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Olasoji M, Henderson K, Hopkins L, Keppich-Arnold S, Joseph B. Views of Mental Health Nurses on Responding to Clinical Aggression on General Wards. Int J Ment Health Nurs 2024. [PMID: 38867479 DOI: 10.1111/inm.13377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/20/2024] [Accepted: 05/30/2024] [Indexed: 06/14/2024]
Abstract
The overall aim of this study was to explore the views of mental health nurses (MHNs) about their experience of responding to workplace violence (WPV) and aggression (code greys and blacks) within acute general wards. WPV continues to pose a significant source of challenge within healthcare settings despite several initiatives that have been trialled over the years. It has the potential to impact patient care and overall staff health and well-being. Nurses play a significant role in the management of WPV; hence, it is important to understand how they respond to and manage incidents of WPV. The study design was an explorative descriptive qualitative design. Data were collected through semi-structured interviews involving n = 10 MHNs working within a mental health consultation liaison team that responds to incidents of violence and aggression (codes grey and black) in acute general wards. Participants were recruited using a convenient sampling method. Data were analysed using thematic analysis. The findings of this study highlighted the following themes: (1) Patient care (subthemes: patient frustration with hospital processes, lack of time and resources); (2) Staffing skills and confidence (subthemes: lack of adequate training, inability to intervene early and communication skills); (3) Understanding patient behaviours (subthemes: it's a psychiatry problem and zero tolerance approach). The management of WPV within acute hospital settings needs to be given due attention by healthcare services. Although a number of organisations are developing measures and guidelines to manage WPV, there is still a gap in the ability of general nursing staff to properly manage such incidences. Proper attention needs to be taken to the training of staff.
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Affiliation(s)
- Michael Olasoji
- Alfred Mental Health and Addictions, Alfred Health Victoria, Melbourne, Victoria, Australia
- Institute of Health and Wellbeing, Federation University, Ballarat, Victoria, Australia
| | - Kathryn Henderson
- Alfred Mental Health and Addictions, Alfred Health Victoria, Melbourne, Victoria, Australia
| | - Liza Hopkins
- Alfred Mental Health and Addictions, Alfred Health Victoria, Melbourne, Victoria, Australia
| | - Sandra Keppich-Arnold
- Alfred Mental Health and Addictions, Alfred Health Victoria, Melbourne, Victoria, Australia
| | - Bindu Joseph
- Institute of Health and Wellbeing, Federation University, Ballarat, Victoria, Australia
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Touzet S, Buchet-Poyau K, Denis A, Occelli P, Jacquin L, Potinet V, Sigal A, Delaroche-Gaudin M, Fayard-Gonon F, Tazarourte K, Douplat M. Impact of the presence of a mediator on patient violent or uncivil behaviours in emergency departments: a cluster randomised crossover trial. Eur J Emerg Med 2024; 31:201-207. [PMID: 38329117 DOI: 10.1097/mej.0000000000001121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
BACKGROUND AND IMPORTANCE Several studies reported that violent behaviours were committed by patients against healthcare professionals in emergency departments (EDs). The presence of mediators could prevent or resolve situations of tension. OBJECTIVE To evaluate whether the presence of mediators in EDs would have an impact on violent behaviours committed by patients or their relatives against healthcare professionals. Design, settings and participants A 6-period cluster randomised crossover trial was performed in 4 EDs during 12 months. Patients aged ≥18 and their relatives were included. INTERVENTION In order to prevent or resolve situations of tension and conflict, four mediators were recruited.Outcome measure and analysis Using a logistic regression mixed model, the rate of ED visits in which at least one act of violence was committed by a patient or their relatives, reported by healthcare professionals, was compared between the intervention group and the control group. RESULTS A total of 50 429 ED visits were performed in the mediator intervention group and 50 851 in the control group. The mediators reported 1365 interventions; >50% of the interventions were to answer questions about clinical management or waiting time. In the intervention group, 173 acts of violence were committed during 129 ED visits, and there were 145 acts of violence committed during 106 ED visits in the control group. The rate of ED visits in which at least one act of violence was committed, was 0.26% in the intervention group and 0.21% in the control group (OR = 1.23; 95% CI [0.73-2.09]); on a 4-level seriousness scale, 41.6% of the acts of violence were rated level-1 (acts of incivility or rudeness) in the intervention group and 40.0% in the control group. CONCLUSION The presence of mediators in the ED was not associated with a reduction in violent or uncivil behaviours committed by patients or their relatives. However, the study highlighted that patients had a major need for information regarding their care; improving communication between patients and healthcare professionals might reduce the violence in EDs. TRIAL REGISTRATION Clinicaltrials.gov (NCT03139110).
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Affiliation(s)
- Sandrine Touzet
- Hospices Civils de Lyon, Pôle de Santé Publique
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1
| | | | | | - Pauline Occelli
- Hospices Civils de Lyon, Pôle de Santé Publique
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1
| | - Laurent Jacquin
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Accueil des Urgences
| | - Véronique Potinet
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d'Accueil des Urgences
| | - Alain Sigal
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service d'Accueil des Urgences, Lyon, France
| | | | - Florence Fayard-Gonon
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service d'Accueil des Urgences, Lyon, France
| | - Karim Tazarourte
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Accueil des Urgences
| | - Marion Douplat
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d'Accueil des Urgences
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Hou Y, Corbally M, Timmins F. Violence against nurses by patients and visitors in the emergency department: An integrative review. J Adv Nurs 2024; 80:430-445. [PMID: 37658637 DOI: 10.1111/jan.15837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/10/2023] [Accepted: 08/14/2023] [Indexed: 09/03/2023]
Abstract
AIM This integrative review explored violence against emergency nurses by patients/visitors, examining its nature, contributing factors and consequences. DESIGN Integrative review. DATA SOURCES Articles were obtained from PubMed, CINAHL, EMBASE, Web of Science and PsycInfo databases, up until December 2021. REVIEW METHODS 26 articles were reviewed, evaluating study quality with the Crowe Critical Appraisal Tool and synthesizing conclusions through theme development and coding. RESULTS This review delves into the issue of violence perpetrated against emergency nurses by patients and visitors. It elucidates three overarching themes: the nature of violence, the contributing factors and the consequences of such acts. CONCLUSION The findings inform healthcare policy for the development of prevention approaches while identifying research gaps and emphasizing the need for alternative study designs and methodologies. IMPACT This review has implications for nursing practice, policymaking and research, emphasizing the need for stakeholder engagement and tailored interventions for at-risk emergency nurses. NO PATIENT OR PUBLIC CONTRIBUTION This project was an integrative review of the literature therefore no patient or public contribution was necessary. WHAT ALREADY IS KNOWN Violence by patients and visitors in healthcare settings, especially in emergency departments, has garnered considerable attention. WHAT THIS PAPER ADDS This review specifically examines violence-targeting emergency department nurses from patients and visitors, assessing its characteristics, contributing factors and consequences. IMPLICATIONS FOR PRACTICE/POLICY The findings will guide stakeholder engagement in developing interventions to support vulnerable emergency nurses.
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Affiliation(s)
- Yongchao Hou
- Emergency Department, ShanXi Provincial People's Hospital, Taiyuan, ShanXi, China
- School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - Melissa Corbally
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Fiona Timmins
- School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
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Sófi G, Törő K, Csikós G, Fliegauf G. Perceiving violence against healthcare workers in a child and adolescent emergency psychiatric ward in Hungary: a qualitative pilot study. Front Psychol 2023; 14:1220183. [PMID: 38023022 PMCID: PMC10646461 DOI: 10.3389/fpsyg.2023.1220183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/02/2023] [Indexed: 12/01/2023] Open
Abstract
Aim Psychiatry is a challenging setting that requires extraordinary effort from the staff. Healthcare workers in the field of psychiatry face substantial levels of violence, making the identification of abuse risk factors a social concern. Both the conduct of the children and their relatives can pose potential harm. Our study delved into the criminological and psychiatric factors underlying violence against healthcare workers. Methodology We used qualitative, semi-structured, self-developed, online questionnaire involving 21 respondents. The participants were representing the staff composition of our department. The data set was coded in two phases using a multi-stage content analysis method. The results were compared with Hungarian and international literature. Findings Among the participants, 52% reported no instances of physical abuse. The most prevalent form of perceived non-contact abuse was threats, accounting for 38% of reported cases. The identified risk factors for abuse included the child's psychiatric disorder, communication issues, parental behavior, and low socio-economic status. Psychological trauma was identified as the most severe consequence. The respondents' opinion indicated that the most common cause of violence (52%) was attributed to the child's mental disorder. Workers primarily deal with abuse through negative emotions, with 76% of them reporting feelings of victimization. Additionally, 43% believed that abuse cannot be avoided, while 19% emphasized the significance of worker competence. Value Our research can help to identify risk factors in child psychiatry wards and provide guidance for developing effective responses to violence against healthcare workers in Hungary, especially at our ward.
