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Martins Irvine A, Moloney W, Jacobs S, Anderson NE. Support mechanisms that enable emergency nurses to cope with aggression and violence: Perspectives from New Zealand nurses. Australas Emerg Care 2024; 27:97-101. [PMID: 37743125 DOI: 10.1016/j.auec.2023.09.003] [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: 05/18/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Although efforts to reduce aggression and violence in emergency departments are important, it is also critical to minimise harm and support staff where this occurs. This research describes support mechanisms emergency nurses value when they experience occupational aggression and violence. METHODS A mixed-methods design including thematic analysis of six interviews and descriptive analysis of fifty-one surveys, with experienced emergency nurse participants and respondents from a single large urban emergency department. RESULTS Four key themes summarised coping with aggression and violence: Minimising exacerbating factors (mental health, lack of understanding of zero tolerance in practice, and wait times); Support before violence (use of huddles and having experienced nurses on each shift); Support during violence (education including restraint, self-defence, de-escalation and legalities); and Support after violence (debriefing, incident reporting and a sense of 'toughness') CONCLUSION: Emergency nurses need preparation and support to competently manage complex mental health presentations, understand legal rights, communicate effectively with patients, families and colleagues and access event debriefing. Security staff are valued team members but also need adequate resourcing and preparation.
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Affiliation(s)
- Alice Martins Irvine
- School of Nursing, University of Auckland, Auckland, New Zealand; Waikato Emergency Department, Te Whatu Ora Waikato, Hamilton, New Zealand
| | | | - Stephen Jacobs
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - Natalie Elizabeth Anderson
- School of Nursing, University of Auckland, Auckland, New Zealand; Auckland Emergency Department, Te Whatu Ora Te Toka Tumai, Auckland, New Zealand.
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Lin E, Malhas M, Bratsalis E, Thomson K, Hargreaves F, Donner K, Baig H, Boateng R, Swain R, Benadict MB, Busch L. Behavioral skills training for teaching safety skills to mental health service providers compared to training-as-usual: a pragmatic randomized control trial. BMC Health Serv Res 2024; 24:639. [PMID: 38760754 PMCID: PMC11102142 DOI: 10.1186/s12913-024-10994-1] [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: 09/06/2023] [Accepted: 04/16/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Violence in the healthcare workplace has been a global concern for over two decades, with a high prevalence of violence towards healthcare workers reported. Workplace violence has become a healthcare quality indicator and embedded in quality improvement initiatives of many healthcare organizations. The Centre for Addiction and Mental Health (CAMH), Canada's largest mental health hospital, provides all clinical staff with mandated staff safety training for self-protection and team-control skills. These skills are to be used as a last resort when a patient is at imminent risk of harm to self or others. The purpose of this study is to compare the effectiveness of two training methods of this mandated staff safety training for workplace violence in a large psychiatric hospital setting. METHODS Using a pragmatic randomized control trial design, this study compares two approaches to teaching safety skills CAMH's training-as-usual (TAU) using the 3D approach (description, demonstration and doing) and behavioural skills training (BST), from the field of applied behaviour analysis, using instruction, modeling, practice and feedback loop. Staff were assessed on three outcome measures (competency, mastery and confidence), across three time points: before training (baseline), immediately after training (post-training) and one month later (follow-up). This study was registered with the ISRCTN registry on 06/09/2023 (ISRCTN18133140). RESULTS With a sample size of 99 new staff, results indicate that BST was significantly better than TAU in improving observed performance of self-protection and team-control skills. Both methods were associated with improved skills and confidence. However, there was a decrease in skill performance levels at the one-month follow-up for both methods, with BST remaining higher than TAU scores across all three time points. The impact of training improved staff confidence in both training methods and remained high across all three time points. CONCLUSIONS The study findings suggest that BST is more effective than TAU in improving safety skills among healthcare workers. However, the retention of skills over time remains a concern, and therefore a single training session without on-the-job-feedback or booster sessions based on objective assessments of skill may not be sufficient. Further research is needed to confirm and expand upon these findings in different settings.
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Affiliation(s)
- Elizabeth Lin
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada.
| | - Mais Malhas
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Emmanuel Bratsalis
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Kendra Thomson
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Applied Disability Studies, Brock University, St. Catharines, ON, Canada
| | - Fabienne Hargreaves
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Kayle Donner
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Heba Baig
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Rhonda Boateng
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Rajlaxmi Swain
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Mary Benisha Benadict
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Louis Busch
- Department of Education, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Kynoch K, Liu XL, Cabilan CJ, Ramis MA. Educational programs and interventions for health care staff to prevent and manage aggressive behaviors in acute hospitals: a systematic review. JBI Evid Synth 2024; 22:560-606. [PMID: 37851359 DOI: 10.11124/jbies-22-00409] [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: 10/19/2023]
Abstract
OBJECTIVE The objective of this review was to determine the effect of educational programs that have been implemented in acute health care settings to manage or prevent aggressive behaviors toward staff perpetrated by patients, families, or visitors. INTRODUCTION Health care staff working within acute-level and tertiary-level hospitals are at high risk of exposure to aggressive behaviors by patients, their family, or visitors. Negative staff and organizational impacts reported in the literature include individual psychological or emotional distress and severe harm, increased absenteeism, high staff turnover, and awarded compensation. Reports of this kind of occupational violence are increasing globally; therefore, strategies to address prevention and management are needed to mitigate the risk of harm to staff and the wider hospital service. Various educational activities have been implemented to address the issue, but the overall effect of these is unclear. INCLUSION CRITERIA Experimental and quasi-experimental studies were considered for inclusion if they reported on an educational program or intervention for staff working within an acute hospital setting and aimed at managing or preventing occupational violence perpetrated by patients, family, or visitors. Reports of programs implemented to address occupational violence, whether verbal or physical, were included. Studies were excluded if they reported on upward violence or bullying, patients in psychiatric or dementia facilities, or pediatric patients, due to the specific care needs of these cohorts. METHODS The following databases were searched: PubMed (PubMed Central), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), Embase, ERIC (ProQuest), Cochrane Central Register of Controlled Trials (Cochrane Library), and Scopus. ProQuest Dissertations and Theses was searched for unpublished studies. To obtain a wider perspective of the issue, studies published in Chinese were also searched in WanFang Database, China National Knowledge Infrastructure, and Chongqing VIP. A date filter of 2008-2023 was applied in a deliberate effort to expand from previous work. No language filters were applied. The review was conducted in accordance with JBI methodology for systematic reviews of effectiveness, and reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS The search process retrieved 4681 citations. A total of 32 studies representing 3246 health staff were included in the review. The studies were either before-and-after or pre-test/post-test study designs. Methodological quality of studies varied, with the main issues being absence of CIs within statistical analysis, limited detail on participant selection or attrition/non-response, and underreporting of confounding factors. Educational programs varied in content and duration. Content delivery across the studies also varied, with several didactic, role-play, debriefing, group work, and simulation exercises reported. While studies reported some improvement in self-reported confidence levels, results were mixed for other outcomes. Determining overall effect of included studies was challenging due to heterogeneity within and across studies with regard to intervention types, populations, measurement tools, and outcomes. CONCLUSIONS This review is unable to determine which workplace educational programs had an effect on staff outcomes or on the number of occupational violence incidents. In the future, educators and researchers could use the findings of this review to guide the design of educational programs and employ measures that are comparable to their settings. REVIEW REGISTRATION PROSPERO CRD42020190538. SUPPLEMENTAL DIGITAL CONTENT A Chinese-language version of the abstract of this review is available [ http://links.lww.com/SRX/A33 ].
