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Paul FA, Ganie AUR, Dar DR, Saikia P, Banerjee I. Exploring psychiatric patient restraints: Balancing safety, ethics, and patient rights in mental healthcare. Asian J Psychiatr 2024; 96:104051. [PMID: 38643681 DOI: 10.1016/j.ajp.2024.104051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/26/2024] [Accepted: 04/12/2024] [Indexed: 04/23/2024]
Abstract
Restraint, often linked with limiting an individual's freedom of movement, has become a focal point of extensive discussion and evaluation within the realm of mental healthcare. Striking a delicate balance between ensuring individual safety and minimizing reliance on restraint methods poses a significant challenge. In mental health inpatient settings, the prevalent forms of restraint encompass physical, chemical, environmental, and psychological methods. Paradoxically, the consequences of employing restraint can be severe, ranging from injuries and cognitive decline to sedation and, in extreme cases, fatalities. This paper seeks to offer a nuanced exploration of the landscape surrounding psychiatric patient restraints, considering both global perspectives and specific insights from the Indian context. The guidelines outlined in India's Mental Healthcare Act of 2017, which governs the use of restraint on individuals suffering with mental illnesses, are also examined in detail.
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Affiliation(s)
- Fayaz Ahmad Paul
- Department of Psychiatric Social Work, LGB Regional Institute of Mental Health, Tezpur, Assam, India.
| | - Aasim Ur Rehman Ganie
- Sharda School of Humanities and Social Sciences, Sharda University, Knowledge Park-3, Greater Noida 201310, India.
| | - Danishwar Rasool Dar
- Department of Psychiatric Social Work, LGB Regional Institute of Mental Health, Tezpur, Assam, India.
| | - Priyanka Saikia
- Department of Psychiatric Social Work, LGB Regional Institute of Mental Health, Tezpur, Assam, India.
| | - Indrajeet Banerjee
- Department of Psychiatric Social Work, LGB Regional Institute of Mental Health, Tezpur, Assam, India.
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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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3
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Spencer E. Using body-worn cameras in emergency departments: a pilot project. Emerg Nurse 2024:e2188. [PMID: 38204198 DOI: 10.7748/en.2024.e2188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 01/12/2024]
Abstract
Nurses and other emergency department (ED) staff often experience verbal and physical abuse as part of their everyday work. Body-worn cameras are one tool that ED staff can use to try to reduce workplace violence and abuse and have been shown to be effective in other healthcare environments, such as mental health units. This article describes a pilot service evaluation which used a survey to assess the effectiveness of using body-worn cameras for staff in the author's ED. Findings suggest that nurses believed the cameras provided support when they were confronted by abusive or aggressive patients or relatives and in some instances diffused potentially violent situations.
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Affiliation(s)
- Emily Spencer
- emergency department, Bristol Royal Infirmary, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England
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Gharaveis A, Hamilton DK, Pati D, Shepley MM, Rodiek S, McCall D. How Visibility May Reduce Security Issues in Community Hospitals' Emergency Departments. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024; 17:135-147. [PMID: 37522704 DOI: 10.1177/19375867231188985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
This research explored the relationship between visibility and the level of security risks as perceived by nurses and physicians in emergency departments (EDs). Security in EDs has been reported as a major global concern, and visibility has been identified as a design factor impacting behavior. However, few previous studies have rigorously investigated the role of visibility in reduction of ED security risks with evidence-based design approach. There is a lot of significant questions about how visibility impacts the reduction of security issues in EDs. METHODS How visibility may influence ED security was explored via qualitative methods in five EDs using semi-structured one-on-one interviews with 17 clinical staff and 48 hr of field observations. The coding process for both interviews and observational notes followed the principles of naturalistic inquiry. RESULTS The findings suggest security risks can be decreased by improving visibility. Medical staff (registered nurses and physicians) felt more secure in the EDs with higher visibility. DISCUSSION This study provides a framework to identify preferable levels of visibility in EDs and proposes design strategies to minimize security issues. Registered nurses and physicians can improve their team's sense of security by considering visibility throughout their daily practices.
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Affiliation(s)
| | | | | | | | | | - Denise McCall
- Emergency Department, Houston Methodist West Hospital, TX, USA
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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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Timmins F, Catania G, Zanini M, Ottonello G, Napolitano F, Musio ME, Aleo G, Sasso L, Bagnasco A. Promoting holistic approaches to management of violence in the ED-a response to Ramacciati (2023). J Clin Nurs 2023; 32:6771-6772. [PMID: 37661313 DOI: 10.1111/jocn.16847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/02/2023] [Indexed: 09/05/2023]
Affiliation(s)
- Fiona Timmins
- School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin 4, Ireland
| | - Gianluca Catania
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Milko Zanini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Giulia Ottonello
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Maria Emma Musio
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Giuseppe Aleo
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
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Chazel M, Alonso S, Price J, Kabani S, Demattei C, Fabbro-Peray P. Violence against nurses in the emergency department: an observational study. BMJ Open 2023; 13:e067354. [PMID: 37015789 PMCID: PMC10083775 DOI: 10.1136/bmjopen-2022-067354] [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] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the number and risk factors of violent events encountered in the emergency department. An observation grid was developed following interviews with emergency department staff to target the most pertinent information to collect in a prospective study design. DESIGN Observational study. SETTING Emergency department of a tertiary hospital in France. OUTCOME MEASURES Number of violent events occurring during a single shift, recorded over 6 months by two observers. Information collected included time and date of incident; number of male/female staff; number of patients and accompaniers present in the service and the waiting room and length of staff debriefing. Perpetrator, victim and patient information were collected. Victims were followed-up 72 hours later. RESULTS Eighty-two periods were observed between November 2015 and April 2016 recording 35 violent incidents affecting 37 perpetrators and 48 victims, equally distributed over the days of the week and months of the year. The median interval until violence was 0 [0-96] min from entry. Eight (23%) events were officially reported, with two (6%) resulting in charges being pressed. No risk factors were significantly associated with violent incidents in multivariate analysis, although there was a tendency towards significance for fewer senior female doctors present (p=0.0787) and a resulting longer debriefing session (p=0.0712). CONCLUSIONS We confirm the high rate of violence in the emergency department and poor level of official reporting. Strategies should be implemented to anticipate and reduce incidence and encourage reporting by affected staff. TRIAL REGISTRATION NUMBER NCT02116439.
