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Ayaz B, Dozois G, Baumann AL, Fuseini A, Nelson S. Perpetrators of gender-based workplace violence amongst nurses and physicians-A scoping review of the literature. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003646. [PMID: 39240832 DOI: 10.1371/journal.pgph.0003646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 08/02/2024] [Indexed: 09/08/2024]
Abstract
In healthcare settings worldwide, workplace violence (WPV) has been extensively studied. However, significantly less is known about gender-based WPV and the characteristics of perpetrators. We conducted a comprehensive scoping review on Type II (directed by consumers) and Type III (perpetuated by healthcare workers) gender based-WPV among nurses and physicians globally. For the review, we followed the Preferred Reporting Items for Systematic and Meta Analyses extension for Scoping Review (PRISMA-ScR). The protocol for the comprehensive review was registered on the Open Science Framework on January 14, 2022, at https://osf.io/t4pfb/. A systematic search in five health and social science databases yielded 178 relevant studies that indicated types of perpetrators, with only 34 providing descriptive data for perpetrators' gender. Across both types of WPV, men (65.1%) were more frequently responsible for perpetuating WPV compared to women (28.2%) and both genders (6.7%). Type II WPV, demonstrated a higher incidence of violence against women; linked to the gendered roles, stereotypes, and societal expectations that allocate specific responsibilities based on gender. Type III WPV was further categorized into Type III-A (horizontal) and Type III-B (vertical). With Type III WPV, gendered power structures and stereotypes contributed to a permissive environment for violence by men and women that victimized more women. These revelations emphasize the pressing need for gender-sensitive strategies for addressing WPV within the healthcare sector. Policymakers must prioritize the security of healthcare workers, especially women, through reforms and zero-tolerance policies. Promoting gender equality and empowerment within the workforce and leadership is pivotal. Additionally, creating a culture of inclusivity, support, and respect, led by senior leadership, acknowledging WPV as a structural issue and enabling an open dialogue across all levels are essential for combating this pervasive problem.
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Affiliation(s)
- Basnama Ayaz
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | | | - Andrea L Baumann
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Adam Fuseini
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Sioban Nelson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Sridharan V, Leung KCY, Peisah C. Understanding aggression displayed by patients and families towards intensive care staff: A systematic review. J Intensive Care Soc 2024; 25:266-278. [PMID: 39224426 PMCID: PMC11366191 DOI: 10.1177/17511437241231707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Abstract
Objectives The objective of this systematic review was to synthesise literature pertaining to patient and family violence (PFV) directed at Intensive Care Unit (ICU) staff. Design Study design was a systematic review. The data was not amenable to meta-analysis. Data Sources and Review Methods Electronic searches of databases were conducted to identify studies between 1 January 2000 and 6 March 2023, limited to literature in English only. Published empirical peer-reviewed literature of any design (qualitative or quantitative) were included. Studies which only described workplace violence outside of ICU, systematic reviews, commentaries, editorials, letters, non-English literature and grey literature were excluded. All studies were appraised for quality and risk of bias using validated tools. Results Eighteen studies were identified: 13 quantitative; 2 qualitative and 3 mixed methodology. Themes included: (i) what is abuse and what do I do about it? (ii) who is at risk? (iii) it is common, but how common? (iv) workplace factors; (v) impact on patient care; (vi) effect on staff; (vii)the importance of the institutional response; and (viii) current or suggested solutions. Conclusions This systematic review demonstrated that PFV in the ICU is neither well-understood nor well-managed due to multiple factors including non-standardised definition of abuse, normalisation, inadequate organisational support and general lack of education of staff and public. This will guide in future research and policy decision making.
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Affiliation(s)
- Varadaraj Sridharan
- Department of Psychiatry, Central Coast Local Health District, NSW, Australia
| | - Kelvin CY Leung
- Psychiatry Specialty, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Carmelle Peisah
- Psychiatry Specialty, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
- Discipline of Psychiatry and Mental Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
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Nelson S, Ayaz B, Baumann AL, Dozois G. A gender-based review of workplace violence amongst the global health workforce-A scoping review of the literature. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003336. [PMID: 38954697 PMCID: PMC11218983 DOI: 10.1371/journal.pgph.0003336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 05/20/2024] [Indexed: 07/04/2024]
Abstract
Workplace violence (WPV) impacts all levels of the health workforce, including the individual provider, organization, and society. While there is a substantial body of literature on various aspects of WPV against the health workforce, gender-based WPV (GB-WPV) has received less attention. Violence in both the workplace and broader society is rooted in gendered socio-economic, cultural, and institutional factors. Developing a robust understanding of GB-WPV is crucial to explore the differing experiences, responses, and outcomes of GB-WPV with respect to gender. We conducted a scoping review and report on the prevalence and risk factors of GB-WPV in healthcare settings globally. The review followed the Preferred Reporting Items for Systematic and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We registered the scoping review protocol on the Open Science Framework on January 14, 2022, at https://osf.io/t4pfb/. A systematic search was conducted of empirical literature in five health and social science databases. Of 13667, 226 studies were included in the analysis. Across the studies, more women than men experienced non-physical violence, including verbal abuse, sexual harassment, and bullying. Men experienced more physical violence compared to women. Younger age, less experience, shifting duties, specific clinical settings, lower professional status, organizational hierarchy, and minority status were found to be sensitive to gender, reflecting women's structural disadvantages in the workplace. Given the high prevalence and impact of GB-WPV on women, we provided recommendations to address systemic issues in clinical practice, academia, policy, and research.
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Affiliation(s)
- Sioban Nelson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Basnama Ayaz
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Andrea L. Baumann
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Graham Dozois
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
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Suo L, Lu L, Li J, Qiu L, Liu J, Shi J, Sun Z, Lao W, Zhou X. The effect of deep and awake extubation on emergence agitation after nasal surgery: a randomized controlled trial. BMC Anesthesiol 2024; 24:177. [PMID: 38762729 PMCID: PMC11102170 DOI: 10.1186/s12871-024-02565-y] [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] [Received: 01/14/2024] [Accepted: 05/14/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND Post-anesthetic emergence agitation is common after general anesthesia and may cause adverse consequences, such as injury as well as respiratory and circulatory complications. Emergence agitation after general anesthesia occurs more frequently in nasal surgery than in other surgical procedures. This study aimed to assess the occurrence of emergence agitation in patients undergoing nasal surgery who were extubated under deep anesthesia or when fully awake. METHODS A total of 202 patients (18-60 years, American Society of Anesthesiologists classification: I-II) undergoing nasal surgery under general anesthesia were randomized 1:1 into two groups: a deep extubation group (group D) and an awake extubation group (group A). The primary outcome was the incidence of emergence agitation. The secondary outcomes included number of emergence agitations, sedation score, vital signs, and incidence of adverse events. RESULTS The incidence of emergence agitation was lower in group D than in group A (34.7% vs. 72.8%; p < 0.001). Compared to group A, patients in group D had lower Richmond Agitation-Sedation Scale scores, higher Ramsay sedation scores, fewer agitation episodes, and lower mean arterial pressure when extubated and 30 min after surgery, whereas these indicators did not differ 90 min after surgery. There was no difference in the incidence of adverse events between the two groups. CONCLUSIONS Extubation under deep anesthesia can significantly reduce emergence agitation after nasal surgery under general anesthesia without increasing the incidence of adverse events. TRIAL REGISTRATION Registered in Clinicaltrials.gov (NCT04844333) on 14/04/2021.
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Affiliation(s)
- Lulu Suo
- Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200125, China
| | - Lu Lu
- Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200125, China
| | - Jingjie Li
- Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200125, China
| | - Lin Qiu
- Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200125, China
| | - Jinxing Liu
- Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200125, China
| | - Jinya Shi
- Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200125, China
| | - Zhujie Sun
- Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200125, China
| | - Wei Lao
- Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200125, China.
| | - Xuhui Zhou
- Department of Anaesthesiology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.639 Zhizaoju Road, Shanghai, 200125, China.
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Luck L, Kaczorowski K, White M, Dickens G, McDermid F. Medical and surgical nurses' experiences of modifying and implementing contextually suitable Safewards interventions into medical and surgical hospital wards. J Adv Nurs 2024. [PMID: 38414101 DOI: 10.1111/jan.16102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 01/14/2024] [Accepted: 02/06/2024] [Indexed: 02/29/2024]
Abstract
AIM To explore general nurses' experiences of modifying and implementing contextually suitable Safewards interventions into medical and surgical hospital wards. DESIGN Qualitative action research was used working with nurses as co-researchers. METHODS Pre-implementation focus groups were conducted in April 2022 to understand and explore the current strategies nurses utilized to avert, respond to or decrease violence. Following this, two Safewards interventions were modified by the nurses on the wards. Post-implementation focus groups were conducted in October 2022, to explore the nurses' experience of implementing Safewards interventions and the effect on their nursing practice. Data were analysed using Braun and Clarke's framework for thematic analysis. RESULTS Three themes emerged from the analysis of the pre-implementation focus groups that reflected the type of violence experienced by these nurses and the context within which they occurred: 'the space is hectic'; 'it can feel like a battlefield'; and 'the aftermath'. These themes encompass the nurses' experience of violence from patients and their visitors. Following the implementation of two modified Safewards interventions, the analysis of the focus groups reflected a change in nursing skills to avert or respond to violence: 'Safewards in action'; 'empathy and self-reflection'; and 'moving forward'. CONCLUSION Safewards interventions can be successfully modified and used in general hospital wards and influence nursing practice to manage patient and visitor violence. IMPLICATIONS FOR THE PROFESSION In the interests of safety, successful interventions to reduce violence towards general hospital nurses should be a priority for managers and healthcare organizations. Averting, mitigating and managing violence can decrease the negative professional and personal effect on nurses and ultimately improve well-being, job satisfaction and retention rates. Furthermore, decreasing violence or aggressive incidents leads to a safer patient experience and decreased number of nursing errors ultimately improving patient experiences and outcomes. Understanding nurses' experiences of violence and working with them to explore and develop contextually relevant solutions increases their capacity to respond to and avert violent incidents. Contextually modified Safewards interventions offer one such solution and potentially has wider implications for healthcare settings beyond the specific wards studied. IMPACT This study addressed the implementation of modified Safewards strategies in medical and surgical wards to prevent violence. Three themes emerged from the analysis of the pre-implementation focus groups that reflected the type of violence experienced by these nurses and the context within which they occurred. Following the implementation of two modified Safewards interventions, the post-implementation focus groups reported positive changes to their practices using the modified resources to prevent violence from patients and their visitors. Mental health interventions, such as those used in the Safewards model can be modified and provide a tool kit of interventions that can be used by medical and surgical nurses. REPORTING METHOD This paper has adhered to the COREQ guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: This paper outlines and discusses the action research approach undertaken to work with general hospital nurses to modify mental health nurses' Safewards interventions into their clinical practice. This paper provides evidence of the 'real world' application of Safewards interventions by medical and surgical nurses in general hospital wards. This paper presents qualitative findings based on focus group methods to highlight the narratives of general nurses and their experiences of violence.