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Affiliation(s)
- Kathryn Kynoch
- Mater Health, Brisbane, QLD, Australia
- Queensland Centre for Evidence Based Nursing and Midwifery: A JBI Centre of Excellence, Brisbane, QLD, Australia
- Queensland University of Technology (QUT), School of Nursing, Brisbane, QLD, Australia
| | - Xian-Liang Liu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Homantin, Kowloon, Hong Kong, China
- Charles Darwin Centre for Evidence-Based Practice: A JBI Affiliated Group, Brisbane, QLD, Australia
| | - C J Cabilan
- Queensland Centre for Evidence Based Nursing and Midwifery: A JBI Centre of Excellence, Brisbane, QLD, Australia
- Princess Alexandra Hospital Emergency Department, Brisbane, QLD, Australia
- School of Nursing, Midwifery and Social Work, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Mary-Anne Ramis
- Mater Health, Brisbane, QLD, Australia
- Queensland Centre for Evidence Based Nursing and Midwifery: A JBI Centre of Excellence, Brisbane, QLD, Australia
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Emmerling SA, McGarvey JS, Burdette KS. Evaluating a Workplace Violence Management Program and Nurses' Confidence in Coping With Patient Aggression. J Nurs Adm 2024; 54:160-166. [PMID: 38381570 DOI: 10.1097/nna.0000000000001402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
OBJECTIVE The purpose of this study was to evaluate nurse confidence in coping with patient aggression after implementing a workplace violence prevention program that includes management and postevent support. BACKGROUND Patient aggression toward nurses is increasing, leading many healthcare organizations to develop workplace violence prevention programs. METHODS This cross-sectional study was conducted at a large healthcare system in the Midwestern United States. Clinical nurses caring for adult patients across the care continuum ≥51% of the time were invited to participate. RESULTS In situ simulation plus standard training did not have a significant impact on confidence after controlling for the year education occurred; however, nurses completing training in 2022 had significantly higher confidence than nurses completing training in 2019. Use of the Violence Assessment Tool and participating in a post-control alert debriefing were also associated with significantly higher confidence. CONCLUSION Factors other than education may influence nurses' confidence in coping with patient aggression.
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Affiliation(s)
- Sheryl A Emmerling
- Author Affiliations: Director of Clinical Practice and Research (Dr Emmerling), Senior Statistician (McGarvey), OSF HealthCare, Peoria, IL; and Manager of Professional Practice and Education (Burdette), OSF HealthCare Saint Elizabeth Medical Center, Ottawa, and OSF HealthCare Saint Paul Medical Center, Mendota, Illinois
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Abedi G, Haghgoshayie E, Hasanpoor E, Etemadi J, Nazari M, Vejdani R. Improvement of violence management among nurses in Iran: The best practice implementation project in a health promoting hospital. PLoS One 2023; 18:e0284758. [PMID: 38011071 PMCID: PMC10681186 DOI: 10.1371/journal.pone.0284758] [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: 05/31/2022] [Accepted: 04/08/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND This project aimed to assess compliance with evidence-based criteria' for the prevention and management of workplace violence against nursing staff in Shahid-Beheshti hospital, Maragheh, Iran. Workplace violence is a managerial and workplace occupational health and safety issue that can affect the performance of an institution. Further, it might turn the work environment into an insecure and hostile one which can influence the performance of employees and their professional relationships negatively. Nevertheless, staff have their own legal rights, and their organizations are legally and ethically in charge of providing them with safe work environments. METHODS Following the JBI Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tool with three phases of activities, this project utilized an implementation framework incorporating quality improvement. Furthermore, the audit tool was used to establish the project and set up the measurement and evaluation of three evidence-based criteria. RESULTS The post-implementation audit results indicated a significant improvement in violence management and prevention. The compliance rate on the first criterion, i.e. aggression management training, increased from 49% at baseline to 81% at the end. The second criterion, i.e. timely support and assistance following an incident, exhibited greater increase from eight to 73%. Finally, an increased compliance was noted on the third criterion, i.e. policy for risk management and safe environment, from 22 to 77%. CONCLUSIONS The current project successfully implements evidence-based violence management in Shahid-Beheshti hospital. It reveals significant results on compliance and the increasing knowledge of nurses on evidence-based stress management, communication skills and self-companion.
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Affiliation(s)
- Ghasem Abedi
- Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Elaheh Haghgoshayie
- Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Edris Hasanpoor
- Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Jalil Etemadi
- Department of Clinical Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Morteza Nazari
- Department of Healthcare Services Management, School of Health, Alborz University of Medical Sciences, Karaj, Iran
| | - Razieh Vejdani
- Assistant Professor of Obstetrics and Gynecology, Shahid Beheshti Hospital, Maragheh University of Medical Sciences, Maragheh, Iran
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Zhang Y, Cai J, Qin Z, Wang H, Hu X. Evaluating the impact of an information-based education and training platform on the incidence, severity, and coping resources status of workplace violence among nurses: a quasi-experimental study. BMC Nurs 2023; 22:446. [PMID: 38007470 PMCID: PMC10675880 DOI: 10.1186/s12912-023-01606-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 11/14/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND Workplace violence among nurses has emerged as a critical issue, posing a significant threat to their occupational safety. Education and training are the primary measures employed to prevent and respond to workplace violence. However, the current approaches have proven ineffective, possibly due to a lack of consideration for the specific needs of clinical nurses. Therefore, it is essential to explore the effectiveness of an informational education and training platform tailored to nurses' requirements. This study aimed to investigate the impact of such a platform on the incidence, severity, and coping resources of WPV in nurses. METHODS This research was a quasi-experimental study. An information-based education and training platform focused on nurse workplace violence was developed through literature reviews, expert meetings, consultations with software development companies, and a trial run. A tertiary general hospital in Suzhou was selected, in which hospital district A was the intervention group and hospital district B was the control group. A total of 276 nurses were recruited, 140 in the intervention group and 136 in the control group. The nurses' incidence, severity, coping resources status, and evaluation of the application were measured before the intervention and at 1, 3, and 6 months after the intervention. RESULTS The overall incidence of workplace violence, verbal aggression, and verbal threat among nurses showed statistically significant differences (P < 0.05) for the time effect, while the incidence of physical aggression demonstrated statistically significant differences (P < 0.05) for the between-group effect and the time effect. The severity of physical violence among nurses exhibited statistically significant differences (P < 0.05) for the between-group effect and time effect, and the severity of psychological violence showed statistically significant differences (P < 0.05) for the time effect. Nurses' total coping resources score and dimensions also showed statistically significant differences in terms of group, time, and interaction effects (P < 0.001). The evaluation questionnaire for the mobile application indicated usefulness scores of 2 (1, 2); ease of learning scores of 2 (1, 2); ease of use scores of 2 (1, 2); trust scores of 2 (1, 2.75); acceptance score of 1 (1, 2); and satisfaction scores of 2 (1, 2). CONCLUSIONS Implementing the nurse workplace violence information-based education and training platform proved beneficial in reducing the incidence and severity of workplace violence among nurses and enhancing their coping resources. This outcome suggested the platform's potential for further application and promotion in clinical settings.
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Affiliation(s)
- Ying Zhang
- The First Affiliated Hospital of Soochow University, Suzhou, China
- Department of Nursing, Soochow University, Suzhou, China
| | - Jianzheng Cai
- The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Ziyu Qin
- The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Haifang Wang
- The First Affiliated Hospital of Soochow University, Suzhou, China.
| | - Xiuying Hu
- Department of Nursing, West China Hospital of Sichuan University, Sichuan, China.
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Cai J, Wu S, Wang H, Zhao X, Ying Y, Zhang Y, Tang Z. The effectiveness of a workplace violence prevention strategy based on situational prevention theory for nurses in managing violent situations: a quasi-experimental study. BMC Health Serv Res 2023; 23:1164. [PMID: 37885009 PMCID: PMC10605776 DOI: 10.1186/s12913-023-10188-1] [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: 03/21/2023] [Accepted: 10/20/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Workplace violence (WPV) poses a significant occupational hazard for nurses. The efficacy of current education and training programs in mitigating WPV incidence among nurses remains uncertain, possibly due to insufficient consideration of clinical contexts and nurses' specific needs. Therefore, this study developed a WPV prevention strategy based on the actual requirements of clinical nurses and situational prevention theory and aimed to explore its application effects. METHODS Under the guidance of situational prevention theory, a WPV prevention strategy for nurses was constructed through literature review, semi-structured interviews and focus group discussion. This study adopted a self-controlled research design, and trained 130 nurses selected from a comprehensive tertiary grade A hospital in Suzhou in this WPV prevention strategy. Data were collected through structured questionnaires, including the revised WPV questionnaire, WPV severity grading scale, and hospital WPV coping resources scale. The WPV incidence, severity, and WPV coping resource scores of nurses were collected before the intervention, as well as at 3 months, 6 months, and 9 months after training. RESULTS The WPV prevention strategy comprised 11 prevention plans based on 11 high-risk situational elements of WPV. Each prevention plan included the WPV prevention flowchart, treatment principle, and communication strategy. The strategy demonstrated excellent feasibility and practicality. Following the intervention, the overall incidence of WPV among nurses significantly decreased from 63.85% (baseline) to 46.15% (9 months after training) (P < 0.05). After the training, the severity of psychological violence (Wald χ² = 20.066, P < 0.001) and physical violence (Wald χ² = 9.100, P = 0.028) reported by nurses decreased compared to the baseline (P < 0.05). Moreover, the overall WPV coping resource score significantly increased from [66.50 (57.00, 77.25) points] (baseline) to [80.00 (68.00, 97.25) points] (9 months after training) (P < 0.05). CONCLUSIONS The described WPV prevention strategy, grounded in situational prevention theory and tailored to the needs of clinical nurses, effectively reduced WPV incidence, mitigated its severity, and enhanced nurses' WPV coping resources. This approach offered new avenues for nurses in the prevention of WPV.