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Affiliation(s)
- Muriel Chazel
- Department of Cardiology, Centre Hospitalier Universitaire de Nimes, Nimes, Languedoc-Roussillon, France
| | - Sandrine Alonso
- Department of Biostatistics, Clinical Epidemiology, Public Health and Innovation in Methodology (BESPIM), Centre Hospitalier Universitaire de Nimes, Nimes, Languedoc-Roussillon, France
| | - Jane Price
- Nursing Department, Centre Hospitalier Universitaire de Nimes, Nimes, Languedoc-Roussillon, France
| | - Sarah Kabani
- Department of Biostatistics, Clinical Epidemiology, Public Health and Innovation in Methodology (BESPIM), Centre Hospitalier Universitaire de Nimes, Nimes, France
| | - Christophe Demattei
- Department of Biostatistics, Clinical Epidemiology, Public Health and Innovation in Methodology (BESPIM), Centre Hospitalier Universitaire de Nimes, Nimes, Languedoc-Roussillon, France
| | - Pascale Fabbro-Peray
- Department of Biostatistics, Clinical Epidemiology, Public Health and Innovation in Methodology (BESPIM), Centre Hospitalier Universitaire de Nimes, Nimes, Languedoc-Roussillon, France
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Seeburger EF, Gonzales R, South EC, Friedman AB, Agarwal AK. Qualitative Perspectives of Emergency Nurses on Electronic Health Record Behavioral Flags to Promote Workplace Safety. JAMA Netw Open 2023; 6:e239057. [PMID: 37079303 PMCID: PMC10119742 DOI: 10.1001/jamanetworkopen.2023.9057] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/06/2023] [Indexed: 04/21/2023] Open
Abstract
Importance Emergency nurses experience high levels of workplace violence during patient interactions. Little is known about the efficacy of behavioral flags, which are notifications embedded within electronic health records (EHRs) as a tool to promote clinician safety. Objective To explore the perspectives of emergency nurses on EHR behavioral flags, workplace safety, and patient care. Design, Setting, and Participants In this qualitative study, semistructured interviews were conducted with emergency nurses at an academic, urban emergency department (ED) between February 8 and March 25, 2022. Interviews were audio recorded, transcribed, and analyzed using thematic analysis. Data analysis was performed from April 2 to 13, 2022. Main Outcomes and Measures Themes and subthemes of nursing perspectives on EHR behavioral flags were identified. Results This study included 25 registered emergency nurses at a large academic health system, with a mean (SD) tenure of 5 (6) years in the ED. Their mean (SD) age was 33 (7) years; 19 were women (76%) and 6 were men (24%). Participants self-reported their race as Asian (3 [12%]), Black (3 [12%]), White (15 [60%]), or multiple races (2 [8%]); 3 participants (12%) self-reported their ethnicity as Hispanic or Latinx. Five themes (with subthemes) were identified: (1) benefits of flags (useful advisory; prevents violence; engenders compassion), (2) issues with flags (administrative and process issues; unhelpful; unenforceable; bias; outdated), (3) patient transparency (patient accountability; damages patient-clinician relationship), (4) system improvements (process; built environment; human resources; zero-tolerance policies), and (5) difficulties of working in the ED (harassment and abuse; unmet mental health needs of patients; COVID-19-related strain and burnout). Conclusions and Relevance In this qualitative study, nursing perspectives on the utility and importance of EHR behavioral flags varied. For many, flags served as an important forewarning to approach patient interactions with more caution or use safety skills. However, nurses were skeptical of the ability of flags to prevent violence from occurring and noted concern for the unintended consequences of introducing bias into patient care. These findings suggest that changes to the deployment and utilization of flags, in concert with other safety interventions, are needed to create a safer work environment and mitigate bias.
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Affiliation(s)
- Emily F. Seeburger
- Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia
- Penn Urban Health Lab, University of Pennsylvania, Philadelphia
| | - Rachel Gonzales
- Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia
- Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia
| | - Eugenia C. South
- Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia
- Penn Urban Health Lab, University of Pennsylvania, Philadelphia
| | - Ari B. Friedman
- Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia
| | - Anish K. Agarwal
- Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Center for Emergency Care Policy and Research, University of Pennsylvania, Philadelphia
- Penn Medicine Center for Health Care Innovation, University of Pennsylvania, Philadelphia
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Timmins F, Catania G, Zanini M, Ottonello G, Napolitano F, Musio ME, Aleo G, Sasso L, Bagnasco A. Nursing management of emergency department violence-Can we do more? J Clin Nurs 2023; 32:1487-1494. [PMID: 35102617 DOI: 10.1111/jocn.16211] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Emergency departments are the services with the highest risk of violence for nurses. Reports of violence in health care have increased exponentially in the last decade. Front line hospital services are more at risk, and worldwide there are attempts to quantify, manage and prevent episodes of violence, but no consistent solutions have yet been identified. AIMS To stimulate reflection on causal factors of violence against nurses in emergency departments and discuss potential solutions and strategies for aspects that largely remain unresolved. DESIGN A position paper underpinned by experiences and evidence reported in the literature. METHODS A search of Scopus and CINAHL using the term 'violence' provided information concerning the prevalence of the term 'violence' in contemporary literature and enabled to capture a general overview of contributing factors of violence and current approaches to its management and prevention. CONCLUSIONS However, while risk factors have been identified, there is a tendency to over accentuate the extent of their contribution. The main risk factors present conditions related to or accompanied by mental illness and the impact of overcrowding and long waiting times. RELEVANCE TO CLINICAL PRACTICE More is needed in terms of implementation of more far-reaching, holistic, practical and effective management solutions to promote nurses' safety and adequately support vulnerable patients.
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Affiliation(s)
- Fiona Timmins
- School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin 4, Ireland
| | - Gianluca Catania
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Milko Zanini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Giulia Ottonello
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Maria Emma Musio
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Giuseppe Aleo
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
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10
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Ras IA. The factors that affect violence against nurses in emergency departments. Heliyon 2023; 9:e14306. [PMID: 36950614 PMCID: PMC10025084 DOI: 10.1016/j.heliyon.2023.e14306] [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: 08/23/2022] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 03/09/2023] Open
Abstract
Background Violence against nurses within healthcare setting is a serious issue of concern within the global healthcare sector. A considerably large percentage of nurses, 30%, in particular, have experienced or witnessed cases of violence in the workplace. Objective To conduct a scoping review on the factors influencing violence against nurses in emergency departments. Design Literature review. Settings The SLR was performed in various academic databases namely SpringerLink, Google Scholar, Science Direct, ERIC, and Academic Search Elite. Participants A total of N = 10 articles were included in the study. Methods A scoping/mapping review (SR) was performed in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis recommendations. Results The literature review consisted of 10 articles published in the English language within the last 10 yrs (between 2013 and 2022). The studies reviewed utilized various designs. Cross-sectional were 7, Case study was 1, while Qualitative retrospective descriptive studies were 2. The total sample size of all the studies recruited was N = 38, 031 participants. The reviewed literature revealed various factors that contribute to violence against nurses namely the level of a nurse's experience, low quality of service, unmet expectations, patient or colleague disruptive behaviors, delay in care or waiting time, mistakes in care/errors, degree of pain of the patient, death of a patient, class in roles among colleagues, and high workload and overcrowding. Conclusions Violence against nurses is a major problem in the healthcare sector due to its adverse consequences; however, it remains persistent. This study reveals that the main factors of violence against nurses are fewer years of experience as a nurse, level of pain of patients, quality of healthcare service, waiting time, unmet patient expectation, and disagreements among nurses in the workplace.
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Stafford S, Avsar P, Nugent L, O'Connor T, Moore Z, Patton D, Watson C. What is the impact of patient violence in the emergency department on emergency nurses' intention to leave? J Nurs Manag 2022; 30:1852-1860. [PMID: 35767371 PMCID: PMC9796507 DOI: 10.1111/jonm.13728] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 06/24/2022] [Indexed: 01/01/2023]
Abstract
AIM To examine the impact that patient violence, experienced in the emergency department, has on emergency nurses' intention to leave their job. BACKGROUND Emergency departments have become known for their overcrowding, chaos, unpredictability and violence. Emergency nurses are at high risk of experiencing workplace violence, which is cited in the literature as having a direct effect on general nurses' intention to leave. A high rate of nursing turnover may lead to short staffing, jeopardize the quality of patient care and increase overcrowding and wait times. EVALUATION A systematic review was undertaken in CINAHL, Medline and Psych INFO databases using published data until November 2021. Six articles were included, and PRISMA guidelines were adhered it. KEY ISSUES Workplace violence in the emergency department had a direct impact on emergency nurses' intention to leave and decreased their job satisfaction. Verbal abuse is the most experienced form of workplace violence. CONCLUSIONS Workplace violence experienced by emergency nurses in the emergency department had a direct positive impact on their intention to leave and subsequently negative impact on their job satisfaction. IMPLICATIONS FOR NURSING MANAGEMENT This review may inform clinical decision-making and aid in the development of clinical practice guidelines for a workplace violence prevention programme, specific to the emergency department.