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Affiliation(s)
- Gyula Sófi
- Child and Adolescent Psychiatric Unit, Heim Pál National Pediatric Institute, Budapest, Hungary
| | - Krisztina Törő
- Department of Personality and Clinical Psychology, Institute of Psychology, Pázmány Péter Catholic University, Budapest, Hungary
| | - Gábor Csikós
- András Pető Faculty of Semmelweis University, Budapest, Hungary
| | - Gergely Fliegauf
- Child and Adolescent Psychiatric Unit, Heim Pál National Pediatric Institute, Budapest, Hungary
- National University of Public Service, Budapest, Hungary
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Jakobsson J, Örmon K, Axelsson M, Berthelsen H. Exploring workplace violence on surgical wards in Sweden: a cross-sectional study. BMC Nurs 2023; 22:106. [PMID: 37029387 PMCID: PMC10079490 DOI: 10.1186/s12912-023-01275-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/28/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND Workplace violence is a global threat to healthcare professionals' occupational health and safety and the situation has worsened during the COVID-19 pandemic. This study aimed to explore workplace violence directed against assistant and registered nurses working on surgical wards in Sweden. METHODS This cross-sectional study was conducted in April 2022. Using a convenience sampling procedure, 198 assistant and registered nurses responded to an online questionnaire developed for this specific study. The questionnaire comprised 52 items and included, among other items, subscales from validated and previously used instruments. Data analysis included descriptive statistics, the chi-square test, and independent-samples t-test. RESULTS The most frequently reported type of workplace violence was humiliation (28.8%), followed by physical violence (24.2%), threats (17.7%), and unwanted sexual attention (12.1%). Patients and patients' visitors were reported as the main perpetrators of all kinds of exposure. Additionally, one third of the respondents had experienced humiliation from colleagues. Both threats and humiliation showed negative associations with work motivation and health (p < 0.05). Respondents classified as working in a high- or moderate-risk environment were more frequently exposed to threats (p = 0.025) and humiliation (p = 0.003). Meanwhile, half of the respondents were unaware of any action plans or training regarding workplace violence. However, of those who indicated that they had been exposed to workplace violence, the majority had received quite a lot or a lot of support, mainly from colleagues (range 70.8-80.8%). CONCLUSION Despite a high prevalence of workplace violence, and especially of humiliating acts, there appeared to be low preparedness within the hospital organizations to prevent and/or handle such incidents. To improve these conditions, hospital organizations should place more emphasis on preventive measures as part of their systematic work environment management. To help inform such initiatives, it is suggested that future research should focus on the identification of suitable measures regarding different types of incidents, perpetrators, and settings.
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Affiliation(s)
- Jenny Jakobsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden.
- Centre for Work Life and Evaluation Studies (CTA), Malmö University, Malmö, Sweden.
| | - Karin Örmon
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- The Västra Götaland Region Competence Center on Intimate Partner Violence, Gothenburg, Sweden
| | - Malin Axelsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Hanne Berthelsen
- Centre for Work Life and Evaluation Studies (CTA), Malmö University, Malmö, Sweden
- Faculty of Odontology, Malmö University, Malmö, Sweden
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Cabilan CJ, Eley R, Snoswell C, Jones AT, Johnston ANB. Inter-rater reliability of the occupational violence risk assessment tool for emergency departments. Australas Emerg Care 2023; 26:54-58. [PMID: 35906121 DOI: 10.1016/j.auec.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND The three-item occupational violence (OV) risk assessment tool was developed and validated for use in emergency departments (EDs). It prompts review of each patient's aggression history, behaviours, and clinical presentation. However, confidence around representativeness and generalisability are needed before widescale adoption; hence we measured the inter-rater reliability of the tool among a large group of emergency nurses. METHODS A cross-sectional study was conducted between Sep 2021 and Jan 2022. Nurses were directed to a website that hosted an e-learning module about the tool. They were asked to apply the tool to two video scenarios of typical patient presentations. Demographic data, including years of emergency experience, were collected to contextualise their responses. Gwet's Agreement Coefficients (AC1) were calculated to determine inter-rater reliability. RESULTS There were 135 participants: typically female, under the age of 40 years, with more than 3 years of emergency nursing experience. Overall, there was excellent inter-rater agreement (AC1 =0.752, p = 0.001). This was consistent when years of ED experience was stratified: 0-2 years, AC1 = 0.764, p = 0.002; 3-5 years, AC1 = 0.826, p = 0.001; 6-10 years, AC1 = 0.751, p < 0.001; 11-15 years, AC1 = 0.659, p = 0.004; ≥ 16 years, AC1 = 0.799, p < 0.001. CONCLUSION The three-item OV risk assessment tool has excellent inter-rater reliability across a large sample of emergency nurses.
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Affiliation(s)
- C J Cabilan
- Emergency Department, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba, Queensland 4102, Australia; School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland 4072, Australia.
| | - Robert Eley
- Emergency Department, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba, Queensland 4102, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Centaine Snoswell
- Centre for Online Health, Centre for Health Services Research, The University of Queensland, Brisbane, Queensland 4102, Australia
| | - Andrew T Jones
- QCIF Facility for Advanced Bioinformatics, Institute for Molecular Bioscience, The University of Queensland, Australia
| | - Amy N B Johnston
- Emergency Department, Princess Alexandra Hospital, 199 Ipswich Rd, Woolloongabba, Queensland 4102, Australia; School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland 4072, Australia
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Al-Qadi MM, Maruca AT, Beck CT, Walsh SJ. Exploring Jordanian emergency registered nurses’ experiences of workplace violence: A phenomenological study. Int Emerg Nurs 2022; 65:101218. [DOI: 10.1016/j.ienj.2022.101218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 06/04/2022] [Accepted: 09/02/2022] [Indexed: 11/15/2022]
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Grinberg K, Revach C, Lipsman G. Violence in hospitals and burnout among nursing staff. Int Emerg Nurs 2022; 65:101230. [DOI: 10.1016/j.ienj.2022.101230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 09/17/2022] [Accepted: 10/01/2022] [Indexed: 11/28/2022]
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Zhu L, Dongyan L, Luo Z, Mengqi X, Sun L, Sanlian H. Characteristics of workplace violence, responses and their relationship with the professional identity among nursing students in China: a multicenter cross-sectional study. BMC Nurs 2022; 21:262. [PMID: 36163042 PMCID: PMC9511771 DOI: 10.1186/s12912-022-01037-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 09/08/2022] [Indexed: 11/23/2022] Open
Abstract
Background Nursing students are one of the most vulnerable groups suffering from workplace violence. This study aimed to investigate the workplace violence incidence of Chinese nursing students during clinical practice, to describe the characteristics of violence and students’ responses and to analyse the relationship between the experience of workplace violence and professional identity. Methods A cross-sectional study was conducted among 954 nursing students in ten universities in China through convenience sampling. Workplace violence was surveyed through Hospital Workplace Violence Questionnaire for Nursing Students. Students’ professional identity was measured by Professional Identity Questionnaire for Nursing Students. Statistical methods included descriptive statistics, chi-square test, independent-samples t-test, analysis of variance and linear regression analysis. Results It was found that the incidence of workplace violence among nursing students was 42.98%. The violent incidents ranking from high to low were: verbal abuse, threat, physical attack, sexual harassment, and gathering disturbance. The majority of the nursing students chose to avoid the conflict during the incident. 86.34% of the students didn’t report the incidents. More than half of the victims developed post-traumatic stress disorder after the incidents. Regression analysis results showed that workplace violence experience (β = − 0.076, P < 0.05) was a significantly negative predictor of professional identity. Conclusions Chinese nursing students were exposed to physical and psychological violence during clinical practice with insufficient coping solutions and psychological adjustment. The professional identity of the nursing students was significantly associated with the experience of workplace violence.
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Affiliation(s)
- Lingyan Zhu
- Department of Nursing, Shanghai JiaoTong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Lu Dongyan
- School of Nursing, Huzhou University, Huzhou, China
| | - Zhenlan Luo
- School of Nursing, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xu Mengqi
- School of Nursing, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Linfang Sun
- Department of Nursing, Shanghai JiaoTong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Hu Sanlian
- Department of Nursing, Shanghai JiaoTong University Affiliated Sixth People's Hospital, Shanghai, China.
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Hou Y, Corbally M, Timmins F. Violence against nurses by patients and visitors in the emergency department: A concept analysis. J Nurs Manag 2022; 30:1688-1699. [PMID: 35700325 PMCID: PMC9795924 DOI: 10.1111/jonm.13721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 06/10/2022] [Accepted: 06/13/2022] [Indexed: 12/30/2022]
Abstract
AIM This analysis investigates the concept of violence against nurses by patients and visitors in the emergency department. It aims to differentiate, clarify, and clearly identify this specific concept, which will facilitate more apt measurement and reporting, ultimately to contribute violence reduction measures. BACKGROUND Due to contextual factors, occupational risk and patient characteristics, violence against nurses by patients and visitors in the emergency department varies from other types of violence against other health care staff. METHODS This study employed Walker and Avant's concept analysis technique. RESULTS The analysis found that violence against nurses by patients and visitors in the emergency department is primarily an occurrence of interpersonal violence based on the working relationship, whereby the patient and/or visitor becomes an assailant, and a nurse becomes a target in the absence of capable guardianship. There is also an intentional use of physical force or power, which results in or has a high chance of causing harm. CONCLUSION A clearer understanding of the antecedents, attributes, and consequences of violence against nurses by patients and visitors arising from this concept analysis provides a framework that will assist in the understanding, measurement, reporting, and prevention of violence and inform future research. IMPLICATIONS FOR NURSING MANAGEMENT Nursing managers are encouraged to adopt strategies that act on the factors related to attributes and antecedents that will serve to reduce the occurrence of intentional violent acts.
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Affiliation(s)
- Yongchao Hou
- Emergency DepartmentShanXi Provincial People's HospitalTaiyuanShanXiChina
| | - Melissa Corbally
- School of Nursing and MidwiferyTrinity College DublinDublinIreland
| | - Fiona Timmins
- School of Nursing, Midwifery & Health SystemsUniversity College DublinDublinIreland
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Dafny HA, Chamberlain D, Parry YK, Beccaria G. Do nurses receive any support following incidents of workplace violence? A qualitative study. J Nurs Manag 2022; 30:1843-1851. [PMID: 35733397 DOI: 10.1111/jonm.13724] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/18/2022] [Accepted: 06/20/2022] [Indexed: 02/03/2023]
Abstract
AIM We aim to investigate nurses' perceptions of support after incidences of Workplace Violence. BACKGROUND Nurses experience workplace violence daily. Adequate support following incidents of violence can reduce adverse impacts. Current support systems for coping with workplace violence are lacking. METHODS Focus group interviews were conducted with 23 nurses working in a regional Queensland Hospital. Qualitative data was transcribed and thematically analyzed to determine themes. The consolidated criteria for reporting qualitative research checklist was followed. RESULTS The primary source of support after a violent incident was from other nurses. Support was needed immediately to empower nurses to be able to continue their caring role. Often the support was not provided nor were nurses aware of the support services available. Although personal family and friends were a valuable support, most nurses were reluctant to disclose their experiences to protect them. CONCLUSIONS This paper discusses nurses' experience of support following violence incidents at work as part of findings from a more extensive study that explored the perceptions of nurses regarding violence, strategies and support in a regional Queensland Hospital. Hospital support following a violent incident was perceived as inadequate and nurses felt unsupported immediately following an incident. IMPLICATIONS FOR NURSING MANAGEMENT After an incidence of workplace violence, appropriate effective support may mitigate the enduring impacts of experiencing violence. There is the need for hospital management to provide effective support services and improve staff awareness of available support services.