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Affiliation(s)
- Lauretta Luck
- Western Sydney University, Rydalmere, New South Wales, Australia
- Nepean Blue Mountains Local Health District, Penrith, New South Wales, Australia
| | - Kellie Kaczorowski
- Nepean Blue Mountains Local Health District, Penrith, New South Wales, Australia
| | - Melissa White
- Western Sydney University, Rydalmere, New South Wales, Australia
| | | | - Fiona McDermid
- Western Sydney University, Rydalmere, New South Wales, Australia
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Berger S, Grzonka P, Frei AI, Hunziker S, Baumann SM, Amacher SA, Gebhard CE, Sutter R. Violence against healthcare professionals in intensive care units: a systematic review and meta-analysis of frequency, risk factors, interventions, and preventive measures. Crit Care 2024; 28:61. [PMID: 38409034 PMCID: PMC10898135 DOI: 10.1186/s13054-024-04844-z] [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: 12/15/2023] [Accepted: 02/19/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND To assess the frequency, risk factors, consequences, and prevention of violence against healthcare workers in intensive care units. METHODS PubMed, Scopus, Google Scholar, EMBASE, Cochrane, and Web of Science were searched for studies on violence against healthcare workers in adult intensive care units. Risk factors, patient characteristics, and implications for healthcare workers were collected. Study quality, bias, and level of evidence were assessed using established tools. RESULTS Seventy-five studies with 139,533 healthcare workers from 32 countries were included. The overall median frequency of violence was 51% (IQR 37-75%). Up to 97% of healthcare workers experienced verbal violence, and up to 82% were victims of physical violence. Meta-analysis of frequency revealed an average frequency of 31% (95% CI 22-41%) for physical violence, 57% for verbal violence (95% CI 48-66%), and 12% for sexual violence (95% CI 4-23%). Heterogeneity was high according to the I2 statistics. Patients were the most common perpetrators (median 56%), followed by visitors (median 22%). Twenty-two studies reported increased risk ratios of up to 2.3 or odds ratios of up to 22.9 for healthcare workers in the ICU compared to other healthcare workers. Risk factors for experiencing violence included young age, less work experience, and being a nurse. Patients who exhibited violent behavior were often male, older, and physically impaired by drugs. Violence was underreported in up to 80% of cases and associated with higher burnout rates, increased anxiety, and higher turnover intentions. Overall the level of evidence was low. CONCLUSIONS Workplace violence is frequent and underreported in intensive care units, with potential serious consequences for healthcare workers, calling for heightened awareness, screening, and preventive measures. The potential risk factors for violence should be further investigated. SYSTEMATIC REVIEW REGISTRATION The protocol for this review was registered with Prospero on January 15, 2023 (ID CRD42023388449).
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Affiliation(s)
- Sebastian Berger
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
| | - Pascale Grzonka
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Anja I Frei
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Sabina Hunziker
- Medical Faculty, University of Basel, Basel, Switzerland
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Sira M Baumann
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Simon A Amacher
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Medical Communication and Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland
| | - Caroline E Gebhard
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Raoul Sutter
- Clinic for Intensive Care, Department of Acute Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
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Fang IL, Hsu MC, Ouyang WC. Lived Experience of Violence Perpetrated by Treated Patients and Their Visitors in Intensive Care Units: A Qualitative Study of Nurses. J Nurs Res 2023; 31:e284. [PMID: 37252848 DOI: 10.1097/jnr.0000000000000562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Patient and visitor violence (PVV) is a widespread problem for health professionals. Nurses working in intensive care units (ICUs) face a relatively high risk of experiencing PVV, which significantly impacts both the health of nurses and the institution as a whole. The subjective perceptions of ICU nurses regarding PVV are inadequately explored in the literature. PURPOSE The purpose of this study was to explore the perspectives, experiences, and perceptions of PVV in ICU nurses and to better understand the precipitating factors of violence. METHODS A phenomenological qualitative design and purposive sampling were used. A semistructured interview guide was used to conduct in-depth interviews with 12 ICU nurses with PVV experiences. Giorgi's method of analysis was used to discover and identify the essential categories of experience. RESULTS Five main experience categories were identified: family and patient factors as flashpoints, managing suppressed emotions by weathering the emotional storm, spiritual awakening after violence, and strategies for surviving further violence. The participants' experiences with PVV included a range of caring and mental health difficulties. In ICU settings, patient progress is often unpredictable, resulting in discrepancies between patient/family expectations and reality. Because feelings of frustration and powerlessness can eventually cause exhaustion in ICU nurses, implementing effective emotional management, stress adjustment, psychological counseling, team support, and violence intervention programs are crucial. CONCLUSIONS/IMPLICATIONS FOR PRACTICE This study provides new information on the process by which nurses can progress from inner trauma to self-recovery, moving from a negative affectivity disposition to a better understanding of threat appraisals and coping response options. Nurses should increase their awareness of the complexity of the phenomenon and of the interplay among the factors underlying PVV. The results of this study suggest that routine confusion and delirium assessments to rule out patients with ICU delirium in ICUs are important to preventing PVV. This study considers some of the implications of the research findings for nursing managers. Interventions, training programs, and/or management action should be used to ensure psychological and mental support is extended to all witnesses of PVV events and not only to those targeted by violence.
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Affiliation(s)
- I-Lu Fang
- MSN, RN, Head Nurse, Department of Nursing, E-DA Hospital, Kaohsiung City, Taiwan
| | - Mei-Chi Hsu
- PhD, RN, Professor, Department of Nursing, I-Shou University, Kaohsiung City, Taiwan
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Ding C, Li L, Li G, Li X, Xie L, Duan Z. Impact of workplace violence against psychological health among nurse staff from Yunnan-Myanmar Chinese border region: propensity score matching analysis. BMC Nurs 2023; 22:242. [PMID: 37495998 PMCID: PMC10369719 DOI: 10.1186/s12912-023-01402-w] [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: 02/09/2023] [Accepted: 07/19/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Owing to different social background factor in Yunnan-Myanmar Chinese border region, stressful working environment may lead to extra psychological burden among nurse staff in China. However, the prevalence of workplace violence and its effect on psychological characteristics among nurse staff are still unclear. This study aims to explore the effect of workplace violence against psychological health among nurse staff from Yunnan-Myanmar Chinese border region. METHODS A cross-sectional survey was conducted among 18 local governmental hospitals in Dehong districts. Participants were 1,774 nurses. Psychosocial characteristics were screened by sleep quality, the 9-item Patient Health Questionnaire for depressive symptoms, the generalized anxiety disorder-7 for anxiety symptoms, the Connor Davidson Resilience Scale - 10 item for resilience, the multidimensional scale of perceived social support for social support, the Chinese version of Work place Violence Scale for workplace violence. Propensity score matching and multivariate linear regression were applied to analyze the data. RESULTS The nurse staff with workplace violence have a higher risk of bad sleep quality (b = -0.883, 95%CI = [-1.171, -0.595]), anxiety symptoms (b = 2.531, 95%CI = [2.031, 3.031]) and depressive symptoms (b = 3.227, 95%CI = [2.635, 3.819]), loneliness (b = 0.683, 95%CI = [0.503, 0.863]), perceived cognitive deficits (b = 1.629, 95%CI = [1.131, 2.127]), poor resilience (b = -2.012, 95%CI = [-2.963, -1.061]), and poor social support (b = -5.659, 95%CI = [-7.307, -4.011]). CONCLUSIONS Preventing workplace violence can improve mental health outcomes significantly among nurse staff, including loneliness, perceived cognitive deficits, anxiety symptoms, depressive symptoms, sleep quality, resilience and social support.
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Affiliation(s)
- Changmian Ding
- The Medical Record Management Department, Dehong People's Hospital, Yunnan, China
| | - Lidan Li
- The Nursing Department, Dehong People's Hospital, Yunnan, China
| | - Guizhi Li
- The Medical Record Management Department, Dehong People's Hospital, Yunnan, China
| | - Xuehua Li
- The Medical Record Management Department, Dehong People's Hospital, Yunnan, China
| | - Linli Xie
- The Nursing Department, Dehong People's Hospital, Yunnan, China
| | - Zhizhou Duan
- Preventive health service, Jiangxi provincial people's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China.
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Lützerath J, Bleier H, Stassen G, Schaller A. Influencing factors on the health of nurses-a regression analysis considering individual and organizational determinants in Germany. BMC Health Serv Res 2023; 23:100. [PMID: 36717808 PMCID: PMC9887838 DOI: 10.1186/s12913-023-09106-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/25/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The care sector is characterized by high absenteeism of nursing care employees due to illness. Organizational determinants that can affect the mental health of nurses are known. Although nurses are confronted with different framework conditions in different care settings, there is a lack of comparative data in Germany. METHODS The purpose of this study was to examined the relationship between work demands and employee health in different care settings. This cross-sectional survey was conducted between June and October 2021 in four acute care hospitals, seven inpatient care facilities, and five outpatient care services in Germany. 528 nursing care employees (acute care hospitals n = 234; inpatient care facilities n = 152; outpatient care services n = 142) participated in the survey (participation rate: 22.6%-27.9%). For each care setting, data was collected via questionnaire on individual determinants (gender, age, profession, working time), organizational work demands (quantitative workload, qualitative workload, organization of work, social work climate, after work situation, verbal violence, threats, physical violence) and employee health (subjective health status and work ability). Descriptive statistics and binary logistic regressions were performed. RESULTS Increasing age (OR = 0.650, 95% CI = 0.424-0.996) as an individual determinant and organization of work (OR = 0.595, CI = 0.362-0.978) as an organizational determinant were negatively associated with subjective health. Furthermore, age (OR = 0.555, 95% CI = 0.353-0.875), a demanding organization of work (OR = 0.520, CI = 0.315-0.858), increasing quantitative workloads (OR = 0.565, CI = 0.343-0.930) and a poorer perceived social work climate (OR = 0.610, CI = 0.376-0.991) were associated with lower work ability. CONCLUSIONS Based on the study results, health programs should target both individual and organizational factors. The findings seem to support the importance to include nursing care employees in the planning process, as it can have an impact on their health. TRIAL REGISTRATION The project was registered in the German Clinical Trial Register (DRKS00024961, 09/04/2021).
