Background: Aggressive and violent incidents in healthcare settings pose significant challenges to patient safety, staff well-being, and quality of care. Nurses, being at the forefront of patient interaction, play a critical role in preventing and managing aggression through the application of de-escalation techniques. Nurse-led de-escalation training programs have been developed to enhance nurses’ communication, emotional regulation, and crisis management skills, thereby promoting safer clinical environments.

Methods: This quasi-experimental study evaluated the effectiveness of a structured nurse-led de-escalation training program on nurses’ knowledge, confidence, and the frequency of aggressive incidents. A total of 120 nurses participated, representing psychiatric, emergency, and general medical units. Data were collected using a demographic questionnaire, the Staff De-escalation Knowledge and Skills Questionnaire (SDKSQ), and an Incident Reporting Form (IRF). The intervention consisted of a four-week training program including lectures, role-playing, and simulations. Pre- and post-intervention data were analyzed using paired t-tests and chi-square tests, with significance set at p < 0.05.

Results: The findings revealed a significant improvement in nurses’ knowledge and confidence following the intervention. The proportion of participants with good knowledge increased from 18.3% to 71.7%, while those reporting high confidence rose from 16.7% to 68.3% (p < 0.001). Additionally, the total number of reported aggressive incidents decreased by 48.4%, from 184 to 95 cases, with notable reductions in verbal and physical assaults. The mean knowledge and confidence scores improved significantly (p < 0.001), while the mean number of incidents per nurse declined from 1.53 to 0.79.

Conclusion: Nurse-led de-escalation training proved highly effective in enhancing nurses’ knowledge and confidence and in reducing aggression-related incidents in healthcare settings. These findings support the integration of structured de-escalation education into routine professional development and institutional safety policies to foster a culture of communication, empathy, and patient-centered care.