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Affiliation(s)
- Hila Ariela Dafny
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Diane Chamberlain
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Yvonne Karen Parry
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Gavin Beccaria
- School of Psychology and Wellbeing, Faculty of Health Engineering and Sciences, University of Southern Queensland, Toowoomba, Queensland, Australia
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Spelten E, van Vuuren J, O'Meara P, Thomas B, Grenier M, Ferron R, Helmer J, Agarwal G. Workplace violence against emergency health care workers: What Strategies do Workers use? BMC Emerg Med 2022; 22:78. [PMID: 35524175 PMCID: PMC9074314 DOI: 10.1186/s12873-022-00621-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/28/2022] [Indexed: 12/01/2022] Open
Abstract
Background Workplace violence by patients and bystanders against health care workers, is a major problem, for workers, organizations, patients, and society. It is estimated to affect up to 95% of health care workers. Emergency health care workers experience very high levels of workplace violence, with one study finding that paramedics had nearly triple the odds of experiencing physical and verbal violence. Many interventions have been developed, ranging from zero-tolerance approaches to engaging with the violent perpetrator. Unfortunately, as a recent Cochrane review showed, there is no evidence that any of these interventions work in reducing or minimizing violence. To design better interventions to prevent and minimize workplace violence, more information is needed on those strategies emergency health care workers currently use to prevent or minimize violence. The objective of the study was to identify and discuss strategies used by prehospital emergency health care workers, in response to violence and aggression from patients and bystanders. Mapping the strategies used and their perceived usefulness will inform the development of tailored interventions to reduce the risk of serious harm to health care workers. In this study the following research questions were addressed: (1) What strategies do prehospital emergency health care workers utilize against workplace violence from patients or bystanders? (2) What is their experience with these strategies? Methods Five focus groups with paramedics and dispatchers were held at different urban and rural locations in Canada. The focus group responses were transcribed verbatim and analyzed using thematic analysis. Results It became apparent that emergency healthcare workers use a variety of strategies when dealing with violent patients or bystanders. Most strategies, other than generic de-escalation techniques, reflect a reliance on the systems the workers work with and within. Conclusion The study results support the move away from focusing on the individual worker, who is the victim, to a systems-based approach to help reduce and minimize violence against health care workers. For this to be effective, system-based strategies need to be implemented and supported in healthcare organizations and legitimized through professional bodies, unions, public policies, and regulations.
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Affiliation(s)
- Evelien Spelten
- Violet Vines Marshman Research Centre, Rural Health School, La Trobe University, Melbourne, Australia.
| | - Julia van Vuuren
- Violet Vines Marshman Research Centre, Rural Health School, La Trobe University, Melbourne, Australia
| | - Peter O'Meara
- Department of Paramedicine, Monash University, Melbourne, Australia
| | - Brodie Thomas
- Violet Vines Marshman Research Centre, Rural Health School, La Trobe University, Melbourne, Australia
| | | | - Richard Ferron
- Niagara Emergency Medical Services, Niagara Region, Niagara, Canada
| | - Jennie Helmer
- School of Population and Public Health, University of British Columbia, Vancouver, Canada.,British Columbia Emergency Health Services, Vancouver, Canada
| | - Gina Agarwal
- Department of Family Medicine, McMaster University, Hamilton, Canada.,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
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Yıldız İ, Tok Yıldız F. Pediatric emergency nurses' workplace violence experiences: A qualitative study. Int Emerg Nurs 2022; 62:101160. [PMID: 35339106 DOI: 10.1016/j.ienj.2022.101160] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 01/13/2022] [Accepted: 02/28/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Workplace violence is a crucial problem experienced by health workers who serve at the emergency service. The identification of emergency nurses' workplace experiences is of importance to the prevention of violence and the development of solutions. PURPOSE This study was performed to identify the workplace violence experiences of the nurses working for the pediatric emergency units. METHOD A total of 20 nurses who experienced violence at the emergency service participated in the study that was conducted as qualitative research. The data were collected with the semi-structured interview form and were evaluated by using thematic analysis. RESULTS Five themes, namely, "the characteristics of violence", "the causes of violence", "the approach during/after the violence", "the consequences of the violence for the person", and the "consequences of the violence for the profession", were identified. Nurses stated that they often experienced verbal violence due to patient relatives' unmet expectations, the failure of patient relatives to understand treatments and practices, and the heavy workload, they endeavored to eliminate violence by trying to communicate with perpetrators of the violence, calling the security staff, and reporting the violence to their managers, and they were individually and professionally affected by the violence. CONCLUSION Nurses are negatively affected by workplace violence. Pediatric emergency nurses should be supported with training programs and policies to be developed for the prevention and solution of violence.
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Affiliation(s)
- İlknur Yıldız
- Faculty of Health Sciences, Department of Nursing, Sivas Cumhuriyet University, Sivas 58140, Turkey.
| | - Fatma Tok Yıldız
- Vocational School of Health Care Services, Sivas Cumhuriyet University, Sivas 58140, Turkey
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Hsu MC, Chou MH, Ouyang WC. Dilemmas and Repercussions of Workplace Violence against Emergency Nurses: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052661. [PMID: 35270354 PMCID: PMC8909790 DOI: 10.3390/ijerph19052661] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 02/06/2023]
Abstract
Nurses received the highest rate of workplace violence due to their close interaction with clients and the nature of their work. There have been relatively few qualitative studies focus on nurses' perceptions of and experiences with the antecedents, dilemma and repercussions of the patient and visitor violence (PVV), leaving a considerable evidence gap. The aim of this study was to explore nurses' experience of PVV in emergency department, the impact of PVV on quality of care, and supports needed after exposure to such incidents. We conducted semi-structured interviews with a purposive and snowball sample of nurses, and analyzed the content of the interview transcripts. A total of 10 nurses were approached and agreed to participate. Those participants ranged in age from 24 to 41 years old, eight female and two male nurses, and the majority of them (80%) held a university Bachelor degree in nursing. The average time in nursing practice was 7.2 years. We conceptualized five analytical themes, which comprised: (1) multifaceted triggers and causes of PVV; (2) experiences following PVV; (3) tangled up in thoughts and struggle with the professional role; (4) self-reflexivity and adjustment; and, (5) needs of organizational efforts and support following PVV. This paper provides compelling reasons to look beyond solely evaluating the existence of workplace, and considering the perceived professional inefficacy, impacts of being threatened or assaulted in nurses. There are also urgent needs in provision of prevention and management of workplace training programs to ensure the high-quality nursing care.
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Affiliation(s)
- Mei-Chi Hsu
- Department of Nursing, I-Shou University, Kaohsiung City 82445, Taiwan; (M.-C.H.); (M.-H.C.)
| | - Mei-Hsien Chou
- Department of Nursing, I-Shou University, Kaohsiung City 82445, Taiwan; (M.-C.H.); (M.-H.C.)
| | - Wen-Chen Ouyang
- Department of Geriatric Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan City 71742, Taiwan
- Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung City 82144, Taiwan
- Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung City 80708, Taiwan
- Correspondence: ; Tel.: +886-6-2795019
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Dafny HA, Beccaria G, Muller A. Australian nurses' perceptions about workplace violence management, strategies and support services. J Nurs Manag 2021; 30:1629-1638. [PMID: 34806236 DOI: 10.1111/jonm.13522] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 11/11/2021] [Accepted: 11/16/2021] [Indexed: 11/29/2022]
Abstract
AIMS This study ascertained nurses' perceptions about workplace violence management, strategies and support services. BACKGROUND Nurses regularly encounter verbal and physical violence in their workplace. Workplace violence has long-term consequences on nurses' personal lives and professional work ability. However, more needs to be known about nurses' perceptions of violence management and interventions used. METHODS Ninety-eight nurses from a regional public hospital in Queensland, Australia, completed a survey about workplace violence. Nurses worked in the Emergency Department, Intensive Care Unit or Mental Health Department. RESULTS Ninety-five per cent of nurses stated that all violence should be reported, but 18% would take no action, and 22% would not complete an incident from. Perceptions and preferred responses differed for verbal and physical violence. Low-level interventions and aggression management training were preferred by nurses. Nearly all nurses felt that they should be involved in the development of workplace violence policies. CONCLUSIONS Nurses rate aggression management training highly, and they desire more input into violence policies. The under-reporting of violent incidents remains an issue for future management. IMPLICATIONS FOR NURSING MANAGEMENT Understanding nurses' perceptions of workplace violence management enables the identification of gaps when applying policy and adopting practical approaches to reduce the incidence and severity of workplace violence.
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Affiliation(s)
- Hila A Dafny
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Gavin Beccaria
- School of Psychology and Counselling, Faculty of Health Engineering and Sciences, University of Southern Queensland, Toowoomba, Australia
| | - Amanda Muller
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
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16
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Saridi M, Toska A, Latsou D, Giannakouli A, Geitona M. Verbal Abuse in the Operating Room: A Survey of Three General Hospitals in the Peloponnese Region. Cureus 2021; 13:e18098. [PMID: 34692310 PMCID: PMC8525541 DOI: 10.7759/cureus.18098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2021] [Indexed: 11/10/2022] Open
Abstract
Background The operating room is a special place in a hospital structure, which has a very high psychological load and many moments of tension, often leading to difficulties in communication between the health professionals involved, as well as cases of verbal and physical violence. Purpose The purpose of the study was to investigate the existence of verbal violence in the operating rooms of three general hospitals in the Peloponnese region of Greece. Methods A cross-sectional survey was conducted of health professionals (physicians and nurses) employed in the operating rooms of three general hospitals in the Peloponnese region. For the data collection, the Verbal Abuse Scale questionnaire (VAS) was used. A total number of 80 questionnaires were self-completed and collected. The statistical analysis was performed with the SPSS Statistics software v.25 (IBM Corp., Armonk, NY). Results Regarding the frequency of verbal violence faced by health professionals, 36.8% of physicians stated that they experience verbal violence once a year whereas more than 20% of nurses reported that such incidents occur more than once a month (p=0.148). For the physicians, the abuser was usually their supervisor, while for the nurses, a physician. The majority of physicians stated that they felt mainly anger (2.94 ± 1.35), disgust (2.58 ± 1.54), and sadness/hurt (2.35 ± 1.37) after the verbal abuse, whereas most of the nurses felt anger (3.49 ± 1.39), disgust (3.05 ± 1.52) and frustration (2.95 ± 1.47). Conclusion Nurses are more often the victims of verbal abuse than physicians and are more likely to feel frustrated after experiencing verbal abuse. Gradual change to the organizational culture is an important measure to stop the occurrence of such incidents.