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Affiliation(s)
- Jasmin Lützerath
- grid.27593.3a0000 0001 2244 5164Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany ,Institute for Workplace Health Promotion, Cologne, Germany
| | - Hannah Bleier
- grid.27593.3a0000 0001 2244 5164Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Gerrit Stassen
- grid.27593.3a0000 0001 2244 5164Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Andrea Schaller
- grid.27593.3a0000 0001 2244 5164Working Group Physical Activity-Related Prevention Research, Institute of Movement Therapy and Movement-Oriented Prevention and Rehabilitation, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
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Karlsen IL, Andersen DR, Jaspers SØ, Sønderbo Andersen LP, Aust B. Workplace's Development of Activities and Action Plans to Prevent Violence From Clients in High-Risk Sectors. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP872-NP904. [PMID: 35465743 DOI: 10.1177/08862605221086633] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Interventions trying to prevent violence from clients towards employees tend to show limited effect on the risk or the frequencies of violent episodes, possibly due to a too-narrow focus on only one or a few preventive strategies. This study aimed to show what employees and line managers identify as key intervention areas for preventing violence and threats. METHODS The study is based on data collected during a participatory intervention study aiming to improve violence prevention in Danish psychiatric units and prison and detention centers. In the intervention study, employees and line managers from 13 work units developed 293 suggestions and 92 action plans to prevent workplace violence. Through qualitative thematic analysis of the suggestions and action plans, we identified the main categories that work units viewed as important and realistic to work with to improve violence prevention. RESULTS We identified 12 topics of violence prevention that work units considered relevant. Action plan topics used by more than half of the work units included: specific approaches to violence prevention (e.g., de-escalating techniques), communication between employees to transfer knowledge between shifts, and introduction to new employees and temporary workers. Topics used by three to five work units were: interdisciplinary corporation, communication and relational work, uniform approaches, organization of work, and staffing. Topics used rarely were: definition of violence and threats, policy and guidelines, support from colleagues and management, and engagement in violence prevention. For nine of the 12 topics, action plans were developed in both high-risk sectors. CONCLUSIONS The violence prevention action plans developed by work units from two high-risk sectors indicate that workplaces estimate the prevention of client-induced workplace violence to require activities on many levels and cannot be solved by a single focused approach. This variety of preventive activities needs to be considered when designing violence prevention interventions.
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Affiliation(s)
- Iben Louise Karlsen
- 2686National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Dorte Raaby Andersen
- Department of Occupational Medicine - University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Herning, Denmark
| | | | - Lars Peter Sønderbo Andersen
- Department of Occupational Medicine - University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Herning, Denmark
| | - Birgit Aust
- 2686National Research Centre for the Working Environment, Copenhagen, Denmark
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Conceptualize Health Communication Impacts on Patient Outcomes in Oncology Outpatient Settings: A Mixed-Methods Study. Semin Oncol Nurs 2022:151355. [DOI: 10.1016/j.soncn.2022.151355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 10/12/2022] [Indexed: 11/15/2022]
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Otachi JK, Robertson H, Okoli CTC. Factors associated with workplace violence among healthcare workers in an academic medical center. Perspect Psychiatr Care 2022; 58:2383-2393. [PMID: 35388480 DOI: 10.1111/ppc.13072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 03/10/2022] [Accepted: 03/13/2022] [Indexed: 12/22/2022] Open
Abstract
PURPOSE We examined demographic, work-related, and behavioral factors associated with witnessing and/or experiencing workplace violence among healthcare workers. DESIGN AND METHODS Utilizing a correlational design, we analyzed the data to determine the associative factors related to workplace violence among the participants. FINDINGS More than half of the participants (54.5%) reported witnessing (23.8%) or experiencing (30.7%) workplace violence. There were significant differences between health provider groups in witnessing or experiencing workplace violence (Χ2 = 41.9[df12], p < 0.0001). Moreover, the experience of workplace violence differed by practice setting (Χ2 = 65.9[df14], p < 0.0001), with highest rates occurring in psychiatric (45.1%) and emergency (44.1%) services. PRACTICE IMPLICATIONS Findings may inform research, policies, and practice interventions to assess risks for workplace violence and implement preventative policies within high-risk professional groups and settings.
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Affiliation(s)
- Janet K Otachi
- NIH HEAL Initiative, Healing Communities Study, Substance Use Priority Research Area, University of Kentucky, Lexington, Kentucky, USA
| | - Heather Robertson
- Mental and Behavioral Health Nursing, Behavioral Health Wellness Environments for Living and Learning (BH WELL), University of Kentucky College of Nursing, Lexington, Kentucky, USA
| | - Chizimuzo T C Okoli
- Behavioral Health Wellness Environments for Living and Learning (BH WELL), University of Kentucky College of Nursing, Lexington, Kentucky, USA
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Kumari A, Ranjan P, Sarkar S, Chopra S, Kaur T, Baitha U. Identifying Predictors of Workplace Violence Against Healthcare Professionals: A Systematic Review. Indian J Occup Environ Med 2022; 26:207-224. [PMID: 37033752 PMCID: PMC10077728 DOI: 10.4103/ijoem.ijoem_164_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 05/30/2022] [Accepted: 06/28/2022] [Indexed: 12/24/2022] Open
Abstract
Understanding the predictors of workplace violence amongst healthcare professionals is important to develop and implement prevention and mitigation strategies. We conducted a systematic review to synthesize the recent evidence on predictors of workplace violence across healthcare settings. The review has been done as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two electronic databases (PubMed and Google Scholar) were used to search peer-reviewed studies published for the year 2009-2020 to identify studies reporting predictors of workplace violence. The significant predictors were analyzed using descriptive statistics such as proportions in most of the studies and some studies used inferential statistics such as logistic regression analysis, Chi-square test, ANOVA and Student's t-test. A total of 46 studies were identified and overall evidence was graded using an adapted GRADE approach. Some of the moderate quality predictors associated with workplace violence were the patient with a history of mental health disease, psychiatric setting, professional's gender and work experience and evening shift workers. Being a nurse was the only high-quality predictor. Healthcare professionals and administration can identify the predictors relevant to their setting to mitigate episodes of violence against healthcare personnel.
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Affiliation(s)
- Archana Kumari
- Department of Obstetrics and Gynaecology, Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Piyush Ranjan
- Department of Medicine, Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Siddharth Sarkar
- Department of Psychiatry and National Drug Dependence Treatment Centre, Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Sakshi Chopra
- Department of Home Science, University of Delhi, New Delhi, India
| | - Tanveer Kaur
- Department of Medicine, Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Upendra Baitha
- Department of Medicine, Treatment Centre, All India Institute of Medical Sciences, New Delhi, India
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14
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Workplace Violence in Healthcare Settings: Work-Related Predictors of Violence Behaviours. PSYCH 2022. [DOI: 10.3390/psych4030039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Healthcare workers are exposed to workplace violence such as physical assaults, psychological violence and threats of violence. It is crucial to understand factors associated with workplace violence to prevent and mitigate its consequences. This study aims to identify work-related factors that might influence workplace violence in healthcare settings. A cross-sectional study was developed between March and April of 2022 with healthcare workers. The Aggression and Violence at Work Scale was used to assess workplace violence, and psychosocial risks were assessed through the Health and Work Survey—INSAT. Statistical analysis using bivariate analysis was performed to identify the psychosocial risk factors related to physical violence, psychological violence and vicarious violence. Subsequently, a multiple linear regression was performed to identify the models that better explained the relationship between psychosocial risk factors and the three dimensions of violence. Psychological violence was frequently experienced by the healthcare workers. Significant associations were found between psychosocial risk factors and physical, psychological and vicarious violence, namely working hours, work relationships, employment relations, high demands and work intensity. These findings highlight the importance of taking into consideration work-related factors when designing interventions to prevent and address workplace violence in healthcare settings.
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15
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Aspects of Violence Leading to Distress and Changed Attitudes for Physiotherapists: A Qualitative Investigation. Physiotherapy 2022; 117:63-70. [DOI: 10.1016/j.physio.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 03/08/2022] [Accepted: 08/23/2022] [Indexed: 11/20/2022]
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16
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Guo YQ, Huang J, Xu NN, Ma XJ. Worker Characteristics and Measures Associated With Patient and Visitor Violence in the COVID-19 Pandemic: A Multilevel Regression Analysis From China. Front Public Health 2022; 10:877843. [PMID: 35719686 PMCID: PMC9201521 DOI: 10.3389/fpubh.2022.877843] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/12/2022] [Indexed: 11/25/2022] Open
Abstract
Objective To analyze the patient and visitor workplace violence (PVV) toward health workers (HWs) and identify correlations between worker characteristics, measures against violence and exposure to PVV in COVID-19 pandemic. Methods A cross-sectional survey utilizing the international questionnaires in six public tertiary hospitals from Beijing in 2020 was conducted, and valid data from 754 respondents were collected. Multilevel logistic regression models were used to determine the association between independents and exposure to PVV. Results During COVID-19 pandemic and regular epidemic prevention and control, doctors were 5.3 times (95% CI = 1.59~17.90) more likely to suffer from physical PVV than nurses. HWs most frequently work with infants were 7.2 times (95% CI = 2.24~23.19) more likely to suffer from psychological PVV. More than four-fifth of HWs reported that their workplace had implemented security measures in 2020, and the cross-level interactions between the security measures and profession variable indicates that doctors in the workplace without security measures were 11.3 times (95% CI = 1.09~116.39) more likely to suffer from physical PVV compared to nurses in the workplace with security measures. Conclusion Doctors have higher risk of physical PVV in COVID-19 containment, and the security measures are very important and effective to fight against the physical PVV. Comprehensive measures should be implemented to mitigate hazards and protect the health, safety, and well-being of health workers.
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Affiliation(s)
- Ya-Qian Guo
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ju Huang
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Na-Na Xu
- The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Xiao-Jing Ma
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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17
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La Torre G, Firenze A, Di Gioia LP, Perri G, Soncin M, Cremonesi D, De Camillis N, Guidolin S, Evangelista G, Marte M, Fedele NG, De Sio S, Mannocci A, Sernia S, Brusaferro S. Workplace violence among healthcare workers, a multicenter study in Italy. Public Health 2022; 208:9-13. [PMID: 35660281 DOI: 10.1016/j.puhe.2022.04.008] [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: 02/28/2022] [Revised: 04/23/2022] [Accepted: 04/27/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The purpose of this study is to assess the prevalence and determinants of workplace violence and the sociodemographic risk factors associated. STUDY DESIGN This was a multicenter cross-sectional study. METHODS The study was performed using self-compiled Italian version of the World Health Organization's questionnaire on workplace violence online by filling in a Google form. The survey was opened from May 2018 to March 2020 and lasted 5-10 min. RESULTS The sample consists of 3659 healthcare workers, of which 2525 (69%) are females, 1446 (39.5%) are nurses, and 2029 (55.5%) are health workers from northern Italy. The most frequent age group of the sample is 50-54 years (16.7%). A total of 366 (10%) healthcare workers are victims of physical aggression at work in the last 12 months, of which 6.3% with a weapon. The risk of being a victim of physical aggression at work in the last 12 months is significantly associated with the following independent variables: male gender (odds ratio [OR] 1.72, 95% confidence interval [CI]: 1.36-2.17), work in southern Italy (OR 1.59, 95% CI: 1.10-2.28), and being a nurse (OR 2.56, 95% CI: 2.01-3.25). The risk of being a victim of physical aggression at work with a weapon in the last 12 months is significantly associated with work in southern Italy (OR 9.33, 95% CI: 3.83-22.73). A total of 1723 (47.1%) of healthcare workers declare to be a victim of verbal aggression at work in the last 12 months. The risk of being a victim of verbal aggression at work in the last 12 months is significantly associated with the following independent variables: work in northern Italy (adjusted OR [aOR] 1.54, 95% CI: 1.32-1.81), work in southern Italy (aOR 3.68, 95% CI: 2.90-4.68), and be more than 55 years old (aOR 0.73, 95% CI: 0.63-0.85). CONCLUSIONS The study underlines that the problem of verbal and physical aggression against healthcare workers is still central and is a further starting point for research. The prevalence of violence is difficult to assess because violent incidents are underreported or unreported. The results of the study suggest that increased awareness is needed to develop effective control strategies at the individual, hospital, and national levels to prevent aggression and improve the conditions of victims.
