthermore, we think that implementation of these interventions in the ED could lead to a higher level of job satisfaction and autonomy amongst caregivers and a higher quality of patient care. It might even lead to a higher level of efficiency of ED care.
To our knowledge non-pharmacological interventions to increase patient comfort are infrequently used in the ED and no previous studies have been performed investigating the use of non-pharmacological interventions in the Emergency Department. In this study we will investigate whether the use of non-pharmacological interventions can easily be implemented in the ED after a one day training of ED health care providers. Furthermore we will analyse the effects of the use of non-pharmacological interventions on health care providers themselves and ED patients.
We will investigate to what extent health care providers feel competent to use non-pharmacological interventions to treat pain, fear and discomfort after a one-day training course and how often non-pharmacological interventions are used by ED health care workers. Furthermore, we will investigate levels of job satisfaction in health care workers and levels of comfort in patients before and after the training course.

An ED health care provider will use non-pharmacological skills more often and feel more competent to treat pain, discomfort and fear in ED patients after a one-day training course in non-pharmacological skills to increase comfort, measured as a moderate effect.

Before training, directly after training, 6 weeks after training, 3 months after training.

At four different moments a questionnaire will be distributed amongst emergency department employees. These four different moments are defined as followed: before training, directly after training, 6 weeks after training and 3 months after training. These questionnaires consist of validated questions, selected by our research group.