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Affiliation(s)
- Maria Saridi
- Epidemiology and Public Health, General Department of Lamia, University of Thessaly, Lamia, GRC
| | - Aikaterini Toska
- Epidemiology and Public Health, General Department of Lamia, University of Thessaly, Lamia, GRC
| | - Dimitra Latsou
- Social and Educational Policy, University of Peloponnese, Corinth, GRC
| | | | - Mary Geitona
- Social and Educational Policy, University of Peloponnese, Corinth, GRC
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17
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Jakobsson J, Örmon K, Berthelsen H, Axelsson M. Workplace violence from the perspective of hospital ward managers in Sweden: A qualitative study. J Nurs Manag 2021; 30:1523-1529. [PMID: 34273122 DOI: 10.1111/jonm.13423] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/16/2021] [Accepted: 07/15/2021] [Indexed: 02/03/2023]
Abstract
AIM The aims of the study are to explore workplace violence perpetrated by patients or visitors from the perspective of hospital ward managers and to describe how ward managers perceive their leadership role and manage related incidents. BACKGROUND Few studies focus on workplace violence from the perspective of ward managers even though they are the closest managers to the operational staff. METHOD Fifteen semistructured interviews were analysed using qualitative content analysis. RESULTS Four categories emerged: the face of workplace violence, a two-fold assignment, strive towards readiness to act, and managing incidents. CONCLUSION While the most common acts of workplace violence are considered less serious and related to patients' medical conditions or dissatisfied visitors, hospital organizations focus on serious but rarely occurring incidents. Consequently, ward managers have limited opportunities to ensure a safe work environment on an everyday basis. IMPLICATIONS FOR NURSING MANAGEMENT To support ward managers' occupational safety and health management, workplace violence prevention and management should be acknowledged as an important responsibility for senior management in hospitals. It is important to identify incidents that most likely will occur at the wards and to create strategies related to those incidents. Strategies could include risk assessments, prevention, evaluation, education and reflection combined with, for example, scenario training.
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Affiliation(s)
- Jenny Jakobsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden.,Centre for Work Life and Evaluation Studies (CTA), Malmö University, Malmö, Sweden
| | - Karin Örmon
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden.,The Västra Götaland Region Competence Center on Intimate Partner Violence, Gothenburg, Sweden
| | - Hanne Berthelsen
- Centre for Work Life and Evaluation Studies (CTA), Malmö University, Malmö, Sweden.,Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Malin Axelsson
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
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Timmins F, Timmins B. An integrative review of waiting time, queuing, and design as contributory factors to emergency department violence. J Evid Based Med 2021; 14:139-151. [PMID: 34032010 DOI: 10.1111/jebm.12432] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Reports of violence in health care are continuously increasing. Globally there are attempts to manage this phenomenon. However, while risk factors have been identified, there is a tendency to over accentuate the extent of their contribution. Alcohol and drug misuse, for example, are frequently reported, with limited consideration of the ED environment. By far the biggest cause of violence appears to be the presentation of conditions related to or accompanied by mental illness and the impact of queuing and crowded departments on patients and their families. This study aims to examine the extent to which ED waiting times, design and queuing are linked to ED violence. METHODS An integrative literature review was performed using CINAHL Complete and MEDLINE databases. 110 papers were initially selected, and the final analysis included 25 papers. RESULTS The literature revealed three emerging themes: the nature of emergency department violence, environmental contributory factors and its management and control. CONCLUSION The findings of this review reveal several causes of violence. Surprisingly most approaches take a victim blaming approach aimed at identifying potential perpetrators rather than taking a holistic approach to prevention that would also address environmental and societal issues. More is needed in terms of implementation of more far-reaching, practical, and effective management solutions to promote health care workers' safety and adequately support vulnerable patients.
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Affiliation(s)
- Fiona Timmins
- School of Nursing, Midwifery & Health Systems, University College Dublin, Belfied, Dublin, Ireland
| | - Bernard Timmins
- School of Engineering & Built Environment, Technological University of Dublin, Bolton Street, Dublin, Ireland
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19
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Ramacciati N, Guazzini A, Caldelli R, Rasero L. User-friendly system (a smartphone app) for reporting violent incidents in the Emergency Department: an Italian multicenter study. LA MEDICINA DEL LAVORO 2021; 112:68-81. [PMID: 33635296 PMCID: PMC8023056 DOI: 10.23749/mdl.v112i1.9984] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/29/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Nurses, particularly emergency nurses, are among the health workers most exposed to workplace violence. Although reporting systems are increasingly used, under-reporting remains high. Recent studies suggest that the use of easy registration systems could facilitate violence reporting. OBJECTIVES To verify if a friendly reporting system based on a Mobile-app can facilitate the reporting of violent episodes and reduce under-reporting. METHODS Twenty emergency departments of five North and Central Italian regions participated in an interventional, multicentric, pre-post study to verify if a user-friendly reporting system based on a mobile app can facilitate the reporting of violent episodes and reduce under-reporting. RESULTS Three hundred and eighty-four out of 754 potentially eligible nurses answered the short questionnaire at time T0, and 318 registered for the use of the app. One hundred and eighty-nine answered the questionnaire at time T1. The t-Test for Paired Samples, although with a low mean difference, shows a significant difference in the change in the frequency of the reporting of violent episodes. The correlational tests showed no significant differences in the subgroups divided by demographic and professional characteristics. The usability of the app was considered very high. CONCLUSIONS The simplification of the reporting system and the preliminary acquisition of data on the characteristics of the ED and each nurse, can save time and facilitate the reporting, but technology alone is not enough to solve the under-reporting.
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Affiliation(s)
- Nicola Ramacciati
- Experimental Medicine Department, University of Perugia, Perugia, Italy; Training and Quality Department, Azienda Ospedaliera di Perugia, Perugia, Italy.
| | - Andrea Guazzini
- Education, Languages, Intercultures, Literatures and Psychology Department, University of Florence, Florence, Italy.
| | - Roberto Caldelli
- National Interuniversity Consortium for Telecommunications (CNIT), Parma, Italy.
| | - Laura Rasero
- Health Sciences Department, University of Florence, Florence, Italy.
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20
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Charrier P, Occelli P, Buchet-Poyau K, Douplat M, Delaroche-Gaudin M, Fayard-Gonon F, Jacquin L, Potinet V, Sigal A, Tazarourte K, Touzet S. Strategies used by emergency care professionals to handle interpersonal difficulties with patients: a qualitative study. BMJ Open 2021; 11:e042362. [PMID: 33558353 PMCID: PMC7871700 DOI: 10.1136/bmjopen-2020-042362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Identify the strategies implemented by emergency care professionals when facing tension and interpersonal violence from patients and their friends and family. DESIGN Descriptive qualitative study based on 38 semidirective interviews. PARTICIPANTS Doctors, nurses, nursing assistants and administrative staff. SETTING Four emergency departments (EDs) from three French university hospitals. RESULTS According to the medical professionals interviewed, the difficulties that they encounter with patients or their accompanying family members can be explained by a lack of understanding of the functioning of EDs, by a general increase in individualistic behaviours leading to a lack of civility or by deviant behaviours (related to toxic substance abuse or mental illness). While managing deviant behaviours may sometimes require a collective intervention, ED staff also implement what are essentially individual communication strategies (with the use of rational explanation, seduction and empathy), confrontation or flight to deal with interpersonal difficulties. CONCLUSIONS Strategies used by staff members tend to be individualised for the most part, and some, such as confrontational or escape strategies, may not be adapted to all situations. In the face of difficulties between staff and patients, mediators, specialised in resolving conflict, could entrust some cases to professionals. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT03139110).
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Affiliation(s)
- Philippe Charrier
- Centre Max Weber (UMR 5283), University Lumière Lyon 2, F-69007 Lyon, France
- Public Health Department, Hospices Civils de Lyon, F-69003 Lyon, France
| | - Pauline Occelli
- Public Health Department, Hospices Civils de Lyon, F-69003 Lyon, France
- Health Services and Performance Research Lab (HESPER EA 7425), University Claude Bernard Lyon 1, F-69008 Lyon, France
| | | | - Marion Douplat
- Health Services and Performance Research Lab (HESPER EA 7425), University Claude Bernard Lyon 1, F-69008 Lyon, France
- Emergency Department, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite, France
| | | | | | - Laurent Jacquin
- Emergency Department, Edouard Herriot Hospital, F-69008 Lyon, France
| | - Véronique Potinet
- Emergency Department, Centre Hospitalier Lyon Sud, F-69310 Pierre-Bénite, France
| | - Alain Sigal
- Emergency Departement, Croix-Rousse Hospital, F-69004 Lyon, France
| | - Karim Tazarourte
- Health Services and Performance Research Lab (HESPER EA 7425), University Claude Bernard Lyon 1, F-69008 Lyon, France
- Emergency Department, Edouard Herriot Hospital, F-69008 Lyon, France
| | - Sandrine Touzet
- Public Health Department, Hospices Civils de Lyon, F-69003 Lyon, France
- Health Services and Performance Research Lab (HESPER EA 7425), University Claude Bernard Lyon 1, F-69008 Lyon, France
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21
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Ferri P, Stifani S, Accoto A, Bonetti L, Rubbi I, Di Lorenzo R. Violence Against Nurses in the Triage Area: A Mixed-Methods Study. J Emerg Nurs 2021; 46:384-397. [PMID: 32389213 DOI: 10.1016/j.jen.2020.02.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 02/13/2020] [Accepted: 02/14/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Workplace violence is a serious occupational problem among nurses in emergency departments. The aim of this study was to better understand workplace violence experienced by triage nurses. METHODS A mixed-methods study was carried out with 27 Italian nurses involved in the triage area of an emergency department. Quantitative data were collected using the Violent Incident Form and qualitative data were obtained from 3 focus groups. RESULTS Ninety-six percent of triage nurses had suffered an episode of violence during the previous year. Participants reported that perpetrators of violence were primarily patients' relatives or friends (62%), usually male and in a lucid state of consciousness. The aggressor was a male patient in 31% of violent episodes. Male nurses reported only verbal abuse, unlike female nurses who suffered both physical and verbal episodes. Females received assistance from other staff during the aggression event more frequently than males, and females more frequently suffered from physical injury. Only physical and verbal aggressions were associated with physical injury. Four main themes emerged from the focus groups. DISCUSSION Nurses reported that high exposure to workplace violence in triaging had significant consequences on their psychological well-being and on their behavior at work and at home. Violence, perceived as a personal and/or professional injury owing to insufficient organizational support, led professionals to experience feelings of resignation and to believe that abuse was an inevitable part of the job. Nevertheless, in our study, the precipitating factors were investigated, suggesting several possible solutions to limit this phenomenon.