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Affiliation(s)
- G La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
| | - A Firenze
- University of Palermo, Palermo, Italy
| | - L P Di Gioia
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - G Perri
- Dipartimento di Area Medica, Università di Udine, Udine, Italy
| | - M Soncin
- Ospedale Niguarda, Milano, Italy
| | - D Cremonesi
- Ordine Delle Professioni Infermieristiche Como, Italy
| | | | | | - G Evangelista
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - M Marte
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - N G Fedele
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - S De Sio
- R.U. of Occupational Medicine, Sapienza University of Rome, Rome, Italy
| | | | - S Sernia
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - S Brusaferro
- Dipartimento di Area Medica, Università di Udine, Udine, Italy
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18
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Workplace violence in healthcare settings: The risk factors, implications and collaborative preventive measures. Ann Med Surg (Lond) 2022; 78:103727. [PMID: 35734684 PMCID: PMC9206999 DOI: 10.1016/j.amsu.2022.103727] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/27/2022] [Accepted: 05/03/2022] [Indexed: 11/22/2022] Open
Abstract
Violence at work refers to acts or threats of violence directed against employees, either inside or outside the workplace, from verbal abuse, bullying, harassment, and physical assaults to homicide. Even though workplace violence has become a worrying trend worldwide, the true magnitude of the problem is uncertain, owing to limited surveillance and lack of awareness of the issue. As a result, if workplace violence, particularly in healthcare settings, is not adequately addressed, it will become a global phenomenon, undermining the peace and stability among the active communities while also posing a risk to the population's health and well-being. Hence, this review intends to identify the risk factors and the implications of workplace violence in healthcare settings and highlight the collaborative efforts needed in sustaining control and prevention measures against workplace violence. Workplace violence needs to be addressed more comprehensively, involving shared responsibilities from all levels. Emphasis on healthcare management's commitment, assurance, and clearly defined policy, reporting procedures, and training. The healthcare workers' commitment to update their awareness and knowledge regarding workplace violence. The provision of technical support and assistance from professional organizations, NGOs, and the community.
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Shiyab A, Ababneh RI, Shyyab Y. Causes of workplace violence against medical staff as perceived by physicians and nurses in Jordanian public hospitals. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2022. [DOI: 10.1108/ijwhm-01-2021-0002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PurposeWorkplace violence against medical staff has become an endemic problem in the healthcare sector in Jordan. This study investigates the perceived main causes of workplace violence (medical staff, administrative, patients, patient's escorts and legislative) against physicians and nurses in public hospitals.Design/methodology/approachA self-administered questionnaire was used to collect data from a convenient random sample of 334 physicians and nurses employed in Jordanian public hospitals. Descriptive statistics and analysis of variance were used to answer questions and test hypotheses.FindingsFindings indicated that the practice of the causes of workplace violence behaviors assessed by the participants is at a moderate level in Jordanian public hospitals with a mean value of 3.26. The causes of violence were reported as most causative to least causative: patient escort (M = 3.60), legislative (M = 3.56), patients (M = 3.40), administrative (M = 3.16) and medical staff related (M = 2.74), respectively. Analysis showed statistical differences in the participants' attitudes toward the causes of workplace violence behaviors due to their gender, job title, education level, experience and income.Practical implicationsThis study has a significant practical contribution in providing information about the causes of workplace violence that will help health policymakers and hospital administrators to deter violence against medical staff. To reduce or eliminate the potential causes of violence, several actions can be taken, such as criminalizing violent behaviors, managing work pressure, staff shortages, developing comfortable and secure medical treatment settings, training the medical staff on aggression and stress management, and enhancing their communication skills with patients and their escorts. Findings also highlight the need for hospital management to develop protocols for reporting and dealing with workplace violence.Originality/valueThis is one of the first studies in the Arab context that examines the causes of workplace violence against medical staff.
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Alfuqaha OA, Albawati NM, Alhiary SS, Alhalaiqa FN, Haha MFF, Musa SS, Shunnar O, AL Thaher Y. Workplace Violence among Healthcare Providers during the COVID-19 Health Emergency: A Cross-Sectional Study. Behav Sci (Basel) 2022; 12:bs12040106. [PMID: 35447678 PMCID: PMC9026762 DOI: 10.3390/bs12040106] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/04/2022] [Accepted: 04/08/2022] [Indexed: 02/05/2023] Open
Abstract
(1) Background: Workplace violence among healthcare providers (HCPs) is a tangible barrier to patient care. The purpose of this study was to gain insight into physicians’ and nurses’ perceptions of workplace violence and their perceptions of communication skills during the COVID-19 health emergency. We also sought to assess and compare the association between types of workplace violence, communication skills, and several sociodemographic factors of physicians and nurses including gender, marital status, site of work, age, and educational level during this era. (2) Methods: We performed a cross-sectional study of a selected hospital in Jordan using the Arabic version of the workplace violence and communication skills scales for September to November 2020. We included a total of 102 physicians and 190 nurses via a self-reported questionnaire. (3) Results: During the COVID-19 health emergency, physicians (48%) experienced workplace violence more than nurses (31.6%). More than two-thirds of the participants did not formally report any type of violence. Multinomial logistic regression analysis showed that marital status, gender, age, site of work, educational levels, and communication skills were associated with different types of violence among the two samples. (4) Conclusions: A high prevalence of workplace violence is noted among HCPs in Jordan compared with before the pandemic, which highlights the importance of promoting public awareness during crises.
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Affiliation(s)
- Othman A. Alfuqaha
- Jordan University Hospital, The University of Jordan, Amman 11942, Jordan
- Correspondence:
| | - Nour M. Albawati
- Department of Nursing, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan; (N.M.A.); (S.S.A.); (O.S.)
| | - Sakher S. Alhiary
- Department of Nursing, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan; (N.M.A.); (S.S.A.); (O.S.)
| | | | - Moh’d Fayeq F. Haha
- School of Medicine, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan; (M.F.F.H.); (S.S.M.)
| | - Suzan S. Musa
- School of Medicine, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan; (M.F.F.H.); (S.S.M.)
| | - Ohood Shunnar
- Department of Nursing, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan; (N.M.A.); (S.S.A.); (O.S.)
| | - Yazan AL Thaher
- Faculty of Pharmacy, Philadelphia University, Amman 19392, Jordan;
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21
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Effects of Integrated Workplace Violence Management Intervention on Occupational Coping Self-Efficacy, Goal Commitment, Attitudes, and Confidence in Emergency Department Nurses: A Cluster-Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052835. [PMID: 35270527 PMCID: PMC8910583 DOI: 10.3390/ijerph19052835] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/20/2022] [Accepted: 02/25/2022] [Indexed: 11/30/2022]
Abstract
Patient and visitor violence (PVV), the most prevalent source of workplace violence, is largely ignored, underreported, and a persistent problem in emergency departments. It is associated with physical injuries, psychological distress, and occupational stress in nurses. A randomized controlled trial was conducted in Taiwan from January to December 2020. This study aimed to test the efficacy of an integrated Workplace Violence Prevention and Management Training Program on PVV in 75 emergency department (ED) nurses from a hospital. Cluster sampling was used because the policy of subdivision strategy was enforced during the COVID-19 pandemic. ED nurses received either the intervention or 1-hour in-service class. Data were collected from questionnaires. Data were analyzed mainly by the repeated measure analysis of variance and generalized estimating equations. The intervention had positive effects on developing stronger goal commitment, improving occupational coping self-efficacy, increasing confidence in ability to deal with violent situations, and modifying attitudes toward the causes and management of PVV in ED nurses (p < 0.05). The marginal R2 of the generalized estimating equation model for goal commitment, occupational coping self-efficacy, confidence, attitudes toward aggression in ED and aggressive behavior variables was high as 0.54 (p < 0.001), 0.45 (p < 0.001), 0.58 (p < 0.001), 0.29 (p < 0.05), and 0.72 (p < 0.001), respectively. These study models could effectively predict changes in the mean values. The benefit was driven by the effect of the intervention in ED nurses. Thus, the intervention, when applied in conjunction with routine in-service class, could exert synergistic improvements on outcomes measured in nurses.
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22
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Hsu MC, Chou MH, Ouyang WC. Dilemmas and Repercussions of Workplace Violence against Emergency Nurses: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052661. [PMID: 35270354 PMCID: PMC8909790 DOI: 10.3390/ijerph19052661] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 02/06/2023]
Abstract
Nurses received the highest rate of workplace violence due to their close interaction with clients and the nature of their work. There have been relatively few qualitative studies focus on nurses' perceptions of and experiences with the antecedents, dilemma and repercussions of the patient and visitor violence (PVV), leaving a considerable evidence gap. The aim of this study was to explore nurses' experience of PVV in emergency department, the impact of PVV on quality of care, and supports needed after exposure to such incidents. We conducted semi-structured interviews with a purposive and snowball sample of nurses, and analyzed the content of the interview transcripts. A total of 10 nurses were approached and agreed to participate. Those participants ranged in age from 24 to 41 years old, eight female and two male nurses, and the majority of them (80%) held a university Bachelor degree in nursing. The average time in nursing practice was 7.2 years. We conceptualized five analytical themes, which comprised: (1) multifaceted triggers and causes of PVV; (2) experiences following PVV; (3) tangled up in thoughts and struggle with the professional role; (4) self-reflexivity and adjustment; and, (5) needs of organizational efforts and support following PVV. This paper provides compelling reasons to look beyond solely evaluating the existence of workplace, and considering the perceived professional inefficacy, impacts of being threatened or assaulted in nurses. There are also urgent needs in provision of prevention and management of workplace training programs to ensure the high-quality nursing care.
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Affiliation(s)
- Mei-Chi Hsu
- Department of Nursing, I-Shou University, Kaohsiung City 82445, Taiwan; (M.-C.H.); (M.-H.C.)
| | - Mei-Hsien Chou
- Department of Nursing, I-Shou University, Kaohsiung City 82445, Taiwan; (M.-C.H.); (M.-H.C.)
| | - Wen-Chen Ouyang
- Department of Geriatric Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan City 71742, Taiwan
- Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung City 82144, Taiwan
- Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung City 80708, Taiwan
- Correspondence: ; Tel.: +886-6-2795019
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Cabilan CJ, McRae J, Learmont B, Taurima K, Galbraith S, Mason D, Eley R, Snoswell C, Johnston A. Validity and reliability of the novel three‐item occupational violence patient risk assessment tool. J Adv Nurs 2022; 78:1176-1185. [PMID: 35128709 PMCID: PMC9306479 DOI: 10.1111/jan.15166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/27/2021] [Accepted: 01/12/2022] [Indexed: 01/04/2023]
Abstract
Aim To develop and psychometrically test an occupational violence (OV) risk assessment tool in the emergency department (ED). Design Three studies were conducted in phases: content validity, predictive validity and inter‐rater reliability from June 2019 to March 2021. Methods For content validity, ED end users (mainly nurses) were recruited to rate items that would appropriately assess for OV risk. Subsequently, a risk assessment tool was developed and tested for its predictive validity and inter‐rater reliability. For predictive validity, triage notes of ED presentations in a month with the highest OV were assessed for presence of OV risk. Each presentation was then matched with events recorded in the OV incident register. Sensitivity and specificity values were calculated. For inter‐rater reliability, two assessors—trained and untrained—independently assessed the triage notes for presence of OV risk. Cohen's kappa was calculated. Results Two rounds of content validity with a total of N = 81 end users led to the development of a three‐domain tool that assesses for OV risk using aggression history, behavioural concerns (i.e., angry, clenched fist, demanding, threatening language or resisting care) and clinical presentation concerns (i.e., alcohol/drug intoxication and erratic cognition). Recommended risk ratings are low (score = 0 risk domain present), moderate (score = 1 risk domain present) and high (score = 2–3 risk domains present), with an area under the curve of 0.77 (95% confidence interval 0.7–0.81, p < .01). Moderate risk rating had a 61% sensitivity and 91% specificity, whereas high risk rating had 37% sensitivity and 97% specificity. Inter‐rater reliability ranged from 0.67 to 0.75 (p < .01), suggesting moderate agreement. Conclusions The novel three‐domain OV risk assessment tool was shown to be appropriate and relevant for application in EDs. The tool, developed through a rigorous content validity process, demonstrates acceptable predictive validity and inter‐rater reliability. Impact The developed tool is currently piloted in a single hospital ED, with a view to extend to inpatient settings and other hospitals.