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Affiliation(s)
- Jianzheng Cai
- Department of Nursing, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Sisi Wu
- Medical Branch, Shanghai Jiao Tong University Press, Shanghai, 200030, China
| | - Haifang Wang
- Department of Nursing, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China.
| | - Xiaoqing Zhao
- Department of Nursing, the First Affiliated Hospital of USTC, Hefei, 230036, China.
| | - Yajie Ying
- Department of Nursing, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Yingying Zhang
- Department of Nursing, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Zhaofang Tang
- Department of Emergency, the First Affiliated Hospital of Soochow University, Suzhou, 215006, China
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Harlan MD, Bench V, Hudack C, Fennimore L, Sherwood P, Ren D, Kelly LK. Using Teaching Videos to Improve Nursing Students' Self-Efficacy in Managing Patient Aggression. J Nurs Educ 2023; 62:423-426. [PMID: 37413673 DOI: 10.3928/01484834-20230509-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
BACKGROUND Nursing students experience patient aggression due to their age and lack of experience. Academic institutions can implement strategies to prepare students to manage aggression. METHOD One-hundred forty-eight undergraduate nursing students in a baccalaureate nursing program participated in this quality improvement initiative. Baseline and postintervention perceived self-efficacy (PSE) data were gathered using the Self-Efficacy in Patient Centeredness Questionnaire-27. Students viewed two educational videos and underwent debriefing. RESULTS Overall PSE scores increased significantly (p < .01) from baseline (M = 76.44, SD = 13.00) to postintervention (M = 91.66, SD = 11.97). PSE in the subscales exploring the patient's perspective, sharing information and power, and dealing with communication challenges increased significantly (p < .01) from pre- to postintervention. CONCLUSION PSE in caring for patients exhibiting aggressive behavior increased after nursing students were taught behaviors to use and how to manage their own biases to avoid provoking patients to respond aggressively. [J Nurs Educ. 2023;62(7):423-426.].
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Brune S, Killam L, Camargo-Plazas P. Caring Knowledge as a Strategy to Mitigate Violence against Nurses: A Discussion Paper. Issues Ment Health Nurs 2023; 44:437-452. [PMID: 37167098 DOI: 10.1080/01612840.2023.2205502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Violence against nurses is a disturbing trend in healthcare that has reached epidemic proportions globally. These violent incidents can result in physical and psychological injury, exacerbating already elevated levels of stress and burnout among nurses, further contributing to absenteeism, turnover, and intent to leave the profession. To ensure the physical and mental well-being of nurses and patients, attention to the development of strategies to reduce violence against nurses must be a priority. Caring knowledge-rooted in the philosophy of care-is a potential strategy for mitigating violence against nurses in healthcare settings. We present what caring knowledge is, analyze its barriers to implementation at the health system and education levels and explore potential solutions to navigate those barriers. We conclude how the application of models of caring knowledge to the nurse-patient relationship has the potential to generate improved patient safety and increased satisfaction for both nurses and patients.
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Affiliation(s)
- Sara Brune
- School of Nursing, Queen's University, Kingston, Ontario, Canada
- Nursing (BSN) Program, University of the Fraser Valley, Chilliwack, British Columbia, Canada
| | - Laura Killam
- School of Nursing, Queen's University, Kingston, Ontario, Canada
- School of Health Sciences and Emergency Services, Cambrian College, Sudbury, Ontario, Canada
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Mambrey V, Ritz-Timme S, Loerbroks A. Prevalence and correlates of workplace violence against medical assistants in Germany: a cross-sectional study. BMC Health Serv Res 2023; 23:350. [PMID: 37038136 PMCID: PMC10088275 DOI: 10.1186/s12913-023-09331-9] [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: 01/11/2023] [Revised: 03/15/2023] [Accepted: 03/23/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Workplace violence is widespread, but studies on workplace violence against health professions in outpatient settings are sparse. We aimed to examine, for the first time, the prevalence of workplace violence against medical assistants as well as potential sociodemographic, occupational and health-related correlates of the exposure to workplace violence. METHODS We used data from a survey (03-05/2021) among medical assistants in Germany (n = 424). We assessed the 12-month prevalence (yes/no) of verbal violence, physical violence, and sexual harassment as well as the types of perpetrators of workplace violence. Further, information was gathered on sociodemographic (e.g., age, educational level), occupational (e.g., years in job), and mental health-related factors (i.e., anxiety, depression). The 12-month prevalences of the different types of workplace violence were merged into a single variable ("any workplace violence" vs. none) for association analysis. We ran multivariable Poisson regression models to examine potential associations between sociodemographic and occupational correlates (i.e., independent variables) with any workplace violence as dependent variable and in addition between any workplace violence (independent variable) and dichotomized mental health as dependent variable. RESULTS Overall, 59.4% of the medical assistants reported verbal violence, 5.9% reported physical violence, 3.8% reported sexual harassment, and 60.1% reported any workplace violence in the previous 12 months. Patients were reported to be the main perpetrators, followed by patients' relatives. Younger age, being single, and working in a medical care center were sociodemographic and occupational correlates of workplace violence (PRs ≥ 1.27). Workplace violence was significantly associated with mental health variables (PRs ≥ 1.72). CONCLUSION Medical assistants experience workplace violence, in particular verbal violence. To devise preventive measures, prospective studies are needed to confirm the potential risk groups for workplace violence and the potential mental health sequels of workplace violence observed in our study.
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Affiliation(s)
- Viola Mambrey
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Moorenstraße 5, Düsseldorf, 40225, Germany.
| | - Stefanie Ritz-Timme
- Institute of Legal Medicine, University Hospital Duesseldorf, Moorenstraße 5, Düsseldorf, 40225, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Duesseldorf, Moorenstraße 5, Düsseldorf, 40225, Germany
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Hsu HJ, Chou YT, Wu HC, Jen HJ, Shen CH, Lin CJ, Chou KR, Ruey-Chen. An online escape room-based lesson plan to teach new nurses violence de-escalation skills. NURSE EDUCATION TODAY 2023; 123:105752. [PMID: 36806359 DOI: 10.1016/j.nedt.2023.105752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 01/29/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Affiliation(s)
- Han-Jen Hsu
- Department of Nursing, Taipei Medical University, Shuang Ho Hospital, New Taipei, Taiwan
| | - Yi-Ting Chou
- Department of Nursing, Taipei Medical University, Shuang Ho Hospital, New Taipei, Taiwan
| | - Huang-Chin Wu
- Department of Nursing, Taipei Medical University, Shuang Ho Hospital, New Taipei, Taiwan
| | - Hsiu-Ju Jen
- Department of Nursing, Taipei Medical University, Shuang Ho Hospital, New Taipei, Taiwan; School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Chun-Hong Shen
- Department of Nursing, Taipei Medical University, Shuang Ho Hospital, New Taipei, Taiwan
| | - Chun-Ju Lin
- Department of Nursing, Taipei Medical University, Shuang Ho Hospital, New Taipei, Taiwan
| | - Kuei-Ru Chou
- Department of Nursing, Taipei Medical University, Shuang Ho Hospital, New Taipei, Taiwan; School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Ruey-Chen
- Department of Nursing, Taipei Medical University, Shuang Ho Hospital, New Taipei, Taiwan; School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
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Humane and Comprehensive Management of Challenging Behaviour in Health and Social Care: Cross-Sectional Study Testing Newly Developed Instrument. Healthcare (Basel) 2023; 11:healthcare11050753. [PMID: 36900759 PMCID: PMC10001172 DOI: 10.3390/healthcare11050753] [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: 01/27/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Management of challenging behaviour causes victimization and violates the human rights of service users in psychiatric and long-term settings for people having mental health issues and learning disabilities. The purpose of the research was to develop and test an instrument for measuring humane behaviour management (HCMCB). The research was guided by the following questions: (1) What is the structure and content of the Human and Comprehensive management of Challenging Behaviour (HCMCB) instrument, (2) What are the psychometric properties of the HCMCB instrument, and (3) How do Finnish health and social care professionals evaluate their humane and comprehensive management of challenging behaviour? METHODS A cross-sectional study design and STROBE checklist were applied. A convenience sample of health and social care professionals (n = 233) studying at the University of Applied Sciences (n = 13) was recruited. RESULTS The EFA revealed a 14-factor structure and included a total of 63 items. The Cronbach's alpha values for factors varied from 0.535 to 0.939. The participants rated their individual competence higher than leadership and organizational culture. CONCLUSIONS HCMCB is a useful tool for evaluating competencies, leadership, and organizational practices in the context of challenging behaviour. HCMCB should be further tested in various international contexts involving challenging behaviour with large samples and longitudinal design.