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22
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Al‐Qadi MM. Workplace violence in nursing: A concept analysis. J Occup Health 2021; 63:e12226. [PMID: 33960074 PMCID: PMC8103077 DOI: 10.1002/1348-9585.12226] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/15/2021] [Accepted: 04/05/2021] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES To clarify the concept of workplace violence in nursing and propose an operational definition of the concept. METHODS The review method used was Walker and Avant's eight-step method. RESULTS Identification of the key attributes, antecedents, consequences, and empirical referents of the concept resulted in an operational definition of the concept. The proposed operational definition identifies workplace violence experienced by nurses as any act or threat of verbal or physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the worksite with the intention of abusing or injuring the target. CONCLUSIONS Developing insights into the concept will assist in the design of new research scales that can effectively measure the underlying issues, provide a framework that facilitates nursing interventions, and improve the validity of future studies.
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Bingöl S, İnce S. Factors influencing violence at emergency departments: Patients' relatives' perspectives. Int Emerg Nurs 2020; 54:100942. [PMID: 33302240 DOI: 10.1016/j.ienj.2020.100942] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 09/28/2020] [Accepted: 10/21/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION In hospitals, the places where the highest rate of violence is perpetrated are emergency departments (EDs). Evaluating patient relatives' perceptions of violence and obtaining their views about how to prevent violence incidents are important in terms of uncovering the factors that increase violent behaviors. This study was aimed at determining the factors increasing violence in the emergency department (ED) from the perspectives of patient relatives. METHODS The sample of this study consisted of 520 individuals who brought a relative to the Adult ED of Akdeniz University Hospital in Turkey between April 2017 and June 2017. Data was collected using a two-part questionnaire prepared by the researcher. The first part consists of 15 items questioning the demographic characteristics of the participants. The second part consists of 20 statements asked the participants to rate the reasons urged patients or their relatives to perpetrate violence in the emergency department. Numbers and percentage calculations were used to evaluate the data. RESULTS Of the participants, 55.6% were men and 54.7% were married. According to the participants' statements, of the relatives of the 520 patients, 141 (27.1%) witnessed verbal violence against emergency department staff, 76 (14.6%) witnessed physical violence against emergency department staff, 9 (1.7%) witnessed verbal threat against emergency department staff, especially against nurses. According to the participants, the primary factor causing people to perpetrate violence at EDs was that patients or their relatives were not adequately informed about the patient's condition. More than 40% of patients' relatives said that anxiety and nervousness arising from being a patient's relative, and stress and sadness they suffered were among the leading factors causing people to perpetrate violent incidents. CONCLUSION In order to prevent and decrease incidents of violence in the emergency departments, healthcare systems should be reviewed and revised. Our study revealed that informing patients and their relatives about the patient's condition and empathic approaches displayed by healthcare employees towards patients reduced the number of incidents of violence. Unlike other studies, this study addresses the negative experiences of patients' relatives in the emergency department and the factors influencing these experiences. Obtaining the opinions of the patients' relatives about possible solutions to the violent events in the ED makes this study unique.
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Affiliation(s)
- Serap Bingöl
- Akdeniz University Hospital of Emergency Department, Campus/Antalya, Turkey
| | - Serpil İnce
- Fundamentals of Nursing Department, Akdeniz University Nursing Faculty Antalya, Turkey.
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Pich J, Roche M. Violence on the Job: The Experiences of Nurses and Midwives with Violence from Patients and Their Friends and Relatives. Healthcare (Basel) 2020; 8:E522. [PMID: 33266225 PMCID: PMC7712129 DOI: 10.3390/healthcare8040522] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/16/2020] [Accepted: 11/25/2020] [Indexed: 11/16/2022] Open
Abstract
Violence in healthcare is recognised as a significant workplace issue worldwide, with nurses recognised as the profession at greatest risk. The purpose of this study was to explore nurses' and midwives' experiences of violence in different clinical areas, work sectors and geographical regions. A cross-sectional design was employed to survey the membership of the New South Wales Nurses and Midwives' Association about their experiences with violence from patients and/or their friends and relatives in their workplace. A total of 3416 participants returned a completed questionnaire and more than three-quarters of had experienced an episode of violence in the preceding six months. Participants working in the public health sector reported significantly more physically violent behaviours than their colleagues in the private sector. No statistically significant difference between the rates of violence (overall) was identified between different geographical areas. Violent behaviours were reported across all clinical settings, with emergency departments, mental health and drug and alcohol settings reporting the highest proportion of episodes. The results of this large study highlight the high levels of violence that nurses and midwives experience in the workplace across all sectors of employment, geographical regions and clinical settings.
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Affiliation(s)
- Jacqueline Pich
- School of Nursing and Midwifery, University of Technology Sydney, Sydney, NSW 2007, Australia;
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25
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Zhang J, Zheng J, Cai Y, Zheng K, Liu X. Nurses' experiences and support needs following workplace violence: A qualitative systematic review. J Clin Nurs 2020; 30:28-43. [PMID: 32936970 DOI: 10.1111/jocn.15492] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 08/23/2020] [Accepted: 08/28/2020] [Indexed: 02/03/2023]
Abstract
AIMS AND OBJECTIVES To systematically identify, appraise and synthesise existing qualitative studies exploring nurses' lived experiences of workplace violence by patients, families and hospital visitors, identifying their support needs following workplace violence. BACKGROUND Workplace violence against nurses is a significant concern globally, as it leads to serious negative consequences for nurses, patients and organisations as a whole. Having adequate support is considered significant. While numerous studies have been conducted on workplace violence, few qualitative reviews have focused on identifying nurses' support needs following episodes of workplace violence. METHODS Four databases (MEDLINE, CINAHL, PsychINFO and Scopus) were systematically searched. Additionally, hand searching of prominent journals, grey literature and reference lists of included studies was also performed to identify additional research. The Critical Appraisal Skills Programme checklist for qualitative studies was used to assess all included articles. Thomas and Harden's three-stage approach to thematic analysis was followed, using the ENTREQ statement for reporting. RESULTS Ten studies published in English, conducted across eight countries, met the inclusion criteria. Four analytical themes relating to nurses' experiences were identified: "inevitable and unpredictable trauma in the career" "higher tolerance and understanding of unintentional violence," "positive learning or passive adjustment" and "struggle with the role and behaviour conflict." In terms of nurses' support needs, the analysis yielded two themes: "informal support needs" and "formal support needs." CONCLUSION Nurses experience significant and lasting psychological trauma due to workplace violence; however, the support for nurses remains seriously inadequate. Establishing an effective and robust support system based on nurses' needs must be viewed as a priority for organisations, as well as researchers. RELEVANCE TO CLINICAL PRACTICE Institutions and managers have a duty to maintain an awareness of nurses' experiences and support needs regarding workplace violence. There is a need for further policymaking and research, based on clinical practice, in order to develop effective preventive and interventive strategies regarding workplace violence.
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Affiliation(s)
- Junfeng Zhang
- Department of Nursing, SSL Central Hospital of Dongguan City, Dongguan, China
| | - Jing Zheng
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yingying Cai
- Department of Chemotherapy, Jieyang People's Hospital, Jieyang, China
| | - Kexin Zheng
- Department of Psychiatry, Zhuhai Center for Chronic Disease Control, Zhuhai, China
| | - Xingling Liu
- Department of Nursing, SSL Central Hospital of Dongguan City, Dongguan, China
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Nurses' perspectives of violence in emergency departments: A metasynthesis. Int Emerg Nurs 2020; 52:100905. [PMID: 32818745 DOI: 10.1016/j.ienj.2020.100905] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 07/03/2020] [Accepted: 07/14/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Workplace violence against nurses in the Emergency Department (ED) is a significant issue worldwide and has received increased attention. Workplace violence against nurses in the ED has increased in recent years. With such a large number of nurses having experienced violence, it is important to understand and elucidate the nurses' perspective of violence in the ED. METHOD Qualitative studies that were published between 2010 and 2019. A metasynthesis of 6 qualitative studies was conducted using Noblit and Hare's metaethnographic methodology. The Critical Appraisal Skills Program (CASP) was used to evaluate the quality of the studies. RESULTS Four overarching themes emerged from the data: the inevitability of violence, invisible wounds and painful memories, post-violence repercussions, and double-sided: physical and verbal abuse. DISCUSSION Findings provide insight into policies actions related to perpetrators and developing violence protections guidelines to support ED nurses in managing workplace violence. CONCLUSION Violence in the ED is an inevitable experience for nurses. Organizations must take a realistic approach to implement violence reduction measures and training programs in the ED.