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Affiliation(s)
- C. J. Cabilan
- Emergency Department Princess Alexandra Hospital Woolloongabba Queensland Australia
- School of Nursing, Midwifery and Social Work The University of Queensland Brisbane Queensland Australia
| | - Joshua McRae
- Office of the Chief Clinical Information Officer Queensland Health Herston Queensland Australia
| | - Ben Learmont
- Emergency Department Princess Alexandra Hospital Woolloongabba Queensland Australia
| | - Karen Taurima
- Emergency Department Princess Alexandra Hospital Woolloongabba Queensland Australia
| | - Sue Galbraith
- Emergency Department Princess Alexandra Hospital Woolloongabba Queensland Australia
| | - Dale Mason
- Emergency Department Princess Alexandra Hospital Woolloongabba Queensland Australia
| | - Robert Eley
- Emergency Department Princess Alexandra Hospital Woolloongabba Queensland Australia
- Faculty of Medicine The University of Queensland Brisbane Queensland Australia
| | - Centaine Snoswell
- Centre for Online Health, Centre for Health Services Research The University of Queensland Brisbane Queensland Australia
| | - Amy N. B. Johnston
- Emergency Department Princess Alexandra Hospital Woolloongabba Queensland Australia
- School of Nursing, Midwifery and Social Work The University of Queensland Brisbane Queensland Australia
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Schwoebel A, Quigley E, Deeley A, DeLuca J, Hollister S, Ruggiero J. A Quality Improvement Project to Reduce Events of Visitor Escalation in the Intensive Care Nursery. Adv Neonatal Care 2022; 22:69-78. [PMID: 33756499 DOI: 10.1097/anc.0000000000000852] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Escalating and aggressive visitor behaviors have become increasingly common in healthcare settings nationally, negatively impacting staff and patients alike. Most healthcare providers do not innately possess the specific skills to manage such behaviors. Management of escalating and aggressive behaviors presents a particularly bedeviling challenge when staff safety must be balanced with the needs of parent-neonate bonding. PURPOSE In the Intensive Care Nursery (ICN), the frequency of aggressive and hostile incidents from visitors increased such that the staff felt frustrated by and uneasy about their work environment. METHODS The ICN convened an interprofessional team to strategize interventions aimed at consistently managing aggressive behavior and supporting the staff after aggressive and/or hostile visitor encounters. FINDINGS Following staff education and training, the unit launched a de-escalation management algorithm in July 2018 that assisted in identifying high-risk families at admission and drove consistent action and management of all visitor behaviors. In the 12 months following the intervention, the frequency of behavioral escalation decreased by 75% and staff perception of safety increased by 25%. IMPLICATIONS FOR PRACTICE Collaborating with staff to design consistent strategies to manage aggressive and escalating visitor behavior can improve safety and improve employee satisfaction in the ICN. IMPLICATIONS FOR RESEARCH Additional research on the effectiveness of the algorithm in other ICNs and alternative areas of practice is needed. Furthermore, validation of a staff perception survey measuring the impact of escalating visitor behaviors on employees would be an important next step in this research.Video abstract available athttps://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=43.
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Tsukamoto SAS, Galdino MJQ, Barreto MFC, Martins JT. Burnout syndrome and workplace violence among nursing staff: a cross-sectional study. SAO PAULO MED J 2022; 140:101-107. [PMID: 34932780 PMCID: PMC9623842 DOI: 10.1590/1516-3180.2021.0068.r1.31052021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 05/31/2021] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Among healthcare professionals, nursing workers are the most prone to becoming victims of workplace violence and present the highest burnout levels. OBJECTIVES To investigate the association between burnout syndrome and workplace violence among nursing workers. DESIGN AND SETTING Cross-sectional study carried out at a teaching hospital in southern Brazil. METHODS This study involved 242 nursing workers. We collected data over a six-month period using a sociodemographic and occupational survey, the Survey Questionnaire Workplace Violence in the Health Sector and the Maslach Burnout Inventory - General Survey. For occupational violence, we selected the Survey Questionnaire Workplace Violence in the Health Sector. Burnout syndrome was evaluated using the Maslach Burnout Inventory - General Survey. The data were analyzed in the Statistical Package for the Social Sciences (SPSS). Categorical variables were described as absolute and relative frequencies and numerical variables in terms of central trend and dispersion measurements. For data analysis, we applied descriptive statistics and multiple logistic regression. RESULTS The multiple models indicated that the workers who had experienced verbal abuse, physical violence and concern about workplace violence over the past 12 months had significantly higher chances of presenting high emotional exhaustion (P < 0.05) and depersonalization (P < 0.05) and low professional accomplishment (P < 0.05). CONCLUSION Occurrence of violence significantly increased the chances of great emotional exhaustion and depersonalization and low professional achievement, within burnout syndrome. Therefore, workplace violence prevention strategies need to be put in place to provide workers with a safe workplace in which to conduct their activities.
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Affiliation(s)
- Sirlene Aparecida Scarpin Tsukamoto
- MSc. Nurse, Hospital Evangélico de Londrina, Londrina (PR), Brazil; and Member of the Núcleo de Estudos da Saúde do Trabalhador, Universidade Estadual de Londrina (NUESTUEL), Londrina (PR), Brazil.
| | - Maria José Quina Galdino
- PhD. Nurse and Adjunct Professor, Department of Nursing, Universidade Estadual do Norte do Paraná (UENP), Bandeirantes (PR), Brazil; and Coordinator, Study Group on Teaching, Health and Work, Universidade Estadual do Norte do Paraná (UENP), Bandeirantes (PR), Brazil.
| | - Maynara Fernanda Carvalho Barreto
- PhD. Nurse and Professor, Department of Nursing, Universidade Estadual do Norte do Paraná (UENP), Bandeirantes (PR), Brazil; and Member of the Study Group on Teaching, Health and Work, Universidade Estadual do Norte do Paraná (UENP), Bandeirantes (PR), Brazil.
| | - Júlia Trevisan Martins
- PhD. Nurse and Associate Professor, Department of Nursing, Universidade Estadual de Londrina (UEL), Londrina (PR), Brazil; and Coordinator, Study Group on Occupational Health, Universidade Estadual de Londrina (UEL), Londrina (PR), Brazil.
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Self-Reported Violence Experienced by Swiss Prehospital Emergency Care Providers. Emerg Med Int 2021; 2021:9966950. [PMID: 34956678 PMCID: PMC8709758 DOI: 10.1155/2021/9966950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 07/21/2021] [Accepted: 11/08/2021] [Indexed: 11/18/2022] Open
Abstract
Background Workplace violence is a serious and increasing problem in health care. Nevertheless, only few studies were carried out concerning this topic and then mainly in English-speaking countries. The objectives were to describe the acts of violence experienced by prehospital emergency care providers (PECPs) in the western part of Switzerland between January and December 2016 and to assess the consequences for subsequent PECPs behaviors. Methods An observational cross-sectional study, carried out using an online survey, has been sent to all 416 PECPs in the Canton of Vaud, in the western, French-speaking, part of Switzerland. The survey contained items of demographic data and items to assess the type and consequence of violence sustained. This was classified as five types: verbal assault, intimidation, physical assault, sexual harassment, and sexual assault. Results 273 (65.6%) PECPs participated in the survey. During 2016, workplace violence was reported by 229 survey participants (83.9%). Most declared to be the victim of such violence between one and three times during the year. In all cases of violence described, the patient and/or a relative initiated aggressive behavior in 96% of cases. Verbal assaults were the most common (99.2% of all acts), followed by intimidation (72.8%), physical assault (69.6%), and sexual harassment (16.3%). Concerning physical assault, PECPs were predominantly victims of spitting and/or jostling (50%). After a violent event, in 50% of cases, the PECPs modified their behavior owing to the experience of workplace violence; 82% now wear protective vests, and 16% carry weapons for self-defense, such as pepper sprays. Seventy-five percent changed their intervention strategies, acting more carefully and using verbal de-escalation techniques or physical restraints for violent patients. Conclusions Workplace violence is frequent and has significant consequences for PECPs. In order to increase their own security, they increased their protection. These results illustrate their feelings of insecurity, which may have deleterious effects on work satisfaction and motivation. Trial Registration. Our article does not report the results of a health care intervention on human participants.
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Yesilbas H, Baykal U. Causes of workplace violence against nurses from patients and their relatives: A qualitative study. Appl Nurs Res 2021; 62:151490. [PMID: 34814994 DOI: 10.1016/j.apnr.2021.151490] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 07/30/2021] [Accepted: 08/13/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Nurses are frequently exposed to violence in workplaces. Although the causes of workplace violence have been widely analyzed, there are only a limited number of qualitative studies dealing with violence against nurses from patient and their relatives with a comprehensive and multi-directional approach. AIM This study aimed to explore the causes of violence against nurses exercised by patients and/or their relatives in different departments of Turkish hospitals. METHODS This study utilized a qualitative descriptive design. Participants were chosen with purposive sampling and maximum variation sampling method from five different hospitals. Semi-structured in-depth interviews were conducted with 34 nurses working in different positions and departments. The interviews were recorded with audio recorders and the data were analyzed with a content analysis. RESULTS Four major themes emerged from the nurses' perspective concerning causes of workplace violence including the followings: (1) health care system, (2) health institutions, (3) health professionals, and (4) patients and their relatives. The themes "health care system" and "health institutions" include four subthemes, "health professionals" include five subthemes and "patients and their relatives" include twelve subthemes. CONCLUSION There are various causes why nurses are exposed to violence in the workplace by patients and/or their relatives. Since the causes of violence are a multifaceted issue, prevention strategies of violence against nurses should be planned and implemented accordingly.