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Effectiveness of dementia education for professional care staff and factors influencing staff-related outcomes: An overview of systematic reviews. Int J Nurs Stud 2023; 142:104469. [PMID: 37080121 DOI: 10.1016/j.ijnurstu.2023.104469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/28/2023] [Accepted: 02/12/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND Care staff often lack knowledge, confidence, skills, and competency to provide optimal care for people with dementia. Dementia education can increase staff competency and wellbeing along with the actual care of people with dementia. Several factors can affect the effectiveness of dementia education; however, it is not yet established which factors are most important. OBJECTIVE The aim of the overview of systematic reviews is to investigate the effectiveness of dementia education for care staff on staff-related outcomes and influencing factors, identify needs for future research, and provide practical recommendations for effective dementia education. METHODS Systematic searches were conducted in PubMed, Cinahl, and PsycInfo accompanied by manual citation and reference searches. For inclusion, reviews must report on either effectiveness of one staff-related outcome or on factors influencing the effectiveness of dementia education for care staff. Quality assessments were conducted using AMSTAR2. After data extraction, results on effectiveness were structured according to satisfaction, learning, behavior, and results. Results on contributing factors to effectiveness were categorized into program, personal and organizational factors. All results were qualitatively summarized and reported according to the PRISMA statement. RESULTS Seventeen systematic reviews of low to medium quality were included. Dementia education positively affects knowledge, self-efficacy, and attitudes towards dementia and people with dementia. Care staff experienced improvements in communication and behavior management and reduction in behavioral symptoms of dementia of people with dementia was seen as well. Most reviews found no changes within restraints, medication, staff well-being and job satisfaction. Factors contributing to effectiveness are relevant and directly applicable content, active learning methods, classroom teaching combined with practical experience, theory-driven approaches and feedback sessions. Finally, the instructor needs to be experienced within dementia and sensitive to the needs of participants. CONCLUSION There is no one-size-fits-all in dementia education: however, perceived relevance and applicability are key elements for effective dementia education. Due to low quality of primary studies, further research of high methodological quality is needed on effectiveness of dementia education on staff behavior, wellbeing, and job satisfaction as well as on influencing factors and their impact on mechanisms of change.
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Reißmann S, Wirth T, Beringer V, Groneberg DA, Nienhaus A, Harth V, Mache S. "I think we still do too little": measures to prevent violence and aggression in German emergency departments - a qualitative study. BMC Health Serv Res 2023; 23:97. [PMID: 36717889 PMCID: PMC9885053 DOI: 10.1186/s12913-023-09044-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/17/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Healthcare workers employed in emergency departments (EDs) are particularly affected by physical and verbal violence. Violent assaults can be committed by both patients and their attendants. Research on interventions for violence prevention is limited and previous studies report that ED employees feel unprepared for violent incidents. Thus, the current study aims to explore ED staff's perceptions regarding available prevention measures, their effectiveness, barriers, and further needs in terms of violence prevention. METHODS In accordance with the qualitative study design, 27 semi-structured interviews were conducted via telephone with doctors and nurses working in direct contact with patients in German EDs. Main subjects were advantages and disadvantages of currently available measures, barriers regarding their implementation, their perceived effectiveness, as well as further needs concerning violence prevention. The transcribed interviews were analysed according to Mayring's qualitative content analysis. RESULTS Participants described environmental (e.g., alarm systems), organisational (e.g., security service), and individual-focused measures (staff training, verbal de-escalation). Measures perceived as effective were, for instance, communication and security service. Both demands and barriers were often related to financial constraints, e.g., staff shortage led to higher workloads and less time to consider violence prevention. In most cases, guidelines or standard operating procedures (SOPs) regarding violence prevention were missing, unknown, or not perceived as helpful in their current form. Furthermore, screening tools were not applied in any of the EDs. CONCLUSIONS The workload in EDs needs to be decreased in order to enable violence prevention, e.g., by reducing patient inflow or by increasing personnel. In addition, violence prevention guidelines tailored to the requirements of the respective ED need to be developed. Hospitals should supply ED staff with such guidelines, e.g., in the form of SOPs, but more importantly, prevention measures have to be practiced and communicated. Furthermore, there is a need for research on the implementation of screening tools for violent behaviour, so that the focus would shift from managing violence to preventing violence.
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Affiliation(s)
- Sonja Reißmann
- grid.13648.380000 0001 2180 3484Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany ,grid.7839.50000 0004 1936 9721Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, 60590 Frankfurt, Germany
| | - Tanja Wirth
- grid.13648.380000 0001 2180 3484Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany
| | - Vanessa Beringer
- grid.13648.380000 0001 2180 3484Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany
| | - David A. Groneberg
- grid.7839.50000 0004 1936 9721Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, 60590 Frankfurt, Germany
| | - Albert Nienhaus
- grid.491653.c0000 0001 0719 9225Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 22089 Hamburg, Germany ,grid.13648.380000 0001 2180 3484Institute for Health Services Research in Dermatology and Nursing (IVDP), Competence Center for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - Volker Harth
- grid.13648.380000 0001 2180 3484Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany
| | - Stefanie Mache
- grid.13648.380000 0001 2180 3484Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany ,grid.7839.50000 0004 1936 9721Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, 60590 Frankfurt, Germany
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Guha MD, Cutler NA, Heffernan T, Davis M. Developing a Trauma-Informed and Recovery-Oriented Alternative to 'Aggression Management' Training for a Metropolitan and Rural Mental Health Service. Issues Ment Health Nurs 2022; 43:1114-1120. [PMID: 35895900 DOI: 10.1080/01612840.2022.2095471] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
For clinicians working in mental health services, 'aggression management' training is generally prioritised, and often mandated. Traditional 'aggression management' training has the potential to reinforce the perception that violence and aggression are inevitable, and thus defensive and coercive practices are needed. This paper outlines the principles and processes that underpinned the development of two training programs designed as recovery-oriented and trauma-informed alternatives to traditional 'aggression management' training. The focus of the paper is on exploring how 'aggression management' training can be aligned with best practice principles. The programs were developed in a metropolitan and rural mental health service and aimed to reduce the need for defensive and coercive practices by promoting therapeutic engagement. A key feature of both programs is an orientation towards safety rather than risk. By embedding the principles of recovery and trauma-informed care in their development and orienting training towards enhancing safety, clinicians are provided with a new way of conceptualising and responding to 'aggression'. Experiential methods in the delivery of the training, and the co-design and co-delivery with peer (consumer) educators were important in supporting attitudinal change. To promote safety, the language and content of training programs must reflect contemporary principles and approaches such as trauma-informed care and recovery. This paper illustrates that to be effective, these principles and approaches must not just be described, but modelled in the development, design, and delivery of the training.