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Affiliation(s)
- Sarah Stafford
- School of Nursing and MidwiferyThe Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health SciencesDublinIreland
| | - Pinar Avsar
- School of Nursing and MidwiferyThe Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health SciencesDublinIreland
| | - Linda Nugent
- School of Nursing and MidwiferyThe Royal College of Surgeons in Ireland (RCSI), University of Medicine and Health SciencesDublinIreland,Fakeeh College of Health SciencesJeddahSaudi Arabia
| | - Tom O'Connor
- Fakeeh College of Health SciencesJeddahSaudi Arabia,Skin Wounds and Trauma Research CentreRCSI University of Medicine and Health SciencesDublinIreland,School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland,School of Nursing and MidwiferyGriffith UniversityGold CoastQueenslandAustralia,Lida InstituteShanghaiChina
| | - Zena Moore
- Fakeeh College of Health SciencesJeddahSaudi Arabia,Skin Wounds and Trauma Research CentreRCSI University of Medicine and Health SciencesDublinIreland,School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland,School of Nursing and MidwiferyGriffith UniversityGold CoastQueenslandAustralia,Lida InstituteShanghaiChina,Faculty of Medicine, Nursing and Health SciencesMonash UniversityClaytonVictoriaAustralia,Department of Public Health, Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium,University of WalesCardiffUK,National Health and Medical Research Council Centre of Research Excellence in Wiser Wound CareMenzies Health Institute QueenslandGold CoastQueenslandAustralia
| | - Declan Patton
- Fakeeh College of Health SciencesJeddahSaudi Arabia,Skin Wounds and Trauma Research CentreRCSI University of Medicine and Health SciencesDublinIreland,School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland,School of Nursing and MidwiferyGriffith UniversityGold CoastQueenslandAustralia,Faculty of Science, Medicine and HealthUniversity of WollongongWollongongNew South WalesAustralia
| | - Chanel Watson
- School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland
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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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Ata EE, Yilmaz EB. Nursing students' experiences and perceptions of aggression: a sample from Turkey. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2022. [DOI: 10.15452/cejnm.2021.12.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Stephen T, King K, Taylor M, Jackson M, Hilario C. A Virtual, Simulated Code White for Undergraduate Nursing Students. Can J Nurs Res 2022; 54:320-330. [PMID: 35578409 PMCID: PMC9379387 DOI: 10.1177/08445621221101290] [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] [Indexed: 11/16/2022] Open
Abstract
Background Nurses and nursing students are increasingly vulnerable to workplace
violence, both verbal and physical, as health care settings and clients cope
with unprecedented challenges including the COVID-19 pandemic. Concurrently,
clinical learning opportunities for nursing students have been curtailed by
public health restrictions and limited capacity. While virtual simulations
have been promoted as an alternative to clinical hours, their effectiveness
as an educational intervention on workplace violence has yet to be
assessed. Purpose The authors sought to evaluate a virtual, simulated code white—a set of
organized responses to a client, visitor, or staff member exhibiting the
potential for violence—involving 4th year undergraduate nursing students,
randomly sorted into an intervention group and a control group. Methods Pre and post test measures of knowledge and attitudes about mental health,
workplace violence and virtual simulation were collected, as well as
qualitative data from focus groups. Findings While the sample size (n = 24) was insufficient to detect meaningful
differences between the intervention and control groups, descriptive
statistics and focus group data revealed significant gaps in participants’
knowledge around managing workplace violence. Participants rated the virtual
simulation highly for its realism and the opportunity to experience working
in a virtual environment, while they felt the preamble and debrief were too
short. Conclusions The findings illustrate a virtual code white simulation has clear educational
benefits, and that multiple iterations, both virtual and in person, would
most likely increase the benefits of the intervention.
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Affiliation(s)
- Tracey Stephen
- Faculty of Nursing, College of Health Sciences, 3158University of Alberta, Edmonton, AB, Canada
| | - Keith King
- Faculty of Nursing, College of Health Sciences, 3158University of Alberta, Edmonton, AB, Canada
| | - Mischa Taylor
- Faculty of Nursing, College of Health Sciences, 3158University of Alberta, Edmonton, AB, Canada
| | - Margot Jackson
- Faculty of Nursing, College of Health Sciences, 3158University of Alberta, Edmonton, AB, Canada
| | - Carla Hilario
- Faculty of Nursing, College of Health Sciences, 3158University of Alberta, Edmonton, AB, Canada
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Yosep I, Hazmi H, Putit Z. Experience of Workplace Violence from the Patients among Mental Health Nurses in Indonesia: A Mixed Method Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Workplace violence by patients and visitors (PVV) against nurses is regarded a devastating occupational issue around the world. The most frequent perpetrators of violence against nurses were patients, followed by their families and other healthcare professionals.
Aim:This study aimed to use a mixed method to analyze violence by patients and visitors against nurses in mental health hospital in Indonesia. Methods: The 250 mental health nurses at two general public hospitals in Bandung were recruited with stratified convenience sampling by years of working experience. Result: All nurses experienced workplace violence from both patients and their families. At least nurses experienced more than 3 types of violence with the most frequent type of violence were verbal and physical violence. The six themes were emerged including variation of violence in nurse, traumatic impact of violence, impacts of violence on profession, violence not only come form patients but also family, reason of violence, and spiritual coping. Conclussion: It is necessary to prioritize more efficient and approachable methods for nurses to deal with patients’ aggresive behavior, and to establish constant training program.
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16
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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: 4] [Impact Index Per Article: 2.0] [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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17
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Díaz-Agea JL, Orcajada-Muñoz I, Leal-Costa C, Adánez-Martínez MG, De Souza Oliveira AC, Rojo-Rojo A. How Did the Pandemic Affect Communication in Clinical Settings? A Qualitative Study with Critical and Emergency Care Nurses. Healthcare (Basel) 2022; 10:373. [PMID: 35206987 PMCID: PMC8872094 DOI: 10.3390/healthcare10020373] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/10/2022] [Accepted: 02/13/2022] [Indexed: 01/10/2023] Open
Abstract
The objective of the present study was to determine the subjective impact of the pandemic due to COVID-19 on communication, as perceived by nurses working at emergency services and Intensive Care Units at various hospitals in the Region of Murcia (Spain). A qualitative study was conducted based on the content analysis of 12 semi-structured individual interviews. The participant recruitment process was performed through a snowball sampling technique. Four main dimensions, eleven categories, and two sub-categories were obtained: (1) communication (communicative expressions, both verbal and non-verbal-, and limitations); (2) emotional aspects (positive, negative); (3) overload (first wave, second wave, and third wave); and (4) relationships (health professionals-patients, healthcare professionals, patients-family, and family-health professionals). The main findings of the study show that communication was slightly affected during the pandemic, especially the non-verbal kind, with verbal communication maintained and, in some occasions, strengthened. The lack of training in communication skills and its influence on the management of difficult periods was another important finding. Communication in general deteriorated during the pandemic, especially during the initial waves. Non-verbal communication was more affected due to the use of Personal Protective Equipment and the initial fear of infection, with this finding strongly observed in departments such as emergencies or critical care. The nurses who were interviewed underlined negative emotional aspects associated with a deficit in communication. The positive aspects described were associated with the creation of mutual support spaces and the group cohesion of the work teams during the pandemic. As an implication for current and future clinical practice, we recommend a coordinated institutional response to mitigate the potential emotional effects on workers by designing appropriate communication and emotional expression protocols.
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Affiliation(s)
- José Luis Díaz-Agea
- Faculty of Nursing, Universidad Católica de Murcia, 30107 Guadalupe, Spain; (J.L.D.-A.); (I.O.-M.); (A.C.D.S.O.); (A.R.-R.)
| | - Irene Orcajada-Muñoz
- Faculty of Nursing, Universidad Católica de Murcia, 30107 Guadalupe, Spain; (J.L.D.-A.); (I.O.-M.); (A.C.D.S.O.); (A.R.-R.)
| | - César Leal-Costa
- Faculty of Nursing, Universidad de Murcia, 30120 El Palmar, Spain
| | | | | | - Andrés Rojo-Rojo
- Faculty of Nursing, Universidad Católica de Murcia, 30107 Guadalupe, Spain; (J.L.D.-A.); (I.O.-M.); (A.C.D.S.O.); (A.R.-R.)