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Dafny HA, Beccaria G. I do not even tell my partner: Nurses’ perceptions of verbal and physical violence against nurses working in a regional hospital. J Clin Nurs 2020; 29:3336-3348. [DOI: 10.1111/jocn.15362] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 05/09/2020] [Accepted: 05/17/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Hila A. Dafny
- School of Nursing and Midwifery Faculty of Health Engineering and Sciences University of Southern Queensland Toowoomba Australia
| | - Gavin Beccaria
- School of Psychology and Counselling Faculty of Health Engineering and Sciences University of Southern Queensland Toowoomba Australia
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Charrier P, Buchet-Poyau K, Delaroche-Gaudin M, Douplat M, Jacquin L, Occelli P, Fayard-Gonon F, Potinet V, Tazarourte K, Touzet S. [Mediators in emergency services: what missions according to the staff?]. SANTE PUBLIQUE 2020; 31:797-807. [PMID: 32550662 DOI: 10.3917/spub.196.0797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES Violence in emergency services has become a central issue in the daily work of hospital employees. While the use of video surveillance and the training of professionals in conflict management are the most common methods used, there are few cases using the setting up of a third part such as a mediator. We conducted a qualitative study with professionals to examine their representations associated with mediation. METHOD Semi-directive interviews were conducted with professionals from four emergency units. The topics discussed in interviews were the definition of mediation and the missions that the mediators should fulfil. The content of 38 semi-directive interviews was analysed according to the inductive approach of the grounded theory. A content analysis was made, followed by an analysis aiming to bring out types and convergences/divergences. RESULTS Professionals were not aware of the definition of mediation and of its missions. They linked to it an instrumental theme, making mediation a tool for conflict prevention and management, a tool for communication with patients about their care, and about the organisation of emergency unit. The upcoming presence of mediators was seen as an help. A potential competition between professionals and mediators in the tasks performed was identified. CONCLUSION The study shows a favourable opinion towards mediation. It has allowed to identify obstacles to the well-functioning of the missions assigned to mediators. One of the challenges is the integration of this new actor, the mediator.
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The Face of Workplace Violence: Experiences of Healthcare Professionals in Surgical Hospital Wards. Nurs Res Pract 2020; 2020:1854387. [PMID: 32550024 PMCID: PMC7275198 DOI: 10.1155/2020/1854387] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/07/2020] [Accepted: 05/13/2020] [Indexed: 02/07/2023] Open
Abstract
Background Though workplace violence (WPV) is a global problem for healthcare professionals, research within in-hospital care has mainly focused on WPV in emergency healthcare settings. Thus, the number of qualitative studies that explores experiences of WPV in general hospital wards with a longer length of stay is limited. Aim The aim of this study was to explore how healthcare professionals in surgical hospital wards experience and manage WPV perpetrated by patients or visitors. Method The study applied a qualitative, inductive approach using focus group interviews for data collection. A purposeful sample of 16 healthcare professionals working in surgical wards was included. Data were analysed using a thematic analysis. Findings. The analysis resulted in four main themes: workplace violence characteristics, partly predictable yet not prevented, approaching workplace violence, and consequences from workplace violence. During the focus group interviews, the healthcare professionals described various acts of physical violence, verbal abuse, and gender discrimination perpetrated by patients or their visitors. Despite the predictability of some of the incidents, preventive strategies were absent or inadequate, with the healthcare professionals not knowing how to react in these threatful or violent situations. They experienced that WPV could result in negative consequences for the care of both the threatful or violent person and the other patients in the ward. WPV caused the healthcare professionals to feel exposed, scared, and unprotected. Conclusion and clinical implications. Exposure to WPV is a problem for healthcare professionals in surgical wards and has consequences for the patients. Preventive strategies, guidelines, and action plans are urgently needed to minimise the risk of WPV and to ensure a safe work and care environment.
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Workplace violence: Examination of the tensions between duty of care, worker safety, and zero tolerance. Health Care Manage Rev 2020; 45:E13-E22. [PMID: 32358237 DOI: 10.1097/hmr.0000000000000286] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Workplace violence (WPV) remains an international problem. This raises challenges for staff in meeting their duty of care to consumers while enforcing zero tolerance for violence directed toward them. PURPOSE The aim of the study was to expose the values and beliefs underpinning practice and reveal any flawed assumptions or evidence, upon which decisions related to WPV are made. By increasing staff awareness, the secondary aim is to decrease staff stress when confronted with conflicting policies and duty of care responsibilities. METHODOLOGY Explanatory research as part of a larger descriptive study was used. Semistructured interviews with a sample of managers and staff (n = 99) in Victorian Health Services (Australia) were performed. Initial descriptive analysis identified a tension between duty of care, worker safety, and zero tolerance. This article reports the secondary analysis to examine these relationships in depth. FINDINGS Feeling obligated and providing care for aggressive patients was difficult while maintaining own safety: "You cannot do both." Although there were contrasting views about the merits of zero tolerance, policies were rarely enacted: "We cannot refuse to treat." Incongruency between legislative requirements creates confusion for decision-making: "Which Act trumps what?" CONCLUSION Despite policies supporting zero tolerance, staff do not enact these because they prioritize duty of care to consumers before duty of care to self. Zero tolerance, with incongruent legislation, compounds this tension and impairs decision-making. PRACTICAL IMPLICATIONS This article exposes the underlying values, beliefs, and flawed assumptions underpinning practice related to WPV. Managers need to amend policies to reduce staff confusion, adopt a trauma-sensitive and resilience approach, and develop a clearly written framework to guide decision-making related to duty of care to consumers and staff safety. Incident reports and staff well-being/satisfaction surveys need to evaluate the effects of zero tolerance on staff and consumers. Regulators need to ensue legislative requirements are congruent with staff safety and well-being.
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Spelten E, Thomas B, O’Meara P, van Vuuren J, McGillion A. Violence against Emergency Department nurses; Can we identify the perpetrators? PLoS One 2020; 15:e0230793. [PMID: 32240231 PMCID: PMC7117706 DOI: 10.1371/journal.pone.0230793] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 03/08/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Violence against health care workers is a major issue in health care organisations and is estimated to affect 95% of workers, presenting an enormous risk for workers and employers. Current interventions generally aim at managing rather than preventing or minimising violent incidents. To create better-targeted interventions, it has been suggested to shift attention to the perpetrators of violence. The aim of this study was to identify and discuss the perceptions, held by Emergency Department nurses, about perpetrators of occupational violence and aggression. METHODS Two focus groups were conducted with Emergency Department nurses at a major metropolitan hospital in Australia. In the focus groups, the nurses' perceptions about perpetrators of violence against health care workers were identified and discussed. The results were analysed using descriptive analysis. RESULTS This study confirmed that violence is a major issue for Emergency Department nurses and has a considerable impact on them. Participants acknowledged that violence at work had become an intrinsic part of their job and they tend to focus on coping mechanisms. The nurses identified six overlapping groups of perpetrators and described their approach to dealing with these perpetrators. The results highlighted additional factors that impact on the occurrence and management of violence, such as the presence of security, wait times, and the triage system. CONCLUSIONS Based on the focus groups with Emergency Department nurses we conclude that violence at work is an everyday danger for Emergency Department nurses, who feel vulnerable and recognise that it is not within their power to solve this issue given the societal component. Our conclusion is that attention needs to shift from equipping workers with tools to manage violence to the perpetrator and the development of interventions to reduce violence from targeted perpetrator groups.
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Affiliation(s)
- Evelien Spelten
- Department of Psychology and Public Health, Rural Health School, La Trobe University, Melbourne, Australia
| | - Brodie Thomas
- La Trobe Rural Health School, La Trobe University, Mildura, Australia
| | - Peter O’Meara
- Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Australia
| | - Julia van Vuuren
- Department of Psychology and Public Health, Rural Health School, La Trobe University, Melbourne, Australia
| | - Anthony McGillion
- School of Nursing and Midwifery, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
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Experiences of nurses working in a triage area: An integrative review. Aust Crit Care 2020; 33:567-575. [PMID: 32143883 DOI: 10.1016/j.aucc.2020.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 01/19/2020] [Accepted: 01/19/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES The aim of the study is to review the literature on the experiences of nurses working in triage within emergency departments in hospitals. REVIEW METHOD This is an integrative review based on Cooper's five-stage framework. DATA SOURCES Primary research articles published from January 2008 to January 2018 were identified from seven databases: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Cochrane, ProQuest, and Scopus. A manual search of the end references from the published studies was also conducted to ensure a comprehensive search. REVIEW METHOD The included studies were evaluated independently by two authors based on the Joanna Briggs Institute appraisal checklist for Interpretive and Critical Research and Descriptive/Case Series to ensure methodological rigour and validity of the review. RESULTS The literature review included 35 articles; of which, 18 were qualitative studies, 13 were quantitative studies, and four were mixed-method studies. The findings from this review were categorised into three themes: (1) making judgement, (2) service delivery, and (3) effective communication. CONCLUSIONS The results from the review suggest that triage is a complex process involving decision-making and interprofessional communication. Nurses need to make judgement, consider factors affecting service delivery, and engage in effective communication, which is central to triaging. Decision-making is contextual and requires judicious judgement. Effective communication with fellow healthcare personnel and with patients and their caregivers is paramount to optimise care delivery. Finally, more support is needed to empower the nurses to cope with the work involved in triaging.