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Affiliation(s)
| | | | - Tim Heffernan
- Mental Health Commission of NSW and Mental Health Peer Coordinator, South Eastern NSW PHN, NSW, Australia
| | - Martin Davis
- Western NSW Local Health District, Orange, Australia
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Musse JLL, Musse FCC, Pelloso SM, Carvalho MDDB. Violence against health personnel before and during the COVID-19 pandemic. Rev Assoc Med Bras (1992) 2022; 68:1524-1529. [DOI: 10.1590/1806-9282.20220345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/31/2022] [Indexed: 11/29/2022] Open
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17
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Lee PY, Lee BO. Effectiveness of simulation-based education on nursing students’ professional knowledge, attitude and self-confidence in handling child abuse cases. Nurse Educ Pract 2022; 65:103480. [DOI: 10.1016/j.nepr.2022.103480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/08/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
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Schnelli A, Ott S, Zeller A, Mayer H. Aggressive incidents in home care services and organizational support: A cross-sectional survey in Switzerland. J Nurs Manag 2022; 30:1600-1609. [PMID: 34783102 PMCID: PMC9788333 DOI: 10.1111/jonm.13508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/13/2021] [Accepted: 11/03/2021] [Indexed: 12/30/2022]
Abstract
AIMS To explore the available organizational structures addressing aggressive incidents towards home care services staff. BACKGROUND Organizational structures how professional caregivers deal with care recipients' aggressive incidents. METHODS An explorative cross-sectional survey using the Violence Experienced by Staff (German version revised) and the Impact of Patient Aggression on Carers Scale was conducted. Data from 852 health care professionals in the German-speaking part of Switzerland were collected between July and October 2019. Multiple logistic regression models were used to investigate associations. The STROBE-Checklist was used as the reporting guideline. RESULTS Organizational support and management support in home care services were generally rated high and found to cause a significant decrease in negative feelings. Some self-rated skills regarding aggression management were linked to a decrease in perceived burden after aggressive incidents, whereas others increased the perceived burden. CONCLUSION Organizational structures including official procedures for affected professional caregivers should be established in home care services. This should contain efficient reporting systems and aggression management training for the specific setting. IMPLICATIONS FOR NURSING MANAGEMENT The study highlights the importance of organizational support regarding aggressive incidents in the home care setting as well as of aggression management training.
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Affiliation(s)
- Angela Schnelli
- Department of Nursing ScienceUniversity of ViennaViennaAustria,Center for Dementia Care, Institute of Applied Nursing Sciences, Department of HealthUniversity of Applied Sciences of Eastern SwitzerlandSt. GallenSwitzerland
| | - Stefan Ott
- Department of EconomyUniversity of Applied Sciences of Eastern SwitzerlandSt. GallenSwitzerland
| | - Adelheid Zeller
- Center for Dementia Care, Institute of Applied Nursing Sciences, Department of HealthUniversity of Applied Sciences of Eastern SwitzerlandSt. GallenSwitzerland
| | - Hanna Mayer
- Department of Nursing ScienceUniversity of ViennaViennaAustria
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Mitchell M, Newall F, Williams K. Behavioural emergencies in a paediatric hospital environment. J Paediatr Child Health 2022; 58:1033-1038. [PMID: 35147266 PMCID: PMC9305421 DOI: 10.1111/jpc.15896] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 10/15/2021] [Accepted: 01/04/2022] [Indexed: 11/30/2022]
Abstract
AIM Aggression and high-risk behaviours triggered by children in paediatric hospitals are increasing globally. There is a paucity of research describing behavioural emergencies in paediatric acute care settings. METHODS We conducted a 1-year retrospective study of behavioural emergencies that triggered an emergency response team attendance in a quaternary paediatric hospital. RESULTS In 2018, 218 children triggered 1050 behavioural emergencies, which utilised 386 h of the emergency response team time. Thirty-three (15%) children triggered more than five activations each (range 6-272) and nearly half (16) were children with autism spectrum disorder or intellectual disability. More than 80% of children who triggered an emergency team response also had at least one psychiatric co-morbidity. CONCLUSIONS Behavioural emergencies, by definition, put staff, children or their families at risk. They occur frequently in hospital with some children repeating these behaviours despite allocation of resources and expertise. New approaches to prevention and amelioration are needed.
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Affiliation(s)
- Marijke Mitchell
- Neurodevelopment & Disability, Nursing Research, Royal Children's HospitalMelbourneVictoriaAustralia,Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia,Murdoch Children's Research InstituteMelbourneVictoriaAustralia,Department of PaediatricsMonash University, Monash Children's HospitalMelbourneVictoriaAustralia
| | - Fiona Newall
- Neurodevelopment & Disability, Nursing Research, Royal Children's HospitalMelbourneVictoriaAustralia,Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia,Murdoch Children's Research InstituteMelbourneVictoriaAustralia,Department of NursingThe University of MelbourneMelbourneVictoriaAustralia
| | - Katrina Williams
- Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia,Department of PaediatricsMonash University, Monash Children's HospitalMelbourneVictoriaAustralia
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Bakker EJM, Dekker-van Doorn CM, Kox JHAM, Miedema HS, Francke AL, Roelofs PDDM. Conflict or connection? A feasibility study on the implementation of a training based on connecting communication in a nursing curriculum. NURSE EDUCATION TODAY 2022; 111:105302. [PMID: 35259563 DOI: 10.1016/j.nedt.2022.105302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 12/23/2021] [Accepted: 02/14/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Nursing students frequently experience offensive behaviour and communication problems with patients, clinical supervisors, and nursing and faculty staff. A communication training was developed based on connecting communication to prevent and manage conflict, and build interpersonal trust-based relationships. OBJECTIVES Feasibility study to evaluate the acceptability, demand, implementation, integration, and limited efficacy of a training based on connecting communication within a nursing curriculum. DESIGN Mixed method design. PARTICIPANTS Third-year nursing students (n = 24). SETTING A Dutch Bachelor of Nursing degree programme in Rotterdam. METHODS Between November 2019 and March 2020, data were collected from students and trainers, using quantitative and qualitative methods. Feasibility aspects, including limited efficacy testing, were measured with pre- and post-training surveys. Descriptive statistical analyses and (non)parametric tests were used to analyse feasibility aspects and baseline and follow-up scores for empathy, self-compassion, and exposure to violence. In addition, reflection reports of students and two paired interviews with the two trainers were analysed using qualitative content analysis with a deductive approach. RESULTS The post-training survey and reflection reports showed a positive assessment of the training on acceptability, demand, and integration. Students rated the training as helpful in improving their communication skills and in dealing with conflict situations. Furthermore, they recommended to implement the training in earlier years of the educational programme. According to the trainers, miscommunication, students' lack of preparation for lessons, and the timing of the training prohibited full participation in the training. The pretest-posttest survey results show statistically significant improved self-compassion (3.77 vs. 4.10; p = 0.03) and decreased self-judgement (4.21 vs. 3.50; p = 0.03). Empathy and exposure to violence did not change. CONCLUSIONS From the perspective of nursing students and trainers involved, this 10-week training based on connecting communication is feasible to implement in the Bachelor of Nursing degree programme, preferably before clinical placements.
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Affiliation(s)
- Ellen J M Bakker
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands.
| | - Connie M Dekker-van Doorn
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands; Erasmus University Medical Centre, Department of Anaesthesiology, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Jos H A M Kox
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands; Erasmus University Medical Centre, Department of General Practice, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Harald S Miedema
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands
| | - Anneke L Francke
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands; NIVEL Netherlands institute for health services research, P.O. Box 1568, 3500 BN Utrecht, The Netherlands
| | - Pepijn D D M Roelofs
- Rotterdam University of Applied Sciences, Research Centre Innovations in Care, P.O. Box 25035, 3001 HA Rotterdam, the Netherlands; University Medical Center Groningen, University of Groningen, Department of Health Sciences, Community and Occupational Medicine, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands
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Maguire T, McKenna B, Daffern M. Establishing best practice in violence risk assessment and violence prevention education for nurses working in mental health units. Nurse Educ Pract 2022; 61:103335. [DOI: 10.1016/j.nepr.2022.103335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
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22
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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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Hsu MC, Chou MH, Ouyang WC. Dilemmas and Repercussions of Workplace Violence against Emergency Nurses: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052661. [PMID: 35270354 PMCID: PMC8909790 DOI: 10.3390/ijerph19052661] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 02/06/2023]
Abstract
Nurses received the highest rate of workplace violence due to their close interaction with clients and the nature of their work. There have been relatively few qualitative studies focus on nurses' perceptions of and experiences with the antecedents, dilemma and repercussions of the patient and visitor violence (PVV), leaving a considerable evidence gap. The aim of this study was to explore nurses' experience of PVV in emergency department, the impact of PVV on quality of care, and supports needed after exposure to such incidents. We conducted semi-structured interviews with a purposive and snowball sample of nurses, and analyzed the content of the interview transcripts. A total of 10 nurses were approached and agreed to participate. Those participants ranged in age from 24 to 41 years old, eight female and two male nurses, and the majority of them (80%) held a university Bachelor degree in nursing. The average time in nursing practice was 7.2 years. We conceptualized five analytical themes, which comprised: (1) multifaceted triggers and causes of PVV; (2) experiences following PVV; (3) tangled up in thoughts and struggle with the professional role; (4) self-reflexivity and adjustment; and, (5) needs of organizational efforts and support following PVV. This paper provides compelling reasons to look beyond solely evaluating the existence of workplace, and considering the perceived professional inefficacy, impacts of being threatened or assaulted in nurses. There are also urgent needs in provision of prevention and management of workplace training programs to ensure the high-quality nursing care.