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18
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Abstract
Empathy is an integral aspect of communication with older people and is central to person-centred care. As part of the provision of person-centred care, empathy supports effective communication, producing positive effects such as increased emotional well-being, increased adherence to treatment plans, reduced pain levels and improved wound healing. Empathy involves attempting to understand the other person's perspective and feelings and communicate that understanding back to them. Empathic communication can help older people feel that they are being listened to and valued as partners in healthcare relationships. This article focuses on why it is important to demonstrate empathy when communicating with older people and how this can be achieved. It explains the origin of the concept of empathy in nursing and provides different ways of characterising empathy. It explores barriers to empathic communication in older people nursing and identifies verbal and non-verbal communication skills that nurses can use to enhance their empathy. Finally, it explains the importance for nurses to develop self-awareness and undertake self-care to preserve their capacity to demonstrate empathy towards older people.
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Affiliation(s)
- Kirsten Jack
- Manchester Metropolitan University, Manchester, England
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19
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García-Pérez MD, Rivera-Sequeiros A, Sánchez-Elías TM, Lima-Serrano M. Agresiones laborales a profesionales sanitarios e infradeclaración: Caracterización y brechas en el conocimiento para su prevención. ENFERMERIA CLINICA 2021. [DOI: 10.1016/j.enfcli.2021.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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20
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Xu J, Cao Y, Wang Y, Qiao Q. Judicial judgment and media sensation of violence against medical staff in China: A fuzzy set qualitative comparative analysis (fsQCA). PLoS One 2021; 16:e0259014. [PMID: 34679107 PMCID: PMC8535389 DOI: 10.1371/journal.pone.0259014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 10/11/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Violence against medical staff has been prevalent in China over the past two decades. Although Chinese authorities have released many laws and regulations to protect medical staff from violence since 2011, the legal approach alone is unlikely to resolve this complex issue. In particular, several cases of violence against medical staff in China have caused great media sensation. METHOD This paper proposes an integrated model that combines the environmental stimuli theory, broken windows theory, and rational choice theory. It adopts the fuzzy set qualitative comparative analysis (fsQCA) to untangle the causal relationship between violence against medical staff, media sensation, and judicial judgment. We examined reports of medical violence on media and news websites from January 1, 2010, to January 31, 2020, and selected 50 cases with detailed information for this study. RESULTS The results show that each condition is not sufficient for the absence of judicial judgment, but when combined, they are conducive to the outcome. The conditions of hospital level, medical cost, and media sensation play important roles. The providers, patients, and environmental factors are indicators of inadequate or lack of judicial judgment, which corresponds to previous expectations. CONCLUSIONS The integrated model greatly enriches the extant theories and literature, and also yields implications for preventing violence against medical staff in China. We suggest that sustainable and innovative healthcare reform should be initiated. For example, public hospitals should remain the cornerstone of national public health security. Medical staff in public hospitals must be regarded as "civil servants". Therefore, the current legal system should be improved. The media should objectively report events concerning medical staff and improve public healthcare knowledge.
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Affiliation(s)
- Jian Xu
- School of Media and Communication and China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
| | - Yongrong Cao
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Yangyang Wang
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai, China
| | - Qingquan Qiao
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
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21
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García-Pérez MD, Rivera-Sequeiros A, Sánchez-Elías TM, Lima-Serrano M. Workplace violence on healthcare professionals and underreporting: Characterization and knowledge gaps for prevention. ENFERMERÍA CLÍNICA (ENGLISH EDITION) 2021; 31:390-395. [PMID: 34627729 DOI: 10.1016/j.enfcle.2021.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 05/14/2021] [Indexed: 10/20/2022]
Abstract
Work-related violence against healthcare workers inflicted by healthcare users is a rising multidimensional phenomenon, a cause of concern among those who ensure the safety and health of these professionals. Although different studies indicate high percentages of attacks against healthcare workers, statistics from reports reveal much lower data. Underreporting of occupational violence against healthcare workers is a well-known fact reported in many studies. It is presented as a major obstacle when it comes to proposing adequate preventive measures, because the data on which to base these measures do not correspond to the true incidence of all the assaults that take place. Underreporting also makes it difficult to correctly assess the usefulness of preventive measures implemented. The following article looks at the latest studies carried out on the subject, presenting an overview of the factors accompanying these assaults, as well as the main reasons for this underreporting. It also highlights the lack in the literature of instruments designed to measure underreporting that have undergone a validation process. For all these reasons, this problem requires further study with validated tools to determine the reasons and circumstances that accompany and promote the underreporting of violence against healthcare workers. Knowing these reasons is a preliminary step in the fight against workplace violence and to measure the true magnitude of the problem, to provide the occupational health services with precise data and develop and assess the preventive measures implemented.
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Affiliation(s)
| | - Adriana Rivera-Sequeiros
- Unidad de Investigación e Innovación, Hospital San Juan de Dios del Aljarafe, Grupo de investigación PAIDI CTS1050 «Cuidados Complejos, Cronicidad y Resultados en Salud», Sevilla, Spain.
| | | | - Marta Lima-Serrano
- Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Grupo de investigación PAIDI CTS1050 «Cuidados Complejos, Cronicidad y Resultados en Salud», Sevilla, Spain
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22
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Basis F, Moskovitz K, Tzafrir S. Did the events following the COVID-19 outbreak influence the incidents of violence against hospital staff? Isr J Health Policy Res 2021; 10:36. [PMID: 34140034 PMCID: PMC8210496 DOI: 10.1186/s13584-021-00471-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 06/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND During the COVID-19 outbreak, (March 1 - June 15, 2020) citizens expressed sympathy and gratitude towards medical staff through the media, while the entire hospital staff faced the same danger of infection as other citizens. This might have made hospital staff develop sympathy, understanding for the patients` and family's needs, and a better communication. OBJECTIVES To investigate if there is a relation between the mutual change in attitude between citizens and hospital staff during the first COVID-19 outbreak, and the incidence of violence cases. MATERIALS AND METHODS This is a cross sectional study conducted at Rambam Medical Center (RMC) in Israel. The data about the number of violence cases were collected from the security department, and the data about hospital wards activity were collected from the hospital Business Intelligence (BI) software. The number of violence cases in relation to the number of Emergency Department (ED) visits, admissions to hospital wards, and length of stay (LOS) were compared during the COVID-19 outbreak to the corresponding period in 2019 using the T- test. The difference in the incidence of violence between general population and people with a psychiatric or social disorder (like drug abuse and criminal background) in both periods were also compared using the Fisher exact test. RESULTS During the first COVID-19 outbreak, there were 6 violence cases against medical staff out of 24,740 visits to the ED, vs. 21 cases out of 30,759 visits during the same periods in 2019 (P < 0.05). There were 19 violence cases in the whole hospital with 14,482 admissions in 2020 vs. 51 violence cases of 17,599 admissions in 2019 (P < 0.05). Violence against security guards in the entire hospital dropped from 20 to 11 cases, and in the set of the ED, from 13 to 4 cases in both periods respectively. A 20 % decrease in the number of visits to the ED, might have influenced the average LOS during the study period, 2020 compared to 2019 (4.4 + 0.45 vs. 5.4 + 0.36 h. (P < 0.001). The ratio of violence among general population vs. people with a psychiatric or social background revealed a non-significant change in both periods (P = 0.75 and P = 0.69) respectively. DISCUSSION The COVID-19 outbreak supplied some evidence that a change in environmental conditions, trust, waiting time, personal attitude and communication might have reduced violence against hospital staff. CONCLUSIONS Except for violence coming from patients with psychiatric or social disorders, most other violence cases might be reduced if the environment conditions and attitudes of both citizens and staff are improved.
