Evaluating the impact of an evidence-based tool on healthcare staff's perception of aggression in patients with dementia

Aggressive behaviors in dementia care settings significantly impact staff perceptions, patient interactions, and overall safety. This quality improvement project examined whether structured communication training, combined with the Cohen-Mansfield Agitation Inventory (CMAI), influenced healthcare staff’s perceptions of aggression in patients with dementia compared with no structured training or tool use. Guided by Jean Watson’s Theory of Human Caring and the Transtheoretical Model of Behavior Change, the project emphasized empathetic, patient-centered care and staff behavior change. A quasi-experimental pre-post design was implemented over six weeks in an acute care unit with a high population of dementia patients. Staff completed perception surveys before, during, and after the intervention to measure changes in confidence, recognition of behavioral triggers, and understanding of aggressive behaviors. Post-intervention results showed measurable improvement across all evaluation points. Staff reported increased confidence in managing aggression, greater recognition of behavioral triggers, and improved teamwork. Quantitative data demonstrated steady progress in confidence and perception scores, while qualitative feedback reflected calmer, more intentional communication during episodes of aggression. Conclusions supported all project hypotheses, confirming that integrating structured communication training with a behavioral assessment documentation tool enhanced staff preparedness, compassion, and safety in dementia care. Recommendations included continuing the CMAI and MESSAGE training as part of staff orientation and annual competencies to sustain progress. Expanding implementation to additional units and evaluating long-term sustainability would strengthen system-wide safety, collaboration, and quality improvement in the care of patients with dementia.