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Affiliation(s)
- Mei-Chi Hsu
- Department of Nursing, I-Shou University, Kaohsiung City 82445, Taiwan; (M.-C.H.); (M.-H.C.)
| | - Mei-Hsien Chou
- Department of Nursing, I-Shou University, Kaohsiung City 82445, Taiwan; (M.-C.H.); (M.-H.C.)
| | - Wen-Chen Ouyang
- Department of Geriatric Psychiatry, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan City 71742, Taiwan
- Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung City 82144, Taiwan
- Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung City 80708, Taiwan
- Correspondence: ; Tel.: +886-6-2795019
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Janzen S, Arnetz J, Radcliffe S, Fitzpatrick L, Eden J, Wright MC. Preventing patient violence in hospitals: Applying critical decision method interviews to understand how skilled staff think and act differently. Appl Nurs Res 2022; 63:151544. [PMID: 35034701 DOI: 10.1016/j.apnr.2021.151544] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 09/23/2021] [Accepted: 11/15/2021] [Indexed: 01/10/2023]
Abstract
AIMS Our aims were to understand how hospital staff who are skilled at managing aggressive patients recognize and respond to patient aggression and to compare the approaches of skilled staff to the experiences of staff who were recently involved in incidents of patient violence. BACKGROUND Violence from patients toward staff is prevalent and increasing. There is a need for greater understanding of effective approaches to managing patient aggression in a wide variety of hospital settings. METHODS We conducted grounded theory qualitative research applying Critical Decision Method interviews at two hospitals. Skilled staff and incident-involved staff were asked to describe experiences involving aggressive patients and the data were analyzed qualitatively. RESULTS Our interviews (N = 23) identified positive approaches and challenges to managing aggressive patients. Positive approaches included: maintaining empathy for the patient, allowing the patient time and space, exhibiting a calm demeanor, not taking things personally, and implementing strategies to build trust. Challenges included: inadequate psychiatric resources, balancing priorities between patients with urgent physical needs and those exhibiting difficult behaviors, and perceiving pressure to de-escalate situations quickly. Incident-involved staff were more likely to describe the challenges listed above and a limited tolerance for patients whose behavior they perceived as unjustified or detracting from other patients' care. CONCLUSION The Critical Decision Method proved valuable for highlighting nuanced understandings of skilled staff that sometimes contrasted with perceptions of incident-involved staff. Our findings support investigation of novel approaches to training such as peer coaching and improving empathy through increased understanding of mental illnesses and addiction.
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Affiliation(s)
- Suzanne Janzen
- Saint Alphonsus Regional Medical Center, United States of America
| | | | - Sydney Radcliffe
- Saint Alphonsus Regional Medical Center, United States of America
| | | | - Joyce Eden
- Saint Agnes Medical Center, United States of America
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Guay S, Lemyre A, Geoffrion S. Work-related predictors of mental health, presenteeism, and professional quality of life following exposure to a potentially traumatic event in child protection workers. Eur J Psychotraumatol 2022; 13:2037904. [PMID: 35251530 PMCID: PMC8896205 DOI: 10.1080/20008198.2022.2037904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Exposure to potentially traumatic events (PTEs) at work can have a negative impact on the psychological health and work life of child protection workers (CPWs). The most common form of work-related PTE experienced by CPWs consists of aggressive behaviours from the youths or their parents. OBJECTIVE This study aims to identify modifiable work-related variables that might influence the probability of experiencing impaired mental health and professional adjustment following a PTE. METHOD The participants were CPWs from two youth social services organizations in Canada. A survey was administered to CPWs within one month of a work-related PTE (Time 1; n = 176), two months after the PTE (Time 2; n = 168), six months after the PTE (Time 3; n = 162), and 12 months after the PTE (Time 4; n = 161). Lagged linear mixed models allowed for the independent variables measured at Time 1, Time 2, and Time 3 to predict the outcome variables as measured on the next assessment (Time 2, Time 3, and Time 4, respectively). The outcomes of interest were insomnia symptoms, depressive symptoms, anxiety symptoms, and post-traumatic stress symptoms, as well as presenteeism (inadequate work performance) and professional quality of life. RESULTS Confidence in one's own ability to cope with service user aggression negatively predicted depressive, anxiety, and post-traumatic stress symptoms as well as presenteeism, and positively predicted professional quality of life. The perception of job safety negatively predicted depressive, anxiety, and post-traumatic stress symptoms, and positively predicted professional quality of life. Finally, psychological demands from work positively predicted all mental health outcomes as well as presenteeism, and negatively predicted professional quality of life. CONCLUSIONS This study identified work-related variables that could be modified in an attempt to prevent the negative impacts of exposure to work-related PTEs, especially, aggressive behaviours from the service users.
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Affiliation(s)
- Stéphane Guay
- School of Criminology, Université de Montréal, Montréal, Québec, Canada.,Trauma Studies Centre, Institut universitaire en santé Mentale de Montréal, Montréal, Québec, Canada
| | - Alexandre Lemyre
- School of Criminology, Université de Montréal, Montréal, Québec, Canada.,Trauma Studies Centre, Institut universitaire en santé Mentale de Montréal, Montréal, Québec, Canada
| | - Steve Geoffrion
- Trauma Studies Centre, Institut universitaire en santé Mentale de Montréal, Montréal, Québec, Canada.,School of Psychoeducation, Université de Montréal, Montréal, Québec, Canada
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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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Sprince M, Bush C, Long B, Emery M. Perceived Barriers to Using De-Escalation Techniques to Approach the Agitated Patient: Insights From Fourth-Year Medical Students. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:S215-S216. [PMID: 34705718 DOI: 10.1097/acm.0000000000004283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Meredith Sprince
- Author affiliations: M. Sprince, C. Bush, M. Emery, Michigan State University College of Human Medicine
| | - Colleen Bush
- Author affiliations: M. Sprince, C. Bush, M. Emery, Michigan State University College of Human Medicine
| | | | - Matthew Emery
- Author affiliations: M. Sprince, C. Bush, M. Emery, Michigan State University College of Human Medicine
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Xu H, Cao X, Jin QX, Wang RS, Zhang YH, Chen ZH. The impact of the second victim's experience and support on the career success of psychiatric nurses: The mediating effect of psychological resilience. J Nurs Manag 2021; 30:1559-1569. [PMID: 34435707 DOI: 10.1111/jonm.13467] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 02/03/2023]
Abstract
AIMS We explored the mediating role of psychological resilience in the experience and support of psychiatric nurses as the second victims and their career success. BACKGROUND Psychiatric nurses, as the primary victims of workplace violence, experience physical and psychological distress, which leads to high resignation rate and job burnout. However, not much is known about the mediating role of psychological resilience between the second victims of workplace violence and their career success. METHODS A cross-sectional study was conducted among 683 psychiatric nurses. The participants were scored according to the Chinese career success scale, Chinese version of the psychological resilience scale for nurses and Chinese version of the second victim experience and support tool. The t-test and one-way analysis of variance were used to compare the factors affecting career success. RESULTS Career success scores differed among nurses of different ages having different employment forms, role and working years (p < .05). Mediating effect analysis revealed that psychological resilience played a full mediating role in the experience and support of second victims and their career success. CONCLUSION Psychological resilience-based interventions should be developed to improve the psychological adjustment ability of psychiatric nurses and to strengthen their career success. IMPLICATIONS FOR NURSING MANAGEMENT Nursing managers should create more opportunities and a harmonious working environment and enhance the management system for dealing with workplace violence.