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Affiliation(s)
- Fuad Basis
- Rambam Medical Campus (RMC), the Technion Faculty of Medicine, Haifa, Israel.
| | - Kobi Moskovitz
- RMC Administrative Department, Haifa University, Haifa, Israel
| | - Shay Tzafrir
- School of Business Administration, Haifa University, Haifa, Israel
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23
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Khan MN, Khan I, Ul-Haq Z, Khan M, Baddia F, Ahmad F, Khan S. Managing violence against healthcare personnel in the emergency settings of Pakistan: a mixed methods study. BMJ Open 2021; 11:e044213. [PMID: 34130958 PMCID: PMC8208019 DOI: 10.1136/bmjopen-2020-044213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES The primary objective of this study was to evaluate the effectiveness of a half-day training on de-escalation of violence against healthcare personnel regarding prevention and management of violence incidents versus a similar tertiary-level hospital with no such training. Secondary objectives were to compare the overall satisfaction, burnout, fear of violence and confidence in coping with patients' aggression of the healthcare personnel in the two hospitals. DESIGN Mixed method design, with a comparative cross-sectional (quantitative) and focus group discussions (qualitative) components. SETTING Emergency departments of the two tertiary care hospitals in district Peshawar over 6 months starting from May 2018. PARTICIPANTS Healthcare personnel in the emergency departments of the two hospitals (trained vs untrained). OUTCOME MEASURES Violence exposure (experienced/witnessed) assessed through a previously validated tool in the past 5 months. Burnout, confidence in coping with patient aggression and overall job satisfaction were also assessed through validated tools. The qualitative component explored the perceptions of healthcare personnel regarding the management of violence and the importance of training on de-escalation of violence through focus group discussions in the two hospitals. RESULTS The demographic characteristics of the healthcare personnel within the two hospitals were quite similar. The de-escalation training did not lead to a reduction in the incidences of violence; however, confidence in coping with patient aggression and the overall satisfaction were significantly improved in the intervention hospital. The de-escalation training was lauded by the respondents as led to an improvement in communication skills, and the healthcare personnel suggested for scale-up to all the cadres and hospitals. CONCLUSION The study found significant improvements in the confidence of healthcare personnel in coping with patient aggression, along with better job satisfaction and less burnout in the intervention hospital following the de-escalation training.
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Affiliation(s)
- Muhammad Naseem Khan
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Ikram Khan
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Zia Ul-Haq
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Mirwais Khan
- International Committee of the Red Cross, Geneve, GE, Switzerland
| | - Faryal Baddia
- International Committee of the Red Cross, Geneve, GE, Switzerland
| | - Fayaz Ahmad
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Salman Khan
- International Committee of the Red Cross, Geneve, GE, Switzerland
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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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25
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Özkan Şat S, Akbaş P, Yaman Sözbir Ş. Nurses' exposure to violence and their professional commitment during the COVID-19 pandemic. J Clin Nurs 2021; 30:2036-2047. [PMID: 33761158 PMCID: PMC8251095 DOI: 10.1111/jocn.15760] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/19/2021] [Accepted: 03/10/2021] [Indexed: 02/03/2023]
Abstract
Aims and Objectives This study aimed to determine the relationship between nurses' exposure to violence and their professional commitment during the COVID‐19 pandemic. Background Violence against nurses is a common problem that persists worldwide. Design This was a descriptive cross‐sectional study. Methods An online questionnaire form and the Nursing Professional Commitment Scale were used to collect the data. The study was carried out online during the COVID‐19 pandemic between October–December 2020. A total of 263 nurses agreed to participate in the study. The STROBE checklist was followed for observational studies. Results During the COVID‐19 pandemic, 8.4% of the nurses stated that they were exposed to physical violence, 57.8% to verbal violence, 0.8% to sexual violence and 61.6% to mobbing. 52.1% of the nurses stated that they thought of quitting the profession during the COVID‐19 pandemic. The mean total Nursing Professional Commitment Scale score was 71.33 ± 15.05. Conclusions This study revealed that nurses' exposure to physical, verbal and sexual violence during the COVID‐19 pandemic decreased compared to before the pandemic. Nurses' exposure to mobbing during the pandemic was found to increase. A statistically significant difference was found between the status of the nurses' exposure to physical violence, verbal violence, and mobbing, working hours, number of patients given care, and their thoughts of quitting the profession. It was found that the status of exposure to physical violence, thinking of quitting the profession and working hours decreased professional commitment. Relevance to clinical practice In the light of these results, it is recommended that measures to prevent violence should be addressed in a multifaceted way. In managing the pandemic process, the decisions and practices should not be left to the managers' initiative to prevent mobbing. Initiatives that will increase nurses' professional commitment during the pandemic process should be planned and implemented.
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Affiliation(s)
- Sultan Özkan Şat
- Nursing Department, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Pınar Akbaş
- Karabük Yenice State Hospital, Karabük, Turkey
| | - Şengül Yaman Sözbir
- Nursing Department, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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26
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Bordignon M, Monteiro MI. Analysis of workplace violence against nursing professionals and possibilities for prevention. ACTA ACUST UNITED AC 2021; 42:e20190406. [PMID: 33886920 DOI: 10.1590/1983-1447.2021.20190406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 08/04/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate workplace violence against nursing professionals, its relationship with personal, health and work variables, and to know possibilities for prevention. METHOD Descriptive and cross-sectional study, with quantitative approach, conducted with 267 nursing professionals from urgency and emergency units between 2015 and 2017. The Questionnaire of socio-demographic, life style and work and health aspects and Questionnaire on Workplace violence collected data, after submitted to statistical analysis. RESULTS 61.6% reported having been victims of verbal abuse, sexual harassment, or physical violence at work in the last 12 months. Statistically significant relationships were identified between suffering or not violence and personal, health and work variables. Possibilities for prevention were revealed and constituted a multidimensional model. CONCLUSION More than half of the sample reported having suffered workplace violence in the previous year, and possibilities of how to avoid it were revealed to support prevention protocols.
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Affiliation(s)
- Maiara Bordignon
- Universidade Federal da Fronteira Sul (UFFS), Curso de Graduação em Enfermagem. Chapecó, Santa Catarina, Brasil.,Universidade do Contestado (UnC), Curso de Graduação em Enfermagem. Concórdia, Santa Catarina, Brasil
| | - Maria Inês Monteiro
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Enfermagem. Campinas, São Paulo, Brasil
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27
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Ursachen und Auswirkungen von Gewalt in der Notfallmedizin. Notf Rett Med 2021. [DOI: 10.1007/s10049-020-00726-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
ZusammenfassungMitarbeiter*innen in der präklinischen und klinischen Notfallmedizin sind regelmäßig mit gewalttätigem Verhalten konfrontiert. Auch wenn Definitionen und Studiendesigns sehr heterogen sind, handelt es sich um ein relativ gut im Ausmaß beschriebenes internationales Problem. Viele Mitarbeiter*innen akzeptieren gemachte Gewalterlebnisse, welche überwiegend verbaler Natur sind, als „Teil des Jobs“, obwohl sich diese gravierend auf ihre Arbeit und ihr Leben auswirken können. Der intoxikierte oder psychiatrisch erkrankte männliche Patient steht hierbei ursächlich im Vordergrund. Leider stellt das in der Notfallmedizin tätige Personal durch Unerfahrenheit im Erkennen und in der Interpretation konfrontativer Situationen sowie einen Mangel an kommunikativen Fähigkeiten oft unwissentlich einen Teil der Eskalationsspirale dar.
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28
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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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29
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Rahmani A, Dadashzadeh A, Hassankhani H, Boyle M, Mohammadi E, Campbell S. Iranian Nurses' Experiences of Workplace Violence in Prehospital Emergency Care: A Qualitative Study. Adv Emerg Nurs J 2021; 42:137-149. [PMID: 32358430 DOI: 10.1097/tme.0000000000000292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Prehospital emergency care nurses experience severe workplace violence. However, despite the widespread violence they experience, this phenomenon has not been well studied among these nurses. Therefore, the purpose of this study was to explore the experiences of Iranian nurses working in prehospital setting regarding workplace violence with a focus on the factors leading to such violence. In this qualitative descriptive study, 23 prehospital nurses participated purposefully. The data were collected by individual face-to-face semistructured interviews and analyzed using content analysis methodology. Data analysis led to the identification of 4 main themes, including job competency mismatch, inadequate resources, criticality of the situation and circumstances, and inadequate awareness and misplaced expectations of society. These nurses have not completed specialized training courses, work in a system that is in a critical situation, and face many barriers and deficiencies in terms of intra- and interorganizational coordination. On the other hand, people in the community do not have sufficient awareness about the duties and services provided by prehospital nurses and thus have unrealistic expectations to receive services. The results showed that there was a deep gap between the prehospital emergency realities and public expectations, leading to workplace violence. Therefore, efforts to improve the working conditions of nurses with an emphasis on teaching specialized prehospital emergency courses, especially violence control courses, promoting intra- and interorganizational coordination, and increasing the equipment and personnel of ambulances for special missions, as well as raising the public awareness and outlining more realistic expectations, may reduce the prevalence of violence against prehospital nurses.
