Health care professionals having meeting.

Duke University Health System – North Carolina

The Impact of CPI Training

  • Increase in staff trained
  • Decrease in staff turnover
  • Increase in staff confidence and safety


According to OSHA, health care workers are five times more likely to encounter serious workplace violence incidents. For Duke University Health System staff, this reality posed a serious threat to their safety and patient care. Sara Emory, DNP, RN, and senior clinical director at Duke Health, recognized that by implementing a system-wide, proactive de-escalation training, incidents could become less frequent while overall staff safety would improve.


The customizable and scalable format of CPI training allowed for all staff at Duke Health to receive the appropriate training for their specific role and risk level. “CPI came to our facility, met with our staff, and worked with them to help them tailor how they were using the CPI approach with those patient populations,” explained Sara. “There are not a lot of programs that have that ability to expand or contract the different elements within the program so you can modify if for specific patient populations.”

Now, Duke Health has equipped over 18,000 staff with CPI de-escalation training, with more being trained each month.


Of the 27,000+ staff at Duke Health, 6% reported they feel safer at work after CPI training. “It might not sound like much,” Sara shared, “however, a 6% increase is a significant increase, and we’re proud of that.” The common training and language also enable all staff to debrief after an incident, leading to increased comradery and a decrease in staff turnover. And as more staff gain CPI training, they can proactively adapt their care strategy to safely meet the needs of their patients.

“I recommend CPI to almost everyone who comes to me. CPI offers the ability to modify which interventions you focus on based on whatever group you’re serving. You can consistently employ all the techniques, but tailor it to what it is that you are running into, and what your staff wants to be able to address.”

Sara Emory, DNP, RN, senior clinical director at Duke University Health

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