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Affiliation(s)
- Hua Xu
- Department of Adult Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xiang Cao
- Department of Adult Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Quan-Xiang Jin
- Department of Adult Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Rui-Shi Wang
- Department of Adult Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yan-Hong Zhang
- Department of Nursing, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zhao-Hong Chen
- Department of Adult Psychiatry, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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Konttila J, Holopainen A, Pesonen HM, Kyngäs H. Occurrence of workplace violence and the psychological consequences of it among nurses working in psychiatric outpatient settings. J Psychiatr Ment Health Nurs 2021; 28:706-720. [PMID: 33306239 DOI: 10.1111/jpm.12723] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 10/16/2020] [Accepted: 12/01/2020] [Indexed: 02/03/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: There is a scarcity of studies concerning violence in psychiatric outpatient settings in the 2010s in spite of the deinstitutionalization of psychiatric services. Previous research on violence in psychiatric outpatient settings has failed to consider the association between the psychological consequences of violence, exposures to violence and background factors. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: It has been known for some time that exposures to violence are harmful for psychiatric inpatient nurses; the paper demonstrates that psychiatric outpatient nurses are also at risk. The psychological consequences of exposure to violence are highly individualized and influenced by background factors. Nurses who face harassment have a greater risk of suffering psychological symptoms. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: De-escalation interventions should be implemented in psychiatric outpatient settings. Organizations should consider the possibility of internal violence occurring when planning preventive interventions to manage and reduce workplace violence. Education targeted at violence prevention, management and debriefing should be organized systematically in psychiatric outpatient units and be taken into consideration in the mental health nursing curriculum. ABSTRACT: Introduction There is a scarcity of studies concerning violence and its consequences in psychiatric outpatient setting. Aim This study aimed to explore the occurrence of workplace violence and the psychological consequences of exposure to violence among nurses working in psychiatric outpatient settings. Method Research followed a cross-sectional survey design. Data were collected with the VIA-Q instrument. Results During the 12 months prior to the study, nurses (n = 181) had most often experienced psychological violence, with fatigue being the most common consequence. Harassment most often caused feelings of violated integrity, whereas physical violence most often caused insomnia. Significant relationships between exposure to violence and psychological consequences were identified. Discussion Workplace violence can manifest in a broad array of psychological symptoms and be harmful for nurses in psychiatric outpatient settings. It is important to discuss the subject of workplace violence and its place in the nursing curriculum and to reflect on how nurses are educated and trained to face violence in psychiatric nursing. Implications for Practice De-escalation interventions should be implemented in psychiatric outpatient settings. Organizations should take steps to abolish internal violence. Nurses need appropriate education in order to prepare them to manage workplace violence.
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Affiliation(s)
- Jenni Konttila
- Faculty of Medicine, Research Unit of Nursing Science and Health Management, Medical Research Center, University of Oulu Finland, Oulu, Finland.,University Hospital of Oulu, Oulu, Finland
| | - Arja Holopainen
- Nursing Research Foundation/The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Affiliated Group, Helsinki, Finland
| | | | - Helvi Kyngäs
- Faculty of Medicine, Research Unit of Nursing Science and Health Management, Medical Research Center, University of Oulu Finland, Oulu, Finland.,University Hospital of Oulu, Oulu, Finland
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Tölli S, Kontio R, Partanen P, Häggman-Laitila A. Conceptual framework for a comprehensive competence in managing challenging behaviour: The views of trained instructors. J Psychiatr Ment Health Nurs 2021; 28:692-705. [PMID: 33295055 DOI: 10.1111/jpm.12722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 10/10/2020] [Accepted: 11/30/2020] [Indexed: 11/27/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: There is body of knowledge available about the harms associated with restrictive interventions used in behaviour management, service users' perceptions of the use of restraints, and staff competence in behaviour management. The staff perspective has been studied in terms of staff exposure, responses to and prevention of aggression, staff-related factors associated with service user aggression, and staff attitudes and perceptions towards violence. The definitions of competence in behaviour management provided in training interventions are fragmented and based on unilateral measurements. Training interventions with the purpose of enhancing staff competence in behaviour management are organized regularly, yet there is a lack of clarity on how effective these interventions are. Inadequate conceptual understanding of behaviour management can weaken the effectiveness of these interventions. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Our study produced new knowledge by providing a preliminary conceptual framework that can be used to comprehensively describe and assess competence in managing challenging behaviour and to cover safely the whole care process. Humane care and ethical sensitivity should be the premises of interaction with people in distress. We also pointed out the needs for conceptual clarification of the concepts of confidence, support and restraint. We provide important new insight into the leadership and cultural issues of behaviour management that is relevant for patients, staff members and healthcare organizations. We found that staff members do not consider service user safety and workplace safety as opposing issues. Further, we provide new perspectives for prevention, the risk assessment process and effective communication in the context of behaviour management. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: A comprehensive understanding of the competences related to behaviour management will foster universal definitions for "support" and "restraint," which can then be used to ensure that the best practices are used for behaviour management. Organizational culture and participative leadership on behaviour management should be developed with a special focus on safety issues, common understanding of comprehensive competence, risk assessment and prevention, views regarding the use of restraints, and teamwork. ABSTRACT: Introduction Previous research concerning staff views of behaviour management has not considered instructors' views. The definitions of competence in behaviour management are fragmented, which can undermine the effectiveness of training interventions. Aim/Question This study aimed to describe Finnish and British Management of Actual or Potential Aggression instructors' perceptions of safety and behaviour management-related competences and create a conceptual framework for comprehensive competence. Method An explorative-descriptive qualitative approach with purposive sampling (N = 22), semi-structured interviews and abductive content analysis. Results Conceptual framework of comprehensive competence in managing challenging behaviour includes five categories-knowledge, skills, attitude, confidence and ethical sensitivity-and 21 subcategories. Competent staff and supportive leadership ensured safety, while inconsistent risk management culture, the health and behaviour of service users, and inadequate staff orientation endangered safety. Discussion The study produced new knowledge of safety issues and competences from the perspective of the instructors who deliver behaviour management training. Implications for practice Competence to manage challenging behaviour should be developed based on our conceptual framework to provide an effective and safe training. Prevention, the risk assessment process, alternative communication, and the definitions of "confidence," "support" and "restraint" should all be sufficiently addressed in future training.
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Affiliation(s)
- Sirpa Tölli
- University of Eastern Finland, Kuopio, Finland.,Oulu University of Applied Sciences, Oulu, Finland
| | - Raija Kontio
- Director Hyvinkää Hospital, Adjunct Professor Helsinki University, Helsinki, Finland
| | | | - Arja Häggman-Laitila
- University of Eastern Finland, Kuopio, Finland.,Social and Health Care, City of Helsinki, Helsinki, Finland
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31
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Khan MN, Khan I, Ul-Haq Z, Khan M, Baddia F, Ahmad F, Khan S. Managing violence against healthcare personnel in the emergency settings of Pakistan: a mixed methods study. BMJ Open 2021; 11:e044213. [PMID: 34130958 PMCID: PMC8208019 DOI: 10.1136/bmjopen-2020-044213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES The primary objective of this study was to evaluate the effectiveness of a half-day training on de-escalation of violence against healthcare personnel regarding prevention and management of violence incidents versus a similar tertiary-level hospital with no such training. Secondary objectives were to compare the overall satisfaction, burnout, fear of violence and confidence in coping with patients' aggression of the healthcare personnel in the two hospitals. DESIGN Mixed method design, with a comparative cross-sectional (quantitative) and focus group discussions (qualitative) components. SETTING Emergency departments of the two tertiary care hospitals in district Peshawar over 6 months starting from May 2018. PARTICIPANTS Healthcare personnel in the emergency departments of the two hospitals (trained vs untrained). OUTCOME MEASURES Violence exposure (experienced/witnessed) assessed through a previously validated tool in the past 5 months. Burnout, confidence in coping with patient aggression and overall job satisfaction were also assessed through validated tools. The qualitative component explored the perceptions of healthcare personnel regarding the management of violence and the importance of training on de-escalation of violence through focus group discussions in the two hospitals. RESULTS The demographic characteristics of the healthcare personnel within the two hospitals were quite similar. The de-escalation training did not lead to a reduction in the incidences of violence; however, confidence in coping with patient aggression and the overall satisfaction were significantly improved in the intervention hospital. The de-escalation training was lauded by the respondents as led to an improvement in communication skills, and the healthcare personnel suggested for scale-up to all the cadres and hospitals. CONCLUSION The study found significant improvements in the confidence of healthcare personnel in coping with patient aggression, along with better job satisfaction and less burnout in the intervention hospital following the de-escalation training.
