--- title: "NSQHS Action 5.34 explained: de-escalation and aggression" description: "What NSQHS Action 5.34 asks of a hospital on aggression, violence and de-escalation, in the Commission's own words, and how staff can practise it safely." canonical: https://peopletechrevolution.com/learn/standards/nsqhs-action-5-34 --- [Learn](https://peopletechrevolution.com/learn) / Standards # NSQHS Action 5.34, the line about the shift where somebody raises their voice Aggression at a bedside or a triage counter has its own action in the national standards every Australian hospital is assessed against. This page is about that action, what it asks, and how staff practise it without anyone getting hurt. Where it sits ## One of the standards, and the one about comprehensive care The National Safety and Quality Health Service Standards are set by the Australian Commission on Safety and Quality in Health Care. Action 5.34 sits in the Comprehensive Care Standard. A relative raises his voice; a clinician listens. ### The action with a line in the incident reports Most actions in the standards are about systems. This one is about a moment: the relative who arrives angry at a bedside, the triage counter late in the evening, the corridor update that goes wrong. The last three words of the action are the ones staff feel. A hospital is assessed on whether it has processes for that moment, not on whether it has a policy about it. Processes are things people have done, which is why practice matters more here than on almost any other line. What Action 5.34 says ## In the Commission's own words Quoted from the Comprehensive Care Standard on the Commission's own site, and linked below. Both hands up, and the counter between them. ### Three verbs, one moment Action 5.34 states that the health service organisation has processes to support collaboration with patients, carers and families to identify patients at risk of becoming aggressive or violent, implement de-escalation strategies, and safely manage aggression and minimise harm to patients, carers, families and the workforce. That is the entire action, quoted word for word. Three verbs, and only the first can be done at a desk. Implementing a de-escalation strategy and safely managing aggression are things a person does with their voice, their hands and their distance, in a room, with someone who is not calm. Where a de-escalated conversation ends up, rehearsed first. How it is practised ## Nobody in the room gets hurt, as often as it takes The processes the action asks for are strategies people have rehearsed, not documents they have read. PTR builds those strategies as scenarios: the relative who arrives angry, the counter late at night, the update in the corridor. A person who reacts the way people actually do stands opposite, the exchange can be run as many times as it takes, and every run is recorded against the staff member who did it. That record is what an assessor reads when they ask how the hospital meets this action, and it lives inside the mandatory training program the hospital already runs, which is what [Action 1.20 asks for](https://peopletechrevolution.com/learn/standards/nsqhs-action-1-20). The two lines are built to be met together. [For Directors of Clinical Services](https://peopletechrevolution.com/work/industries/healthcare-medical/directors-of-clinical-services)[Healthcare and medical](https://peopletechrevolution.com/work/industries/healthcare-medical) ## Source The standard this page quotes, on the Commission's own site. ### [Comprehensive Care Standard, Action 5.34](https://www.safetyandquality.gov.au/standards/nsqhs-standards/comprehensive-care-standard) Australian Commission on Safety and Quality in Health Care, National Safety and Quality Health Service Standards The health service organisation has processes to support collaboration with patients, carers and families to identify patients at risk of becoming aggressive or violent, implement de-escalation strategies, and safely manage aggression and minimise harm to patients, carers, families and the workforce.