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Affiliation(s)
- Azad Rahmani
- Medical Education Research Center (Dr Rahmani), Nursing and Midwifery Faculty (Dr Dadashzadeh), and Center of Qualitative Studies, School of Nursing and Midwifery (Dr Hassankhani), Tabriz University of Medical Sciences, Tabriz, Iran; Medical-Surgical Department, Nursing & Midwifery Faculty, Tabriz, East Azerbaijan Province, Iran (Drs Rahmani and Hassankhani and Dr Dadashzadeh); Griffith University, School of Medicine, Queensland, Australia (Dr Boyle); Faculty of Medical Sciences, Nursing Department, Tarbiat Modares University, Tehran, Iran (Dr Mohammadi); and School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada (Dr Campbell)
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A systematic review of factors leading to occupational injuries and fatalities. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-020-01427-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Caruso R, Antenora F, Riba M, Belvederi Murri M, Biancosino B, Zerbinati L, Grassi L. Aggressive Behavior and Psychiatric Inpatients: a Narrative Review of the Literature with a Focus on the European Experience. Curr Psychiatry Rep 2021; 23:29. [PMID: 33825996 PMCID: PMC8026454 DOI: 10.1007/s11920-021-01233-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/21/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW We summarized peer-reviewed literature on aggressive episodes perpetrated by adult patients admitted to general hospital units, especially psychiatry or emergency services. We examined the main factors associated with aggressive behaviors in the hospital setting, with a special focus on the European experience. RECENT FINDINGS A number of variables, including individual, historical, and contextual variables, are significant risk factors for aggression among hospitalized people. Drug abuse can be considered a trans-dimensional variable which deserves particular attention. Although mental health disorders represent a significant component in the risk of aggression, there are many factors including drug abuse, past history of physically aggressive behavior, childhood abuse, social and cultural patterns, relational factors, and contextual variables that can increase the risk of overt aggressive behavior in the general hospital. This review highlights the need to undertake initiatives aimed to enhance understanding, prevention, and management of violence in general hospital settings across Europe.
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Affiliation(s)
- Rosangela Caruso
- Institute of Psychiatry, Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy. .,University Hospital Psychiatry Unit and Consultation-Liaison Psychiatry and Program on Psycho-Oncology and Psychiatry in Palliative Care, S. Anna University Hospital and Health Trust, Via Fossato di Mortara 64a, 44121, Ferrara, Italy.
| | - Fabio Antenora
- Institute of Psychiatry, Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Michelle Riba
- Department of Psychiatry, University of Michigan, Ann Arbor, MI USA ,University of Michigan Comprehensive Depression Center, Ann Arbor, MI USA ,Psycho-oncology Program, University of Michigan Rogel Cancer Center, Ann Arbor, MI USA ,Department of Psycho-oncology, Cancer and Molecular Medicine, University of Leicester, Leicester, UK
| | - Martino Belvederi Murri
- Institute of Psychiatry, Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy ,University Hospital Psychiatry Unit and Consultation-Liaison Psychiatry and Program on Psycho-Oncology and Psychiatry in Palliative Care, S. Anna University Hospital and Health Trust, Via Fossato di Mortara 64a, 44121 Ferrara, Italy
| | | | - Luigi Zerbinati
- Institute of Psychiatry, Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Luigi Grassi
- Institute of Psychiatry, Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy ,University Hospital Psychiatry Unit and Consultation-Liaison Psychiatry and Program on Psycho-Oncology and Psychiatry in Palliative Care, S. Anna University Hospital and Health Trust, Via Fossato di Mortara 64a, 44121 Ferrara, Italy
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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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Ceballos JB, Frota OP, Nunes HFSS, Ávalos PL, Krügel CDC, Ferreira Júnior MA, Teston EF. Physical violence and verbal abuse against nurses working with risk stratification: characteristics, related factors, and consequences. Rev Bras Enferm 2020; 73:e20190882. [PMID: 33338160 DOI: 10.1590/0034-7167-2019-0882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 06/11/2020] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE to analyze the characteristics, related factors, and consequences of physical violence and verbal abuse against nurses working with risk stratification. METHODS a cross-sectional, descriptive and quantitative study carried out with 80 nurses who work with risk stratification in emergency services. Data were collected using an adapted instrument and analyzed using (uni)bivariate inferential statistics. RESULTS companions were the main perpetrators of verbal abuse (86.1%); and patients inflicted physical violence (100%). Professionals with up to five years of experience are 74% less likely to suffer physical violence (p=0.029). Women suffer 5.83 times more verbal abuse than men (p=0.026). Sadness (15.8%) and fear of the aggressor (15.3%) were the main consequences of verbal abuse; and fear of the aggressor (22.2%) and stress (22.2%) were results of physical violence. CONCLUSION violence is influenced by institutional, professional and client aspects. Therefore, coping with it requires multidimensional strategies.
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Affiliation(s)
- Joyce Borges Ceballos
- Universidade Federal de Mato Grosso do Sul. Campo Grande, Mato Grosso do Sul, Brazil
| | - Oleci Pereira Frota
- Universidade Federal de Mato Grosso do Sul. Campo Grande, Mato Grosso do Sul, Brazil
| | | | - Patricia Lima Ávalos
- Universidade Federal de Mato Grosso do Sul. Campo Grande, Mato Grosso do Sul, Brazil
| | | | | | - Elen Ferraz Teston
- Universidade Federal de Mato Grosso do Sul. Campo Grande, Mato Grosso do Sul, Brazil
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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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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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East L, Heaslip V, Jackson D. The symbiotic relationship of vulnerability and resilience in nursing. Contemp Nurse 2020; 56:14-22. [PMID: 32744154 DOI: 10.1080/10376178.2019.1670709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Whilst the terms vulnerability and resilience are commonly used within professional nursing discourses, they are often poorly understood. Vulnerability is often framed negatively and linked to being at risk of harm, whilst resilience is often perceived as the ability to withstand challenges. Aim: The aim of this paper is to explore resilience and vulnerability; re-positioning them within the context of contemporary professional nursing practice. Design: Discussion paper. Method: Drawing upon historical and contemporary international literature, both concepts are de-constructed and then re-constructed, examining them from the position of patient care as well as from the perspective of nurses and the nursing profession. Conclusion: Resilience and vulnerability have an interdependent relationship as resilience comes into play in situations of vulnerability. Yet, contrary to the popular discourse they are multi-faceted, complex phenomena based on factors such as individual circumstances, supports, and resources.