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Affiliation(s)
- Hande Yesilbas
- Department of Nursing Management, Faculty of Nursing, Akdeniz University, 07070 Antalya, Turkey.
| | - Ulku Baykal
- Department of Nursing Management, Florence Nightingale Faculty of Nursing, Istanbul University - Cerrahpasa, Istanbul, Turkey
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The frequency and types of violence experienced by Australian sonographers from patients and visitors: A pilot study. SONOGRAPHY 2021. [DOI: 10.1002/sono.12286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Albalwei HSS, Ahmed NFH, Albalawi NMS, Albalawi SSA, Al-enazi NHK. Violence against Health Care Workers of Pediatric Departments in Saudi Arabia. ARCHIVES OF PHARMACY PRACTICE 2021. [DOI: 10.51847/rj683kldzs] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] 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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Derscheid DJ, Arnetz JE. Patient and Family Member Violent Situations in a Pediatric Hospital: A Descriptive Study. J Pediatr Nurs 2020; 55:241-249. [PMID: 32992261 PMCID: PMC7722004 DOI: 10.1016/j.pedn.2020.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 07/25/2020] [Accepted: 07/25/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The intent of this study is to report on violent situations involving the pediatric patient and/or the patient's family member in the inpatient hospital setting. DESIGN AND METHODS This descriptive study used two independent samples: Behavioral Emergency Response Team (BERT) recipients and surveyed pediatric healthcare staff at a pediatric hospital within a large urban Midwestern academic hospital in the United States. RESULTS Per BERT recipients (N = 26) and staff survey respondents (N = 91), common physical patient behaviors were, respectively, hitting (60%, 77%) and kicking (53%, 82%). Fifteen (75%) patient BERT responses were for violent situations. The most common mental health condition among patients in violent situations was behavior dyscontrol (n = 8, 53%), which was absent among calls for non-violent situations (n = 5). Seizures, which was the most common medical condition among patients in BERT violent situations (n = 6, 40%), was proportionately slightly greater than among non-violent situations (n = 1, 20%). Staff who reported experience with violent situations (n = 64, 73%) were from general medical units (n = 48, 75%), and registered nurses (n = 53, 79%). CONCLUSIONS This study helped illuminate demographic, medical and mental health clues about violent situations with patients and family members on pediatric inpatient hospital units. PRACTICE IMPLICATIONS Pediatric patients and families may struggle to cope during hospitalization. Healthcare providers' knowledge about co-occurring conditions, stress related to hospitalization and use of BERT as a resource may help prevent violent situations.
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Affiliation(s)
| | - Judith E Arnetz
- Department of Family Medicine, Michigan State University, United States.
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Occupational Violence and PTSD-Symptoms: A Prospective Study on the Indirect Effects of Violence Through Time Pressure and Nontraumatic Strains in the Occupational Context. J Occup Environ Med 2020; 61:572-583. [PMID: 31022098 DOI: 10.1097/jom.0000000000001612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The aim of this study was to assess whether frequency of occupational violence (OV) affects posttraumatic stress disorder (PTSD) symptoms through nontraumatic strains in the occupational context. METHODS Twelve-month prospective survey data on 1763 Social educators were used. Path-analysis measured direct and indirect pathways of frequency of OV on PTSD through change in time pressure, change in burnout, change in sense of safety at work, and change in coping with regret in patient work. RESULTS Forty-two pct. of the variance in PTSD symptoms was predicted; F (20, 1541) = 36.8, P < 0.001, R = 0.42. Frequency of OV indirectly affected level of PTSD through all the mediators; estimated indirect effects = 0.14, 95% confidence interval 0.07 to 0.22. CONCLUSION PTSD resulting from OV is not only a result of the violent acts themselves but is also caused by nontraumatic strains. It is essential to include the broader context of work environment factors in prevention of work-related PTSD.
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Folgo AR, Iennaco JD. Staff perceptions of risk factors for violence and aggression in ambulatory care. Work 2020; 65:435-445. [PMID: 32007986 DOI: 10.3233/wor-203096] [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] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Management of violent acts of patients and their visitors in psychiatric and hospital settings has been studied. However, violence has not yet been addressed in the ambulatory care environment. OBJECTIVE To identify potential risk factors for patient and visitor violence [PVV] and staff perceptions of the impact of these risk factors in ambulatory care. METHODS A review of psychiatric inpatient research was conducted examining violence and aggression including risk factors for PVV. Identified risk factors for violence were incorporated into a survey tool and distributed to staff in a community clinic asking for their perception of the impact of these risk factors on aggression in their work environment. RESULTS Risk factors for violence and aggression were categorized as static or dynamic or as related to characteristics of staff or the environment of care. All of the risk factors were identified as possible contributors to PVV by the staff while items related to substance abuse and the clinic environment were selected by the staff as "highly likely" to contribute to PVV in their setting. CONCLUSIONS Continued research is needed in this area to better understand risk factors for PVV and develop appropriate safety interventions and crisis training for ambulatory care settings.
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Geoffrion S, Hills DJ, Ross HM, Pich J, Hill AT, Dalsbø TK, Riahi S, Martínez-Jarreta B, Guay S. Education and training for preventing and minimizing workplace aggression directed toward healthcare workers. Cochrane Database Syst Rev 2020; 9:CD011860. [PMID: 32898304 PMCID: PMC8094156 DOI: 10.1002/14651858.cd011860.pub2] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Workplace aggression constitutes a serious issue for healthcare workers and organizations. Aggression is tied to physical and mental health issues at an individual level, as well as to absenteeism, decreased productivity or quality of work, and high employee turnover rates at an organizational level. To counteract these negative impacts, organizations have used a variety of interventions, including education and training, to provide workers with the knowledge and skills needed to prevent aggression. OBJECTIVES: To assess the effectiveness of education and training interventions that aim to prevent and minimize workplace aggression directed toward healthcare workers by patients and patient advocates. SEARCH METHODS CENTRAL, MEDLINE, Embase, six other databases and five trial registers were searched from their inception to June 2020 together with reference checking, citation searching and contact with study authors to identify additional studies. SELECTION CRITERIA Randomized controlled trials (RCTs), cluster-randomized controlled trials (CRCTs), and controlled before and after studies (CBAs) that investigated the effectiveness of education and training interventions targeting aggression prevention for healthcare workers. DATA COLLECTION AND ANALYSIS Four review authors evaluated and selected the studies resulting from the search. We used standard methodological procedures expected by Cochrane. We assessed the certainty of evidence using the GRADE approach. MAIN RESULTS We included nine studies-four CRCTs, three RCTs, and two CBAs-with a total of 1688 participants. Five studies reported episodes of aggression, and six studies reported secondary outcomes. Seven studies were conducted among nurses or nurse aides, and two studies among healthcare workers in general. Three studies took place in long-term care, two in the psychiatric ward, and four in hospitals or health centers. Studies were reported from the United States, Switzerland, the United Kingdom, Taiwan, and Sweden. All included studies reported on education combined with training interventions. Four studies evaluated online programs, and five evaluated face-to-face programs. Five studies were of long duration (up to 52 weeks), and four studies were of short duration. Eight studies had short-term follow-up (< 3 months), and one study long-term follow-up (> 1 year). Seven studies were rated as being at "high" risk of bias in multiple domains, and all had "unclear" risk of bias in a single domain or in multiple domains. Effects on aggression Short-term follow-up The evidence is very uncertain about effects of education and training on aggression at short-term follow-up compared to no intervention (standardized mean difference [SMD] -0.33, 95% confidence interval [CI] -1.27 to 0.61, 2 CRCTs; risk ratio [RR] 2.30, 95% CI 0.97 to 5.42, 1 CBA; SMD -1.24, 95% CI -2.16 to -0.33, 1 CBA; very low-certainty evidence). Long-term follow-up Education may not reduce aggression compared to no intervention in the long term (RR 1.14, 95% CI 0.95 to 1.37, 1 CRCT; low-certainty evidence). Effects on knowledge, attitudes, skills, and adverse outcomes Education may increase personal knowledge about workplace aggression at short-term follow-up (SMD 0.86, 95% CI 0.34 to 1.38, 1 RCT; low-certainty evidence). The evidence is very uncertain about effects of education on personal knowledge in the long term (RR 1.26, 95% CI 0.90 to 1.75, 1 RCT; very low-certainty evidence). Education may improve attitudes among healthcare workers at short-term follow-up, but the evidence is very uncertain (SMD 0.59, 95% CI 0.24 to 0.94, 2 CRCTs and 3 RCTs; very low-certainty evidence). The type and duration of interventions resulted in different sizes of effects. Education may not have an effect on skills related to workplace aggression (SMD 0.21, 95% CI -0.07 to 0.49, 1 RCT and 1 CRCT; very low-certainty evidence) nor on adverse personal outcomes, but the evidence is very uncertain (SMD -0.31, 95% CI -1.02 to 0.40, 1 RCT; very low-certainty evidence). Measurements of these concepts showed high heterogeneity. AUTHORS' CONCLUSIONS Education combined with training may not have an effect on workplace aggression directed toward healthcare workers, even though education and training may increase personal knowledge and positive attitudes. Better quality studies that focus on specific settings of healthcare work where exposure to patient aggression is high are needed. Moreover, as most studies have assessed episodes of aggression toward nurses, future studies should include other types of healthcare workers who are also victims of aggression in the same settings, such as orderlies (healthcare assistants). Studies should especially use reports of aggression at an institutional level and should rely on multi-source data while relying on validated measures. Studies should also include days lost to sick leave and employee turnover and should measure outcomes at one-year follow-up. Studies should specify the duration and type of delivery of education and should use an active comparison to prevent raising awareness and reporting in the intervention group only.
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Affiliation(s)
- Steve Geoffrion
- École de psychoéducation, Université de Montreal, Montreal, Canada
| | - Danny J Hills
- School of Health, Federation University, Ballarat, Australia
| | - Heather M Ross
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Jacqueline Pich
- Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - April T Hill
- College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | | | - Sanaz Riahi
- Ontario Shores Centre for Mental Health Sciences, Whitby, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | - Stéphane Guay
- School of Criminology, University of Montreal, Montreal, Canada
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The impact of workplace violence on medical-surgical nurses’ health outcome: A moderated mediation model of work environment conditions and burnout using secondary data. Int J Nurs Stud 2020; 109:103666. [DOI: 10.1016/j.ijnurstu.2020.103666] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 05/22/2020] [Accepted: 05/25/2020] [Indexed: 02/07/2023]
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Muir‐Cochrane E, James R. Safe and secure? The complexities of caring in hospitals. J Clin Nurs 2020; 29:3603-3604. [DOI: 10.1111/jocn.15343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 04/13/2020] [Accepted: 05/09/2020] [Indexed: 11/28/2022]
Affiliation(s)
| | - Russell James
- School of Nursing College of Health and Medicine University of Tasmania Adelaide TAS Australia
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Huang J, Zhang M, Liu X. Correlation between patient and visitor violence and workload among public healthcare workers in China: a cross-sectional study. BMJ Open 2020; 10:e034605. [PMID: 32354778 PMCID: PMC7217091 DOI: 10.1136/bmjopen-2019-034605] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES We studied the characteristics of patient and visitor violence (PVV) and the workload of doctors and nurses, and identified the correlation between the incidence of PVV and healthcare worker (HCW) workload in China. DESIGN Cross-sectional study. SETTING 288 public health institutions in a city in northern China. PARTICIPANTS Data on 87 998 HCWs were extracted from the 2015 database of the Medical Quality and Safety Notification System. MEASURES The data included characteristics of the healthcare institution, types of services provided, information about each complaint and reported PVV incidents by hospital level. Pearson correlation analysis and multiple linear regression modelling were used to identify the correlation between the incidence of PVV and HCW workload. RESULTS Three types of institutions were identified as being at particularly high risk for PVV: tertiary hospitals, specialised hospitals and institutions in a downtown district. Incidence rates of PVV at tertiary hospitals, specialised hospitals and institutions in a downtown district were 16.6%, 17.6% and 22.8%, respectively. All three types of institutions had a high inpatient workload (admissions per doctor per day): 0.15, 0.17 and 0.12, respectively. After controlling for scale, type and location, it was found that the overall incidence rate of PVV increased with increasing outpatient workload (β=0.236, p<0.01). CONCLUSIONS PVV poses a significant challenge to public health institutions in China, and the high workload of HCWs likely contributes to higher risk of PVV. Prevention and intervention of PVV may be targeted to HCWs at specific institutions. The patient complaint notification system needs improvement and could be, for example, a better source of PVV information for future interventions.