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Grover S, Dalton N, Avasthi A. Workplace violence against doctors in a tertiary care hospital. Ind Psychiatry J 2020; 29:38-46. [PMID: 33776274 PMCID: PMC7989456 DOI: 10.4103/ipj.ipj_79_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/25/2020] [Accepted: 07/07/2020] [Indexed: 11/24/2022] Open
Abstract
AIM This study aimed to evaluate the magnitude and factors associated with violence against doctors. MATERIALS AND METHODS An online survey of doctors working in a tertiary care hospital in India was done by using the modified version of the workplace violence (WPV) in the Health Sector Questionnaire, developed by the World Health Organization. RESULTS Out of the 353 participants, 193 doctors (54.6%) reported being exposed to violence at their workplace in the past 6 months. Participants from the medical branches (57.8%), senior residents (60.3%), and those who were posted in emergency services (79.4%) and night duty (56.1%) reported more violence. The most common type of WPV was verbal abuse (91.2%), and the perpetrators were relatives of the patients (51.7%). The possible perceived reasons for WPV were patient overload (69.7%), prolonged duty hours and excessive workload (69.7%), and long waiting periods for patients/caregivers (66.9%). The majority of the participants considered that recruiting an adequate number of professional and paraprofessional staff (75.6%) can lead to a reduction in WPV. CONCLUSIONS The present study suggests that more than half of the doctors working in a tertiary care hospital in India face WPV. There is a lack of specific redressal mechanism to address WPV. Accordingly, there is a need to develop a mechanism for reporting of WPV and to implement preventive strategies at the individual level and at the system level. There is need for strengthening and implementing laws and making new policies to reduce WPV.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Nobel Dalton
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajit Avasthi
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Violence and burnout in health care emergency workers in Santiago, Chile: A survey-based cross-sectional study. Int Emerg Nurs 2019; 47:100792. [PMID: 31679969 DOI: 10.1016/j.ienj.2019.100792] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 08/16/2019] [Accepted: 08/27/2019] [Indexed: 02/07/2023]
Abstract
Shortage of quantitative studies regarding health risks for emergency services workers is a concern for Chilean's occupational health organizations. OBJECTIVE To explore the incidence of violence and burnout in emergency services of the Metropolitan Region of Chile, and associations with workers' characteristics and workplace conditions. METHODS A cross-sectional study was carried out from January to August 2016. A self-reported questionnaire explored about frequency and seriousness of violence episodes and about symptoms of burnout with the Maslach Burnout Inventory. RESULTS Of the 565 workers participating, 71% (95% CI 66.7-74.5) said violence episodes occurred at least once a week; 71.3% (95% CI 67.3-75.0) were victims of some aggression in the previous 12 months. Patients companions, relatives or friends arose as the main aggressors and the severity of the episodes was considered slight or moderate by more than 50% of participants. Fifty-seven respondents (10.5%, CI 95% 8.1-13.5) classified as having a burnout syndrome. Having been a victim of violence was associated to high emotional exhaustion (ORadj = 1.7, 95% CI: 1.1-2.8) and depersonalization (ORadj = 2.0, 95% CI 1.3-3.3). CONCLUSIONS Violence is a problem in the emergency departments of Chile's Metropolitan Region. Burnout is also present and independently associated to violence.
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Public knowledge, attitudes, and intention to act violently, with regard to violence directed at health care staff. Nurs Outlook 2019; 68:220-230. [PMID: 31542174 DOI: 10.1016/j.outlook.2019.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 08/04/2019] [Accepted: 08/25/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Violence directed at health care staff is widely prevalent. Few studies have explored public attitudes regarding violence against health care staff. PURPOSES To examine the Israeli public's attitudes regarding violence against health care staff and their intention to act violently in various health care settings. METHOD A cross-sectional study among 609 adult participants used a self-report questionnaire. The questionnaire dealt with attitudes regarding violence toward health care staff and presented the participants with three scenarios of violence in a health care setting. Logistic regression was conducted to explore variables that may explain the public's intentions to act violently. FINDINGS The participants expressed condemnation of violence toward health care staff. Men displayed more violent attitudes than women. Participants who justified violence and were supportive of violent behavior displayed significantly more intentions to act violently. DISCUSSION Actions taken to eliminate violence in the health system must be based on cooperation between health policymakers, health care workers, and the public.
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Cabilan CJ, Johnston ANB. Review article: Identifying occupational violence patient risk factors and risk assessment tools in the emergency department: A scoping review. Emerg Med Australas 2019; 31:730-740. [DOI: 10.1111/1742-6723.13362] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 06/26/2019] [Accepted: 07/01/2019] [Indexed: 12/24/2022]
Affiliation(s)
- CJ Cabilan
- Emergency DepartmentPrincess Alexandra Hospital Brisbane Queensland Australia
- School of Nursing, Midwifery and Social WorkThe University of Queensland Brisbane Queensland Australia
| | - Amy NB Johnston
- Emergency DepartmentPrincess Alexandra Hospital Brisbane Queensland Australia
- School of Nursing, Midwifery and Social WorkThe University of Queensland Brisbane Queensland Australia
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Hills D, Lam L, Hills S. Workplace aggression experiences and responses of Victorian nurses, midwives and care personnel. Collegian 2018. [DOI: 10.1016/j.colegn.2018.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Morphet J, Griffiths D, Beattie J, Velasquez Reyes D, Innes K. Prevention and management of occupational violence and aggression in healthcare: A scoping review. Collegian 2018. [DOI: 10.1016/j.colegn.2018.04.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ziaei M, Massoudifar A, Rajabpour-Sanati A, Pourbagher-Shahri AM, Abdolrazaghnejad A. Management of Violence and Aggression in Emergency Environment; a Narrative Review of 200 Related Articles. ADVANCED JOURNAL OF EMERGENCY MEDICINE 2018; 3:e7. [PMID: 31172118 PMCID: PMC6548084 DOI: 10.22114/ajem.v0i0.117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
CONTEXT The aim of this study is to reviewing various approaches for dealing with agitated patients in emergency department (ED) including of chemical and physical restraint methods. EVIDENCE ACQUISITION This review was conducted by searching "Violence," "Aggression," and "workplace violence" keywords in these databases: PubMed, Scopus, EmBase, ScienceDirect, Cochrane Database, and Google Scholar. In addition to using keywords for finding the papers, the related article capability was used to find more papers. From the found papers, published papers from 2005 to 2018 were chosen to enter the paper pool for further review. RESULTS Ultimately, 200 papers were used in this paper to conduct a comprehensive review regarding violence management in ED. The results were categorized as prevention, verbal methods, pharmacological interventions and physical restraint. CONCLUSION In this study various methods of chemical and physical restraint methods were reviewed so an emergency medicine physician be aware of various available choices in different clinical situations for agitated patients.
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Affiliation(s)
- Maryam Ziaei
- Department of Emergency Medicine, Khatam-Al-Anbia Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ali Massoudifar
- Department of Psychiatry, School of Medicine, Hormozgan University of Medical Sciences, Bandarabbas, Iran
| | | | | | - Ali Abdolrazaghnejad
- Department of Emergency Medicine, Khatam-Al-Anbia Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
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Kleissl-Muir S, Raymond A, Rahman MA. Incidence and factors associated with substance abuse and patient-related violence in the emergency department: A literature review. Australas Emerg Care 2018; 21:159-170. [DOI: 10.1016/j.auec.2018.10.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 10/14/2018] [Accepted: 10/15/2018] [Indexed: 12/29/2022]
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Green O, Ayalon L. Violations of workers' rights and exposure to work-related abuse of live-in migrant and live-out local home care workers - a preliminary study: implications for health policy and practice. Isr J Health Policy Res 2018; 7:32. [PMID: 29929555 PMCID: PMC6011269 DOI: 10.1186/s13584-018-0224-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 05/07/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Home care workers work in an isolated environment, with limited supervision and guidance which makes them more prone to abuse and exploitation. While past research focused mostly on the well-being of care recipients, this study aimed to shed light on the care workers' daily reality and explore if and how boundaries of professional care work are blurred. Our primary aim was to assess the working conditions and the prevalence of abuse and exploitation among live-in migrant home care workers and live-out local home care workers. METHODS A random stratified sample of Israeli older adults aged over 70, who are entitled by law to home care services was used to recruit 338 migrant live-in home care workers and 185 local live-out home care workers to a face-to-face survey. The participants were asked about their relationship with the care recipient and their exposure to violations of workers' rights and work-related abuse. RESULTS Almost all the participants reported exposure to certain workers' rights violations. Among the migrant live-in care workers, it was found that 58% of them did not receive any vacation days besides the weekly day-off, about 30% reported not get even a weekly day-off on a regular basis, and 79% did not get paid sick days. Local live-out care workers also suffered from a high prevalence of exploitation - 58% did not get any vacation days besides the weekly day-off, and 66% did not get paid sick leave. 20% of the local live-out care workers, and 15% of the migrant live-in care workers did not receive a signed contract. A smaller portion (7.4% among migrant care workers, 2.5% among local care workers) reported work-related abuse. When compared to local workers, migrant home care workers were more vulnerable to some worker's rights violations, as well as emotional abuse. CONCLUSION These findings are disturbing, as work-related abuse and exploitation affect not only the well-being of the care worker but also the health of the care recipients, as the quality of care provided deteriorates. At the public policy level, more significant attention and regulation of the home care industry is needed. The frequency and the nature of home visits made by home care agencies must be changed. Also, home care workers should be offered emotional support.
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Violence towards Emergency Nurses. The Italian National Survey 2016: A qualitative study. Int J Nurs Stud 2018; 81:21-29. [DOI: 10.1016/j.ijnurstu.2018.01.017] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 01/29/2018] [Accepted: 01/31/2018] [Indexed: 11/22/2022]
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Pai DD, Sturbelle ICS, Santos CD, Tavares JP, Lautert L. VIOLÊNCIA FÍSICA E PSICOLÓGICA PERPETRADA NO TRABALHO EM SAÚDE. TEXTO & CONTEXTO ENFERMAGEM 2018. [DOI: 10.1590/0104-07072018002420016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: analisar a presença da violência física e psicológica entre trabalhadores da saúde, identificar seus perpetradores e compreender a origem das agressões. Método: estudo de abordagem mista. Os dados quantitativos foram coletados sobre amostra aleatória de 269 profissionais da equipe de saúde em hospital público da Região Sul do Brasil, dentre os quais, 20 sujeitos, vítimas de violência, compuseram sequencialmente a etapa qualitativa. Resultados: a violência física atingiu 15,2% (n=42) dos profissionais e a violência psicológica 48,7% (n=135) dos trabalhadores por meio de agressões verbais, 24,9% (n=69) sofreram assédio moral, 8,7% (n=24) discriminação racial e 2,5% (n=7) assédio sexual. Mulheres foram as principais vítimas da violência física, assédio moral e discriminação racial (p<0,05). Técnicos de enfermagem foram os mais expostos à violência física e assédio moral (p<0,05). O paciente foi o principal agressor da equipe de saúde (35,4%, n=98), seguido pelos colegas de trabalho (25,3%, n=70), chefia (21,7%, n=60) e acompanhantes (15,5%, n=43). Agravos neurológicos, abuso de álcool e de outras drogas foram relacionados à origem da agressão, razões que atenuaram a culpa dos pacientes pela violência. As condições impróprias de trabalho geraram revolta dos pacientes e entre os profissionais. Aspectos da organização do trabalho no hospital público foram apontados como causas para conflitos que repercutem em violências. Conclusões: a violência psicológica foi prevalente, mulheres e técnicos de enfermagem foram os mais expostos e pacientes os principais perpetradores. São necessárias medidas de contenção e prevenção, bem como investimentos sobre as condições e a organização do trabalho no hospital.