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Affiliation(s)
- Leah East
- Joint appointment with the School of Health, University of New England, and Hunter New England Health, Armidale, NSW, Australia
| | - Vanessa Heaslip
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Debra Jackson
- Faculty of Health, University of Technology, Sydney, NSW, 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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D'Ettorre G, Pellicani V, Vullo A. Workplace violence against healthcare workers in Emergency Departments. A case-control study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2019; 90:621-624. [PMID: 31910199 PMCID: PMC7233767 DOI: 10.23750/abm.v90i4.7327] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 07/13/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND AIM Assessment and management of workplace violence (WPV) towards healthcare workers (HCWs) employed in Emergency Departments (EDs) represents a challenge for healthcare organizations worldwide. To date there is a lack of scientific data about the impact of work-shifts on the occurrence of WPV against ED HCWs. The purpose of this study was to investigate the relationship between work shift schedules and WPV against registered nurses (RNs) working on non-traditional shifts, including nights and 12-hour shifts. METHODS The authors conducted a cross-sectional nested case-control analysis of data regarding the episodes of WPV perpetrated by patients or their relatives against RNs employed in three EDs, in the period between January -December 2017. RESULTS The one-year incidence of WPV was 29,30 per 100 Full Time Equivalent (FTE) positions. Cumulative nightshifts were significant for 3 or more nightshifts compared to working less than 3 nightshifts during the 7 days before the episodes of WPV; additionally, RNs working 9 or more night-shifts showed higher risk of experiencing WPV compared to RNs working less than 4 night-shifts in the previous 28 days. CONCLUSION In the present study shift work and WPV occurrence against ED RNs resulted interconnected; improvement interventions aimed at preventing the WPV should consider the characteristics of work shift schedules with the purposes of: 1) limiting the night shifts up to two per week and up eight per month; 2) adopting constant forward-rotating shift schedules. (www.actabiomedica.it).
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Richardson SK, Ardagh MW, Morrison R, Grainger PC. Management of the aggressive emergency department patient: non-pharmacological perspectives and evidence base. Open Access Emerg Med 2019; 11:271-290. [PMID: 31814780 PMCID: PMC6861170 DOI: 10.2147/oaem.s192884] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 08/29/2019] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Aggression in the Emergency Department (ED) remains an ongoing issue, described as reaching epidemic proportions, with an impact on staff recruitment, retention, and ability to provide quality care. Most literature has focused on the definition (or lack of) core concepts, efforts to quantify the phenomenon or provide an epidemiological profile. Relatively little offers evidence-based interventions or evaluations of the same. AIM To identify the range of suggested practices and the evidence base for currently recommended actions relating to the management of the aggressive Emergency Department patient. METHODS A meta-synthesis of existing reviews of violence and aggression in the acute health-care setting, including management of the aggressive patient, was undertaken. This provided the context for critical consideration of the management of this patient group in the ED and implications for clinical practice. RESULTS An initial outline of issues was followed by a systematic search and 15 reviews were further assessed. Commonly identified interventions are grouped around educational, interpersonal, environmental, and physical responses. These actions can be focused in terms of overall responses to the wider issues of violence and aggression, targeted at the pre-event, event, or post-event phase in terms of strategies; however, there is a very limited evidence base to show the effectiveness of strategies suggested. CLINICAL IMPLICATIONS The lack of evidence-based intervention strategies leaves clinicians in a difficult situation, often enacting practices based on anecdote rather than evidence. Local solutions to local problems are occurring in a pragmatic manner, but there needs to be clarification and integration of workable processes for evaluating and disseminating best practice. CONCLUSION There is limited evidence reporting on interventional studies, in addition to identification of the need for high quality longitudinal and evaluation studies to determine the efficacy of those responses that have been identified.
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Affiliation(s)
- Sandra K Richardson
- Emergency Department, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand
- Centre for Postgraduate Nursing Studies, University of Canterbury, Christchurch, New Zealand
| | - Michael W Ardagh
- Emergency Department, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand
- Department of Surgery, University of Otago, Christchurch, New Zealand
| | - Russell Morrison
- Well-being Health and Safety Team, Canterbury District Health Board, Christchurch, New Zealand
| | - Paula C Grainger
- Emergency Department, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand
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Edward KL, Giandinoto JA, Weiland TJ, Hutton J, Reel S. Brief interventions to de-escalate disturbances in emergency departments. ACTA ACUST UNITED AC 2019; 27:322-327. [PMID: 29561674 DOI: 10.12968/bjon.2018.27.6.322] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This study aimed to systematically review evidence to assess the efficacy of non-pharmacological brief interventions in the emergency department to reduce the incidence, severity and impact of acute behavioural disturbances. The literature search was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A total of 18 articles were identified as meeting the inclusion criteria and read in full. Following a full read and a consensus discussion, it was subsequently considered the studies chosen had not met the inclusion criteria. Research into the use of non-pharmacological brief interventions in the management of acute behavioural disturbance in the emergency department is warranted given the absence of evidence found by this systematic review.
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Affiliation(s)
- Karen-Leigh Edward
- Professor of Nursing and Practice Based Research, Faculty of Health, Arts and Design, Swinburne University of Technology; Visiting Professor, St Vincent's Private Hospital, Melbourne, Australia; Visiting Professor, School of Human and Health Sciences, University of Huddersfield
| | | | - Tracey J Weiland
- Professor, Emergency Medicine, University of Melbourne, Australia
| | - Jennie Hutton
- Emergency Physician, St Vincent's Hospital, Melbourne and the University of Melbourne, Australia
| | - Sarah Reel
- Senior Lecturer in Podiatry, School of Human and Health Sciences, University of Huddersfield
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Efrat-Treister D, Cheshin A, Harari D, Rafaeli A, Agasi S, Moriah H, Admi H. How psychology might alleviate violence in queues: Perceived future wait and perceived load moderate violence against service providers. PLoS One 2019; 14:e0218184. [PMID: 31233514 PMCID: PMC6590795 DOI: 10.1371/journal.pone.0218184] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 05/28/2019] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Queues are inherent to service encounters, as it is not always possible to provide service to all clients at the exact moment they request service. Queues involve waiting for a service in a specific place that might also be crowded, they obstruct the client's' goal of receiving service, and at times lead clients to mistreat service providers and in extreme cases even attack them violently. We show, in a hospital setting, that perceived predicted future wait and load can buffer the causes of violence towards service staff. METHODS We combine objective data on crowdedness, reports of violence, and durations of time people waited, with psychological measures of perceived load and perceived future wait, collected from 226 people in the Emergency Department (ED) of a large hospital. Visitors to the ED were recruited as they waited for service. They indicated their perceived load in the ED and their perceived remaining wait for service. This data was then triangulated with objective operational data regarding the actual number of people waiting for service (i.e., crowdedness) and objective data regarding staff calls to security to stop violent accounts. RESULTS We find that with increased crowdedness, there are more calls to security reporting violence. However, this relationship is moderated by two factors: when people perceive the future wait to be short and when they perceive the load on the system to be high. Moreover, a three-way interaction shows that crowdedness is associated with more incidents of violence, however high perceived load and low perceived future wait are associated with fewer violent incidents. CONCLUSIONS This paper demonstrates the relationship between crowded queues and violence towards service staff, and suggests two psychological mechanisms for buffering such violence: reducing perceived future wait and elevating perceived load.
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Affiliation(s)
- Dorit Efrat-Treister
- Department of Management, Ben-Gurion University of the Negev, Beersheba, Israel
- * E-mail:
| | - Arik Cheshin
- Department of Human Services, University of Haifa, Haifa, Israel
| | - Dana Harari
- Scheller College of Business, Georgia Institute of Technology, Atlanta, Georgia, United States of America
| | - Anat Rafaeli
- Faculty of Industrial Engineering and Management, Technion-Israel Institute of Technology, Haifa, Israel
| | - Shira Agasi
- Faculty of Industrial Engineering and Management, Technion-Israel Institute of Technology, Haifa, Israel
| | - Hadar Moriah
- Faculty of Industrial Engineering and Management, Technion-Israel Institute of Technology, Haifa, Israel
| | - Hanna Admi
- Department of Nursing, The Max Stern Yezreel Valley College, Yezreel Valley, Israel
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Bordignon M, Monteiro MI. Uso da simulação na capacitação sobre violência no trabalho da enfermagem. ACTA PAUL ENFERM 2019. [DOI: 10.1590/1982-0194201900047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Avaliar a aplicabilidade e os resultados do uso da simulação nos processos de capacitação de estudantes e profissionais de enfermagem sobre violência no trabalho. Métodos Revisão integrativa da literatura que seguiu recomendações metodológicas para responder à questão: a simulação pode ajudar estudantes e trabalhadores de enfermagem a lidarem com a violência no trabalho? Construiu-se estratégias de busca a partir de operadores booleanos e termos relacionadas à simulação e violência no trabalho, que foram inseridas ao CINAHL, MEDLINE e Proquest Central juntamente com os demais filtros. Dois revisores independentes selecionaram os estudos mediante critérios e houve análise do nível de evidência. Resultados Nove estudos foram selecionados e revelaram a flexibilidade da simulação pela possibilidade de utilizá-la com diferentes propósitos em capacitações. Identificou-se nos estudos que houve o uso de recursos variados de simulação, assim como a abordagem de diferentes tópicos de violência. Os cenários com pacientes ou agressores e a violência com origem no paciente foram os mais frequentes. Os estudos indicaram benefícios da simulação, mas nem todos os resultados foram consensuais. Conclusão A simulação é um recurso com potencial de ajudar estudantes e profissionais de enfermagem a lidarem com casos de violência no trabalho, prevenindo sua ocorrência ou reduzindo danos. Os estudos neste tema são recentes e várias necessidades de pesquisa emanam da aliança entre simulação e violência no trabalho, algumas das quais destacadas nesta revisão e que podem orientar a construção de evidências mais robustas.