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Affiliation(s)
- Ju Huang
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Min Zhang
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin Liu
- Institute of Evidence Law and Forensic Science, China University of Political Science and Law, Beijing, China
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Viottini E, Politano G, Fornero G, Pavanelli PL, Borelli P, Bonaudo M, Gianino MM. Determinants of aggression against all health care workers in a large-sized university hospital. BMC Health Serv Res 2020; 20:215. [PMID: 32178674 PMCID: PMC7077118 DOI: 10.1186/s12913-020-05084-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 03/09/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The paper aims to describe the 3-year incidence (2015/17) of aggressive acts against all healthcare workers to identify risk factors associated to violence among a variety of demographic and professional determinants of assaulted, and risk factors related to the circumstances surrounding these events. METHODS A retrospective observational study of all 10,970 health workers in a large-sized Italian university hospital was performed. The data, obtained from the "Aggression Reporting Form", which must be completed by assaulted workers within 72 h of aggression, were collected for the following domains: worker assaulted (sex, age class, years worked); profession (nurses, medical doctors, non-medical support staff, administrative staff, midwives); aggressive acts (activity type during aggressive acts, season, time and location of aggressive acts); and type of aggressive acts (verbal, non-verbal, consequences, aggressors). RESULTS Three hundred sixty-four (3.3%) workers experienced almost one aggression. The majority of the assaulted workers were female (77.5%), had worked for 6/15 years and were Nurses (64.3%). The majority of aggressive acts occurred during assistance and patient care (38.2%), in the spring and during the afternoon/morning shifts and took place in locations where patients were present (47.3%). The most prevalent aggression type was verbal (76.9%). The patient was the most common aggressor (46.7%). 56% of those assaulted experienced interruptions in their work. Being female, being < 50 years of age, having worked for 6-15 years were significant risk factors for aggression. Midwives suffered the highest risk of experiencing aggression (RR = 12.95). The risk analysis showed that non-verbally aggressive acts were related to assistance and patient care with respect to activity type, to the presence of patients and during the spring and afternoon/evening. CONCLUSIONS The findings suggest the parallel use of future qualitative studies to clarify the motivation behind aggression. These suggestions are needed for the implementation of additional adequate prevention strategies on either an organizational or a personal level.
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Affiliation(s)
- Elena Viottini
- San Giovanni Bosco Hospital, ASL Città di Torino, P.zza Donatore di Sangue, 3, 10154, Turin, Italy
| | - Gianfranco Politano
- Department of Control and Computer Engineering, Politecnico di Torino, Corso Duca degli Abruzzi, 24, 10129, Turin, Italy
| | - Giulio Fornero
- Dipartimento Qualità e Sicurezza dei percorsi di Diagnosi e Cura, AOU Città della salute e della Scienza Teaching Hospital, corso Bramante, 88, 10126, Turin, Italy
| | - Pier Luigi Pavanelli
- Sicurezza Ed Ambiente (S.P.P.), AOU Città della salute e della Scienza, Teaching Hospital, corso Bramante, 88, 10126, Turin, Italy
| | - Paola Borelli
- Dipartimento Qualità e Sicurezza dei percorsi di Diagnosi e Cura, AOU Città della salute e della Scienza Teaching Hospital, corso Bramante, 88, 10126, Turin, Italy
| | - Marco Bonaudo
- Department of Public Health Sciences and Pediatrics, Università di Torino, Via Santena 5 bis, 10126, Turin, Italy.
| | - Maria Michela Gianino
- Department of Public Health Sciences and Pediatrics, Università di Torino, Via Santena 5 bis, 10126, Turin, Italy
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Knor J, Pekara J, Šeblová J, Peřan D, Cmorej P, Němcová J. Qualitative Research of Violent Incidents Toward Young Paramedics in the Czech Republic. West J Emerg Med 2020; 21:463-468. [PMID: 32191205 PMCID: PMC7081846 DOI: 10.5811/westjem.2019.10.43919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 10/04/2019] [Indexed: 11/11/2022] Open
Abstract
Introduction Prehospital and emergency medical services (EMS) providers are usually the first to respond to an individual’s urgent health needs, sometimes in emotionally charged circumstances. Because violence toward EMS providers in the Czech Republic is often overlooked and under-reported, we do not have a complete understanding of the extent of such violence, nor do we have recommendations from EMS professional organizations on how to resolve this problem in prehospital emergency medicine. Methods We conducted this study to explore the process of violence against EMS providers, using the Strauss/Corbin systematic approach of grounded theory to create a paradigm model. The participants in this research included personnel who had at least two years experience in the EMS systems of the city of Prague and the Central Bohemian Region, and who had been victims of violence. Our sample included 10 registered paramedics and 10 emergency medical technicians ages 23–33 (mean ± standard deviation: 27.7). The impact of communication during EMS delivery, in the context of violence from patients or their relatives, emerged as the core category and the main focus of our study. The five main groups of the paradigm model of violence against EMS personnel included causal, contextual and intervening conditions, strategies, and consequences. Results Of the 20 study participants, 18 reported experiencing an attack during the night shift. Ten participants experienced violence on the street, and 10 inside an ambulance. The perpetrators in all 18 cases were men. The behavior of EMS personnel plays a crucial role in how violent confrontations play out: nonprofessional behavior with drunken or addict patients increases the possibility of violence in 70% of cases. Conclusion We found that paramedics and EMTs were exposed to verbal abuse and physical violence. However, in 10 of the violent encounters reported by our 20 participants, the attack was perpetrated by otherwise-ordinary people (ie, individuals with strong family support and good jobs) who found themselves in a very stressful situation. Thanks to grounded theory we learned that for all 20 participants there was a potential opportunity to prevent the conflict.
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Affiliation(s)
- Jiří Knor
- Emergency Medical Services of the Central Bohemian Region, Czech Republic.,Medical College in Prague, Prague, Czech Republic.,Prague Emergency Medical Services, Czech Republic.,Charles University, 3rd Medical Faculty, Prague, Czech Republic
| | - Jaroslav Pekara
- Medical College in Prague, Prague, Czech Republic.,Prague Emergency Medical Services, Czech Republic
| | - Jana Šeblová
- Emergency Medical Services of the Central Bohemian Region, Czech Republic.,Medical College in Prague, Prague, Czech Republic
| | - David Peřan
- Medical College in Prague, Prague, Czech Republic.,Prague Emergency Medical Services, Czech Republic.,Charles University, 3rd Medical Faculty, Prague, Czech Republic
| | - Patrik Cmorej
- Emergency Medical Services of the Ústí nad Labem Region, Czech Republic.,Jan Evangelista Purkyně University, Division of Health Studies, Ústí nad Labem, Czech Republic
| | - Jitka Němcová
- Medical College in Prague, Prague, Czech Republic.,Prague Emergency Medical Services, Czech Republic
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Public knowledge, attitudes, and intention to act violently, with regard to violence directed at health care staff. Nurs Outlook 2019; 68:220-230. [PMID: 31542174 DOI: 10.1016/j.outlook.2019.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 08/04/2019] [Accepted: 08/25/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Violence directed at health care staff is widely prevalent. Few studies have explored public attitudes regarding violence against health care staff. PURPOSES To examine the Israeli public's attitudes regarding violence against health care staff and their intention to act violently in various health care settings. METHOD A cross-sectional study among 609 adult participants used a self-report questionnaire. The questionnaire dealt with attitudes regarding violence toward health care staff and presented the participants with three scenarios of violence in a health care setting. Logistic regression was conducted to explore variables that may explain the public's intentions to act violently. FINDINGS The participants expressed condemnation of violence toward health care staff. Men displayed more violent attitudes than women. Participants who justified violence and were supportive of violent behavior displayed significantly more intentions to act violently. DISCUSSION Actions taken to eliminate violence in the health system must be based on cooperation between health policymakers, health care workers, and the public.
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Cabilan CJ, Johnston ANB. Review article: Identifying occupational violence patient risk factors and risk assessment tools in the emergency department: A scoping review. Emerg Med Australas 2019; 31:730-740. [DOI: 10.1111/1742-6723.13362] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 06/26/2019] [Accepted: 07/01/2019] [Indexed: 12/24/2022]
Affiliation(s)
- CJ Cabilan
- Emergency DepartmentPrincess Alexandra Hospital Brisbane Queensland Australia
- School of Nursing, Midwifery and Social WorkThe University of Queensland Brisbane Queensland Australia
| | - Amy NB Johnston
- Emergency DepartmentPrincess Alexandra Hospital Brisbane Queensland Australia
- School of Nursing, Midwifery and Social WorkThe University of Queensland Brisbane Queensland Australia
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Nowrouzi-Kia B, Chai E, Usuba K, Nowrouzi-Kia B, Casole J. Prevalence of Type II and Type III Workplace Violence against Physicians: A Systematic Review and Meta-analysis. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2019; 10:99-110. [PMID: 31325293 PMCID: PMC6708400 DOI: 10.15171/ijoem.2019.1573] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/21/2019] [Indexed: 11/11/2022]
Abstract
BACKGROUND Workplace violence (WPV) in the health care sector remains a prominent, under-reported global occupational hazard and public health issue. OBJECTIVE To determine the types and prevalence of WPV among doctors. METHODS Primary papers on WPV in medicine were identified through a literature search in 4 health databases (Ovid Medline, EMBASE, PsychoINFO and CINAHL). The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for the mapping and identification of records. To assess the studies included in our review, we used the Critical Appraisal Skills Programme cohort review checklist and the Risk of Bias Assessment. RESULTS 13 out of 2154 articles retrieved were reviewed. Factors outlining physician WPV included (1) working in remote health care areas, (2) understaffing, (3) mental/emotional stress of patients/visitors, (4) insufficient security, and (5) lacking preventative measures. The results of 6 studies were combined in a meta-analysis. The overall prevalence of WPV was 69% (95% CI 58% to 78%). CONCLUSION The impact of WPV on health care institutions is profound and far-reaching; it is quite common among physicians. Therefore, steps must be taken to promote an organizational culture where there are measures to protect and promote the well-being of doctors.