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Ashton RA, Morris L, Smith I. A qualitative meta-synthesis of emergency department staff experiences of violence and aggression. Int Emerg Nurs 2018; 39:13-19. [PMID: 29326038 DOI: 10.1016/j.ienj.2017.12.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/22/2017] [Accepted: 12/20/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Patient and visitor violence or aggression against healthcare workers in the Emergency Department (ED) is a significant issue worldwide. This review synthesises existing qualitative studies exploring the first-hand experiences of staff working in the ED to provide insight into preventing this issue. METHOD A meta-ethnographic approach was used to review papers. RESULTS Four concepts were identified: 'The inevitability of violence and aggression'; 'Staff judgments about why they face violence and aggression'; 'Managing in isolation'; and 'Wounded heroes'. DISCUSSION Staff resigned themselves to the inevitability of violence and aggression, doing this due to a perceived lack of support from the organisation. Staff made judgements about the reasons for violent incidents which impacted on how they coped and subsequently tolerated the aggressor. Staff often felt isolated when managing violence and aggression. Key recommendations included: Staff training in understanding violence and aggression and clinical supervision. CONCLUSION Violence and aggression in the ED can often be an overwhelming yet inevitable experience for staff. A strong organisational commitment to reducing violence and aggression is imperative.
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Affiliation(s)
| | - Lucy Morris
- Merseycare NHS Foundation Trust, Whalley, Lancashire BB7 9PE, UK
| | - Ian Smith
- Furness College, Lancaster University, Lancaster LA1 4YG, UK.
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Jonas-Dwyer DR, Gallagher O, Saunders R, Dugmore H, Bulsara C, Metcalfe H. Confronting reality: A case study of a group of student nurses undertaking a management of aggression training (MOAT) program. Nurse Educ Pract 2017; 27:78-88. [DOI: 10.1016/j.nepr.2017.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 07/19/2017] [Accepted: 08/06/2017] [Indexed: 11/26/2022]
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Zhou C, Mou H, Xu W, Li Z, Liu X, Shi L, Peng B, Zhao Y, Gao L, Fan L. Study on factors inducing workplace violence in Chinese hospitals based on the broken window theory: a cross-sectional study. BMJ Open 2017; 7:e016290. [PMID: 28756386 PMCID: PMC5642795 DOI: 10.1136/bmjopen-2017-016290] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To explore the potential components of hospital workplace violence (HWPV) from the perspectives of hospital administrators and patients, and put forward corresponding strategies for its prevention and control. SETTING Using convenience sampling methods, 116 hospitals in 14 provinces of China were surveyed using a self-designed questionnaire. METHODS A cross-sectional study was used. PARTICIPANTS Hospital administrators and patients from 116 hospitals in 14 provinces of China. RESULTS First, hospital administrators point of workplace factors included six factors, with the following weighting coefficients: hospital administrator factors (29.40%), patient-related factors (20.08%), hospital environmental factors (19.45%), policy and institutional factors (11.92%), social psychological factors (10.26%), objective events factors (8.89%). Second, patients from the hospital workplace predisposing factors included three common factors. The weight coefficients of these were hospital-related factors (60.27%), social and governmental factors (23.64%) and patient-related factors (16.09%). CONCLUSIONS A wide range of factors according to hospital administrators, patients and in the hospital environment play important roles in HWPV. From the perspectives of hospital administrators, communication skills and attitude to the service are important factors for inducing HWPV. From the perspective of patients, the characteristics of staff personalities and medical cognition are more important inducing factors. As far as social factors are concerned, economic compensation of medical malpractice is an important inducing factor for HWPV. In terms of environmental factors, management of Chinese medical hospitals, medical procedures and the layout of departments are all potential factors for the occurrence of violence. Corresponding defects were exposed in the health legal system and the supervision system for influencing public opinion.
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Affiliation(s)
- Chenyu Zhou
- Department of Health Management, School of Public Health, Harbin Medical University, Harbin, China
| | - Huitong Mou
- Department of Health Management, School of Public Health, Harbin Medical University, Harbin, China
| | - Wen Xu
- Department of Health Management, School of Public Health, Harbin Medical University, Harbin, China
| | - Zhe Li
- Department of Health Management, School of Public Health, Harbin Medical University, Harbin, China
| | - Xin Liu
- Department of Health Management, School of Public Health, Harbin Medical University, Harbin, China
| | - Lei Shi
- Department of Health Management, School of Public Health, Harbin Medical University, Harbin, China
| | - Boshi Peng
- Department of Health Management, School of Public Health, Harbin Medical University, Harbin, China
| | - Yan Zhao
- Department of Health Management, School of Public Health, Harbin Medical University, Harbin, China
| | - Lei Gao
- Department of Health Management, School of Public Health, Harbin Medical University, Harbin, China
| | - Lihua Fan
- Department of Health Management, School of Public Health, Harbin Medical University, Harbin, China
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47
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Najafi F, Fallahi-Khoshknab M, Ahmadi F, Dalvandi A, Rahgozar M. Antecedents and consequences of workplace violence against nurses: A qualitative study. J Clin Nurs 2017; 27:e116-e128. [PMID: 28514533 DOI: 10.1111/jocn.13884] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2017] [Indexed: 02/03/2023]
Abstract
AIMS AND OBJECTIVES To explore Iranian nurses' perceptions of and experiences with the antecedents and consequences of workplace violence perpetrated by patients, patients' relatives, colleagues and superiors. BACKGROUND Workplace violence against nurses is a common problem worldwide, including in Iran. Although many studies have reviewed the antecedents and consequences of workplace violence, limited information is available on this topic. An understanding of the predisposing factors for violence and the consequences of violence is essential to developing programs to prevent and manage workplace violence. DESIGN Qualitative descriptive design. METHODS In this qualitative study, 22 unstructured, in-depth interviews were conducted with registered nurses who had experienced workplace violence and who were selecting using purposive sampling in nine hospitals. Inductive content analysis was used to analyse the data. RESULTS Five categories emerged as predisposing factors: unmet expectations of patients/relatives, inefficient organisational management, inappropriate professional communication, factors related to nurses and factors related to patients, patients' relatives and colleagues. Individual, familial and professional consequences were identified as outcomes of workplace violence against nurses. CONCLUSIONS Workplace violence by patients/their relatives and colleagues/superiors is affected by various complicated factors at the individual and organisational levels. In addition to negatively affecting nurses' individual and family lives, workplace violence may lead to a lower quality of patient care and negative attitudes towards the nursing profession. RELEVANCE TO CLINICAL PRACTICE Identifying factors, which lead to workplace violence, could help facilitate documenting and reporting such incidents as well as developing the necessary interventions to reduce them. Furthermore, native instruments must be developed to predict and monitor violence.
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Affiliation(s)
- Fereshteh Najafi
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Fazlollah Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Asghar Dalvandi
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mehdi Rahgozar
- Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Pich JV, Kable A, Hazelton M. Antecedents and precipitants of patient-related violence in the emergency department: Results from the Australian VENT Study (Violence in Emergency Nursing and Triage). ACTA ACUST UNITED AC 2017; 20:107-113. [PMID: 28705687 DOI: 10.1016/j.aenj.2017.05.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 05/15/2017] [Accepted: 05/20/2017] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Workplace violence is one of the most significant and hazardous issues faced by nurses globally. It is a potentially life-threatening and life-affecting workplace hazard often downplayed as just "part of the job" for nurses. METHODS A cross-sectional design was used and data were collected using a purpose developed survey tool. Surveys were distributed to all members of the College of Emergency Nurses' Australasia (CENA) in 2010 and 537 eligible responses were received (RR=51%). RESULTS Patient-related violence was reported by 87% of nurses in the last six months. Precipitants and antecedents for episodes of violence were reported in three categories: nurse-related; patient-related and emergency-department specific factors. Triaging was identified as the highest risk nursing activity, and the triage area identified as the highest risk location in the department. Patients who presented with alcohol intoxication, substance misuse or mental health issues were identified as the groups at greatest risk for potential violence. DISCUSSION Patient-related violence was reported by the majority of emergency nurses surveyed. A number of precipitants and antecedents perceived to be risk factors by participants were found to be significant and are unavoidable in the working lives of emergency department nurses.
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Affiliation(s)
- Jacqueline V Pich
- Faculty of Health, University of Technology, Ultimo, NSW, Australia, Australia.
| | - Ashley Kable
- School of Nursing & Midwifery, University of Newcastle, Callaghan, NSW, Australia
| | - Mike Hazelton
- School of Nursing & Midwifery, University of Newcastle, Callaghan, NSW, Australia; Mental Health Nursing, School of Nursing & Midwifery, University of Newcastle, Callaghan, NSW, Australia
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49
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Zhang L, Wang A, Xie X, Zhou Y, Li J, Yang L, Zhang J. Workplace violence against nurses: A cross-sectional study. Int J Nurs Stud 2017; 72:8-14. [DOI: 10.1016/j.ijnurstu.2017.04.002] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 04/03/2017] [Accepted: 04/04/2017] [Indexed: 12/30/2022]
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50
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Sun Y, Stone TE, Petrini MA. Swearing and verbal aggression in China: A call to action. Nurs Health Sci 2017; 19:139-141. [DOI: 10.1111/nhs.12317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 08/21/2016] [Accepted: 09/15/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Yan Sun
- HOPE School of Nursing; Wuhan University; Wuhan China
| | | | - Marcia A. Petrini
- Dean Emeritus/Professor Wuhan University Wuhan China and Visiting Professor Chiang Mai University Chiang Mai; Thailand
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