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Affiliation(s)
- Maiara Bordignon
- Universidade Regional Integrada do Alto Uruguai e das Missões, Brasil
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Ramacciati N, Gili A, Mezzetti A, Ceccagnoli A, Addey B, Rasero L. Violence towards Emergency Nurses: The 2016 Italian National Survey-A cross-sectional study. J Nurs Manag 2019; 27:792-805. [PMID: 30430675 DOI: 10.1111/jonm.12733] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 10/16/2018] [Accepted: 11/10/2018] [Indexed: 11/28/2022]
Abstract
AIM To analyse the dimensions and characteristics of violence towards Emergency nurses in a national context (Italy). BACKGROUND Nurses are the most exposed to workplace violence, especially in Emergency Department contexts. METHODS A cross-sectional study was conducted in all Italian regions. Descriptive analyses were used to examine violence from patients and relatives (Type II violence) concerning personal characteristics of the Emergency nurses and perpetrators, environmental and organisational factors. Multinomial logistic regression analysis was used to investigate risk factors. RESULTS About 76.0% of Emergency nurses experienced verbal violence, 15.5% both verbal and physical violence and only 8.5% denied having experienced either. Older age and more experience in Emergency settings are protective factors. Working in the South of Italy significantly increases the probability of being exposed. DISCUSSION There are many factors explaining violence, but some correlations are not clear. CONCLUSION Factors that have a positive effect on this problem include: specific training for younger nurses, a strong alliance between users and health personnel to restore a relationship of trust between parties, physical barriers and appropriate architectural measures. IMPLICATIONS FOR NURSING MANAGEMENT Comprehensive approaches can represent an effective strategy to counteract workplace violence.
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Affiliation(s)
- Nicola Ramacciati
- Health Sciences Department, University of Florence, Florence, Italy.,Emergency Department, S. Maria della Misericordia Hospital, Perugia, Italy
| | - Alessio Gili
- Department of Experimental Medicine, Section of Public Health, University of Perugia, Perugia, Italy
| | - Andrea Mezzetti
- Emergency Medical Service, Azienda USL Toscana Centro, Pistoia, Italy
| | - Andrea Ceccagnoli
- Emergency Department, S. Maria della Misericordia Hospital, Perugia, Italy
| | - Beniamino Addey
- Emergency Department, S. Maria della Misericordia Hospital, Perugia, Italy
| | - Laura Rasero
- Health Sciences Department, University of Florence, Florence, Italy.,Research and Development Unit, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
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Yalcin S, Bilgin H. Risk predictions of physical aggression in acute psychiatric wards: Findings of a prospective study. Nurs Health Sci 2019; 21:316-322. [DOI: 10.1111/nhs.12599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 12/11/2018] [Accepted: 12/13/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Suna Yalcin
- Psychiatric NursingResearch Assistant in Kocaeli University Health Sciences Faculty, Nursing Division Kocaeli Turkey
| | - Hulya Bilgin
- Department of Mental Health and Psychiatric NursingIstanbul University Cerrahpaşa Istanbul Turkey
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Information and communication in the emergency department. Int Emerg Nurs 2018; 42:30-35. [PMID: 30122462 DOI: 10.1016/j.ienj.2018.07.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/08/2018] [Accepted: 07/06/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Effective communication between healthcare providers and patients represents an important caveat in healthcare, both nationally and internationally. Providing information to patients about their care and condition can be challenging, particularly in demanding, time-pressured environments such as the Emergency Department (ED). Understanding the process of communication and information between patients and staff in the ED is essential to ensuring patients are satisfied with their treatment and care. AIM This study aimed to develop a holistic understanding of the informational and communicational requirements of patients and staff in the ED. METHODS Action Research involving patient qualitative interviews and a staff focus group were used. RESULTS Fifteen patient and family interviews identified four main themes associated with information and communication in the ED. Six ED staff participated in the focus group, which identified three emergent themes echoing some findings from the patient qualitative interviews. DISCUSSION Meaningful and informative interactions between patients and healthcare providers are an imperative and pragmatic component of a positive patient experience. Establishing communicative procedures that are practical, functional and reflective of the service can improve communications between patients and staff and have implications for practice on a local, national and international level.
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Violence towards emergency nurses: A narrative review of theories and frameworks. Int Emerg Nurs 2018; 39:2-12. [DOI: 10.1016/j.ienj.2017.08.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/09/2017] [Accepted: 08/30/2017] [Indexed: 11/15/2022]
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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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D'Ettorre G, Pellicani V, Mazzotta M, Vullo A. Preventing and managing workplace violence against healthcare workers in Emergency Departments. ACTA BIO-MEDICA : ATENEI PARMENSIS 2018; 89:28-36. [PMID: 29644987 PMCID: PMC6357631 DOI: 10.23750/abm.v89i4-s.7113] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 02/21/2018] [Indexed: 11/23/2022]
Abstract
Background and aim: Healthcare workers (HCWs) employed in Emergency Departments (EDs) frequently face with patients becoming violent because of long wait or diseases or under the influence of alcohol or drugs. Globally, workplace violence (WPV) in EDs is a major challenge to safety for HCWs, involving significant consequences to the victims, patients, and healthcare organizations. We reviewed the current literature with the aim to explore the topics focused on and to detect new evidences about approaching the issue of WPV toward HCWs in EDs. Methods: A search for articles regarding WPV toward HCWs employed in EDs and published from January 2007 through December 2017 was performed; using predetermined criteria for inclusion, selected articles were reviewed and qualitatively assessed for the aims of the review. Results: We found 60 papers which matched our inclusion criteria; the topics, discussed in order of frequency from highest to lowest, were: “Risk Assessment”, “Occurrence Rates”, “Risk Management”, and “Physical/non Physical Consequences”. Dementia, schizophrenia, anxiety, acute stress reaction, suicidal ideation, and alcohol and drug intoxication were found as predictors of physical violence perpetrated by patients against HCWs. Conclusion: A strategic way to the effective management of WPV should prioritize training courses focused on: constructing HCW-patient relationship, improving the workers’ communication skills, accurate reporting of each violent incident, and improving the labor context through management commitment and employee involvement in WPV prevention programs. A special effort is required in implementing workplace design effective in minimizing stressful conditions in waiting rooms which turned out to be the most frequent site of assaults.
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Al-Qadi M. WITHDRAWN: Comment on: “Emergency nurses' perspective of workplace violence in Jordanian hospitals: A national survey” Int. Emerg. Nurs. 24(1) (2016), 61–65 by ALBashtawy M and Aljezawi M. Int Emerg Nurs 2018:S1755-599X(18)30015-6. [PMID: 29456167 DOI: 10.1016/j.ienj.2018.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 02/03/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Mahmoud Al-Qadi
- The University of Massachusetts Amherst, College of Nursing, United States.
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