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Affiliation(s)
- Behdin Nowrouzi-Kia
- Centre for Research in Occupational Safety and Health, School of Rural and Northern Health, Laurentian University, Sudbury, Ontario, Canada and Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Ontario, Canada.
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Emily Chai
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Koyo Usuba
- Centre for Research in Occupational Safety and Health, School of Rural and Northern Health, Laurentian University, Sudbury, Ontario, Canada and Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Behnam Nowrouzi-Kia
- Michael DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer Casole
- Special Education Department, Loretto College, Toronto, Ontario, Canada
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Lowry B, Eck LM, Howe EE, Peterson J, Gibson CA. Workplace Violence: Experiences of Internal Medicine Trainees at an Academic Medical Center. South Med J 2019; 112:310-314. [PMID: 31158883 DOI: 10.14423/smj.0000000000000984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Healthcare professionals are at higher risk for workplace violence (WPV) than workers in other sectors. This elevated risk exists despite the vast underreporting of WPV in the medical setting. The challenge of responding to this risk is compounded by limited empirical research on medical training environments. Understanding trainees' experience and educating them on workplace safety, WPV reporting, and awareness of resources are shared goals of educational and institutional leadership. In our setting, clear understanding and education were urgent after the enactment of a statewide "constitutional carry" law affording individuals a right to carry concealed firearms in all state-owned universities and hospitals, beginning in July 2017. We sought to examine the incidence of WPV affecting Internal Medicine trainees to understand the types of violence encountered, reporting rates, and the factors that influence reporting. METHODS We conducted a cross-sectional online survey of Internal Medicine residents and fellows in practice for the previous 12 months. Survey items included both forced choice and open-ended questions. Descriptive statistics were calculated and used to summarize the study variables. χ2 tests were performed to examine whether sex differences existed for each of the survey questions. Qualitative responses were content analyzed and organized thematically. RESULTS Of 186 trainees, 88 completed the survey. Forty-seven percent of respondents experienced WPV, with >90% of cases involving a patient, a patient's family member, or a patient's friend. Verbal assault was the most common type of incident encountered. Trainees formally reported fewer than half of the violent incidents disclosed in the survey. Major factors that influenced reporting included the severity of the incident, condition of the patient, and clarity of the reporting mechanism. CONCLUSIONS Previous research indicates similar amounts and types of WPV. Likewise, a large percentage of the incidents are not reported. Addressing the key factors related to why physicians underreport can inform institutions on how to make systematic changes to reduce WPV and its negative impact. Future research is needed to examine whether specific interventions can be implemented to improve reporting and reduce the incidence of WPV.
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Affiliation(s)
- Becky Lowry
- From the Department of Internal Medicine, University of Kansas Medical Center, Kansas City
| | - Leigh M Eck
- From the Department of Internal Medicine, University of Kansas Medical Center, Kansas City
| | - Erica E Howe
- From the Department of Internal Medicine, University of Kansas Medical Center, Kansas City
| | - JoHanna Peterson
- From the Department of Internal Medicine, University of Kansas Medical Center, Kansas City
| | - Cheryl A Gibson
- From the Department of Internal Medicine, University of Kansas Medical Center, Kansas City
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Addressing Risks of Violence against Healthcare Staff in Emergency Departments: The Effects of Job Satisfaction and Attachment Style. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5430870. [PMID: 31275976 PMCID: PMC6558649 DOI: 10.1155/2019/5430870] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 05/19/2019] [Indexed: 11/17/2022]
Abstract
Violence in the workplace is one of the most serious issues affecting the healthcare sector. The incidence of violent behaviour towards healthcare workers is increasing worldwide. It is difficult to assess the extent of the problem, however, as violent incidents are underreported. In fact, many doctors and nurses see violence-perpetrated primarily by patients and visitors (friends and relatives of patients)-as a part of their job. Several studies indicate that violent behaviour against healthcare workers has serious consequences for the professionals involved, as well as for the wider healthcare system. The purpose of this study was to ascertain the prevalence of patient and visitor violence in a number of emergency departments in northeastern Italy and to explore the relationship between violence and certain psychosocial factors (adult attachment style, age, and job satisfaction). Data were collected using an online questionnaire. Our results demonstrate that patient and visitor violence in emergency departments is a serious risk for nurses and doctors and that it is affected by several factors relating to both patient pathologies and the way the workplace and work patterns are organised. Previous studies indicate that the most common form of violence experienced in these contexts is emotional violence and that nurses are more likely than doctors to suffer emotional and physical violence. Based on multiple regression analysis of the data, it appears that greater age and higher scores in secure attachment are associated with reduced experience of emotional violence from patients and visitors. Furthermore, our results show that the relationship between secure attachment and the amount of patient-and-visitor-perpetrated emotional violence experienced is mediated by levels of job satisfaction. We also discuss the potential implications of these results in terms of using staff training to prevent and manage patient and visitor violence and improve the safety of healthcare professionals.
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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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Larson LA, Finley JL, Gross TL, McKay AK, Moenck JM, Severson MA, Clements CM. Using a Potentially Aggressive/Violent Patient Huddle to Improve Health Care Safety. Jt Comm J Qual Patient Saf 2019; 45:74-80. [PMID: 30638871 DOI: 10.1016/j.jcjq.2018.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 08/28/2018] [Accepted: 08/28/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Unexpected situations of workplace violence are occurring in the United States at increasing rates in health care environments, warranting increased attention to processes supporting safety for health care workers. At a large, academic hospital, two patient safety incidents had occurred in a two-year period in which a patient had become violent at the time of admission from the emergency department (ED) to the medical unit. METHODS A multidisciplinary quality improvement (QI) team was formed to address the risk of violent patient events. Using two iterative Plan-Do-Study-Act (PDSA) cycles, the QI team designed and tested a huddle handoff communication tool, the Potentially Aggressive/Violent Huddle Form. An ED nurse would initiate the huddle process by informing the admitting unit that a patient at risk for violence was being admitted. The admitting care team would then call the ED team so that both teams participated in the handoff call together. The huddle process occurred for 21 transfers in the first PDSA cycle and for 18 transfers in the second. RESULTS RNs from the ED and the six medical units reported feeling safe during the transfer process 100% of the time during both tests of change PDSAs (vs. 54.7% at baseline). In the ED, from the first test of change to the second test of change, satisfaction with the process improved from 53.3% to 75.0%. CONCLUSION The huddle handoff communication tool and other methods to facilitate the transfer of potentially violent patients have the potential to decrease the number and severity of violent incidents in the health care workplace.
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Fields A, Huang J, Schroeder D, Sprung J, Weingarten T. Agitation in adults in the post-anaesthesia care unit after general anaesthesia. Br J Anaesth 2018; 121:1052-1058. [DOI: 10.1016/j.bja.2018.07.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/30/2018] [Accepted: 07/21/2018] [Indexed: 11/26/2022] Open
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Oyelade OO, Ayandiran EO. Violence Management in a Nigerian Psychiatric Facility: Psychiatric-Mental Health Nurses' Current Practices and Their Effectiveness. J Psychosoc Nurs Ment Health Serv 2018; 56:37-45. [PMID: 29741748 DOI: 10.3928/02793695-20180503-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 03/14/2018] [Indexed: 11/20/2022]
Abstract
Patient violence in mental health care settings is daunting and stressful, as well as increasingly burdensome for professionals in low/middle income countries, specifically Africa. Patient violence has contributed to increased work hazards for health care professionals and may lead to patients being sedated or restrained, potentially resulting in injury to either the patient or provider. The current study assessed Nigerian psychiatric-mental health nurses' current practices of violence management in a hospital in Southwest Nigeria. A qualitative approach, specifically focus group discussion, was used. Results of the study show that patients and providers are prone to maltreatment. Professionals desire involvement of armed military officials to combat acts of violence by psychiatric patients who take advantage of nurses' gender, inexperience, or being lonely on duty, as well as the time of day, to attack nurses. Professionals have reportedly died in the process of violence management. Intervention studies on violence management in African mental health care settings are a priority for future research. [Journal of Psychosocial Nursing and Mental Health Services, 56(11), 37-45.].
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Al-Azzam M, Al-Sagarat AY, Tawalbeh L, Poedel RJ. Mental health nurses' perspective of workplace violence in Jordanian mental health hospitals. Perspect Psychiatr Care 2018; 54:477-487. [PMID: 29077201 DOI: 10.1111/ppc.12250] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 09/04/2017] [Accepted: 10/01/2017] [Indexed: 12/01/2022] Open
Abstract
PURPOSE The purpose was to assess the mental health nurses' perspectives of workplace violence in mental health departments in Jordan. DESIGN AND METHODS A cross-sectional correlation study was utilized to address the study's purposes. Data were collected using self-reported questionnaires from nurses working in governmental mental health departments in Jordan. FINDINGS The findings indicated that 80% of the respondents were victims of at least one violent act in the last 2 years. Verbal abuse was the most indicated type of violence. Patients were considered the main source of violence. PRACTICE IMPLICATIONS Policies and legislations addressing workplace violence should be implemented, and nurses should be trained on using such policies. Hospital managers should create a safe work environment by enforcing effective security measures and maintaining adequate staffing.
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Affiliation(s)
- Manar Al-Azzam
- Department of Community and Psychiatric Mental Health, Princess Salam Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
| | - Ahmad Yahya Al-Sagarat
- Department of Community and Psychiatric Mental Health, Faculty of Nursing, Mutah University, Al-Karak, Jordan
| | - Loai Tawalbeh
- Department of Adult Health, Princess Salam Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan
| | - Robin J Poedel
- Department of Family & Community Health, University of Maryland School of Nursing, University of Maryland, Baltimore, USA
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50
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Zhao S, Shi Y, Sun Z, Xie F, Wang J, Zhang S, Gou T, Han X, Sun T, Fan L. Impact of workplace violence against nurses’ thriving at work, job satisfaction and turnover intention: A cross‐sectional study. J Clin Nurs 2018; 27:2620-2632. [PMID: 29446550 DOI: 10.1111/jocn.14311] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Shi‐Hong Zhao
- Department of Neurosurgery The Second Affiliated Hospital of Harbin Medical University Harbin China
| | - Yu Shi
- College of Public Health Harbin Medical University Harbin China
| | - Zhi‐Nan Sun
- College of Humanities and Social Science of Harbin Medical University Harbin China
| | - Feng‐Zhe Xie
- College of Public Health Harbin Medical University Harbin China
| | - Jing‐Hui Wang
- College of Public Health Harbin Medical University Harbin China
| | - Shu‐E Zhang
- Department of Pharmacy Harbin Medical University Cancer Hospital Harbin China
| | - Tian‐Yu Gou
- The Fourth Affiliated Hospital of Harbin Medical University Harbin China
| | - Xuan‐Ye Han
- Department of Neurosurgery The Second Affiliated Hospital of Harbin Medical University Harbin China
| | - Tao Sun
- College of Public Health Harbin Medical University Harbin China
| | - Li‐Hua Fan
- College of Public Health Harbin Medical University Harbin China
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