Development and Effectiveness of a Simulation-Based Educational Program to Enhance Emergency Nurses’ De-escalation Competency in Aggressive Situations

干预措施: Behavioral : The experimental group will receive a simulation-based educational program designed to enhance de-escalation competency in aggressive situations in the emergency department. The program consists of four sessions totaling 240 minutes, and each session includes didactic education, simulation practice, and debriefing. Session 1 covers early recognition of potential aggression, maintenance of a safe distance, designation of a single communicator, verbal and nonverbal de-escalation principles, boundary setting, criteria for transition to safety measures, and requesting team support. Session 2 focuses on preventive de-escalation for a patient expressing initial dissatisfaction because of a prolonged emergency department waiting time. Session 3 focuses on responding to an emotionally escalated caregiver by acknowledging emotions, setting boundaries, offering limited choices, and determining whether a transition to safety measures is required. Session 4 focuses on a patient experiencing anxiety and agitation while waiting after examination and treatment and includes anxiety reduction, explanation of the situation, reassessment, reduction of environmental stimuli, provision of choices, and determination of the need for safety measures. The simulation will be conducted in small groups, with participants alternating between performer and observer roles. Each simulation will be followed by structured debriefing using the Description–Analysis–Application format. The control group will not receive any separate de-escalation education or simulation-based program during the study period.