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Affiliation(s)
- Muhammad Naseem Khan
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Ikram Khan
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Zia Ul-Haq
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Mirwais Khan
- International Committee of the Red Cross, Geneve, GE, Switzerland
| | - Faryal Baddia
- International Committee of the Red Cross, Geneve, GE, Switzerland
| | - Fayaz Ahmad
- Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Salman Khan
- International Committee of the Red Cross, Geneve, GE, Switzerland
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32
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Özkan Şat S, Akbaş P, Yaman Sözbir Ş. Nurses' exposure to violence and their professional commitment during the COVID-19 pandemic. J Clin Nurs 2021; 30:2036-2047. [PMID: 33761158 PMCID: PMC8251095 DOI: 10.1111/jocn.15760] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/19/2021] [Accepted: 03/10/2021] [Indexed: 02/03/2023]
Abstract
Aims and Objectives This study aimed to determine the relationship between nurses' exposure to violence and their professional commitment during the COVID‐19 pandemic. Background Violence against nurses is a common problem that persists worldwide. Design This was a descriptive cross‐sectional study. Methods An online questionnaire form and the Nursing Professional Commitment Scale were used to collect the data. The study was carried out online during the COVID‐19 pandemic between October–December 2020. A total of 263 nurses agreed to participate in the study. The STROBE checklist was followed for observational studies. Results During the COVID‐19 pandemic, 8.4% of the nurses stated that they were exposed to physical violence, 57.8% to verbal violence, 0.8% to sexual violence and 61.6% to mobbing. 52.1% of the nurses stated that they thought of quitting the profession during the COVID‐19 pandemic. The mean total Nursing Professional Commitment Scale score was 71.33 ± 15.05. Conclusions This study revealed that nurses' exposure to physical, verbal and sexual violence during the COVID‐19 pandemic decreased compared to before the pandemic. Nurses' exposure to mobbing during the pandemic was found to increase. A statistically significant difference was found between the status of the nurses' exposure to physical violence, verbal violence, and mobbing, working hours, number of patients given care, and their thoughts of quitting the profession. It was found that the status of exposure to physical violence, thinking of quitting the profession and working hours decreased professional commitment. Relevance to clinical practice In the light of these results, it is recommended that measures to prevent violence should be addressed in a multifaceted way. In managing the pandemic process, the decisions and practices should not be left to the managers' initiative to prevent mobbing. Initiatives that will increase nurses' professional commitment during the pandemic process should be planned and implemented.
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Affiliation(s)
- Sultan Özkan Şat
- Nursing Department, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Pınar Akbaş
- Karabük Yenice State Hospital, Karabük, Turkey
| | - Şengül Yaman Sözbir
- Nursing Department, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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Cabilan CJ, Eley R, Snoswell CL, Johnston ANB. What can we do about occupational violence in emergency departments? A survey of emergency staff. J Nurs Manag 2021; 30:1386-1395. [PMID: 33723863 DOI: 10.1111/jonm.13294] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/02/2021] [Accepted: 02/19/2021] [Indexed: 11/30/2022]
Abstract
AIMS To explore and collate solutions for occupational violence from emergency department (ED) staff. BACKGROUND Despite publications highlighting the progressively worsening issue of occupational violence in EDs and its detrimental impacts, few strategies aimed to reduce or manage it have been discussed in the literature. METHODS This was a cross-sectional study involving ED staff. Participants completed an electronic survey that prompted interventions for occupational violence. Free-text data were analysed and logically categorized using validated techniques. RESULTS Participants (N = 81) suggested 24 interventions: 12 were classified as prevention strategies, 10 as response strategies and two as recovery strategies. Prevention and response strategies for occupational violence targeted key participants: patients, staff and ED environment. Recovery strategies centred around staff management of the personal impacts of incidences of occupational violence and on systems in place to support them after occupational violence incidents. CONCLUSION Solutions to occupational violence should be multifaceted encompassing prevention, response and recovery for patients, staff and the ED environment. IMPLICATIONS FOR NURSING MANAGEMENT No single, universal intervention can be endorsed to reduce or mitigate the impacts of occupational violence in EDs. However, a combination of the interventions (strategies) discussed in this paper can be recommended.
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Affiliation(s)
- C J Cabilan
- Emergency Department, Princess Alexandra Hospital, Brisbane, Qld, Australia.,School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Qld, Australia
| | - Rob Eley
- Emergency Department, Princess Alexandra Hospital, Brisbane, Qld, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - Centaine L Snoswell
- Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia.,Centre for Online Health, Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - Amy N B Johnston
- Emergency Department, Princess Alexandra Hospital, Brisbane, Qld, Australia.,School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Qld, Australia
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Noga PM, Dermenchyan A, Grant SM, Dowdell EB. Developing Statewide Violence Prevention Programs in Health Care: An Exemplar From Massachusetts. Policy Polit Nurs Pract 2021; 22:156-164. [PMID: 33504282 DOI: 10.1177/1527154420987180] [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: 11/17/2022]
Abstract
Workplace violence is on the rise in health care. This problem contributes to medical errors, ineffective delivery of care, conflict and stress among health professionals, and demoralizing and unsafe work conditions. There is no specific federal statute that requires workplace violence protections, but several states have enacted legislation or regulations to protect health care workers. To address this problem in their state, the Massachusetts Health & Hospital Association developed an action plan to increase communication, policy development, and strategic protocols to decrease workplace violence. The purpose of this article is to report on the quality and safety improvement work that has been done statewide by the Massachusetts Health & Hospital Association and to provide a roadmap for other organizations and systems at the local, regional, or state level to replicate the improvement process.
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Affiliation(s)
- Patricia M Noga
- Massachusetts Health & Hospital Association, Burlington, Massachusetts, United States
| | | | - Susan M Grant
- Beaumont Health, Southfield, Michigan, United States
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Abstract
OBJECTIVES To explore the type of education needed for nurses when dealing with aggression from patients and their families. DESIGN A two-phase sequential mixed-methods study. SETTING This study was conducted in Japan, with phase I from March to November 2016 and phase II in November 2018. MAIN OUTCOME MEASURES The challenges faced by nurses when dealing with incidents of aggression from the neutral perspective of neither nurse nor patient/family and perceptions of the educational contents developed in this study. Descriptive analyses were used to examine the data retrieved from both phases. PARTICIPANTS Phase I entailed semistructured interviews among 11 neutral-party participants who observed aggressive incidents between nurses and patients/families. Phase II consisted of a web survey conducted among 102 nursing students and 308 nursing professionals. RESULTS Phase I resulted in the identification of the following five main educational components: understanding the mechanisms of anger and aggression, maintaining self-awareness, observant listening, managing the self-impression, and communicating based on specific disease characteristics. Each component was related to improved communication through self-awareness. The results of phase II indicated that participants positively perceived these educational contents as likely to be effective for dealing with aggression from patients/families. CONCLUSIONS This study clarified the type of education needed for nurses when dealing with aggression based on multiple viewpoints. Specifically, neutral-party interviews revealed that communication should be improved through self-awareness. A subsequent survey among nurses and nursing students showed that the identified educational contents were positively received.
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Affiliation(s)
- Kana Sato
- Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Yoshimi Kodama
- School of Nursing and Rehabilitation Sciences, Showa University, Yokohama, Kanagawa, Japan
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O'Keeffe V, Boyd C, Phillips C, Oppert M. Creating safety in care: Student nurses' perspectives. APPLIED ERGONOMICS 2021; 90:103248. [PMID: 32889427 DOI: 10.1016/j.apergo.2020.103248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 07/18/2020] [Accepted: 08/17/2020] [Indexed: 06/11/2023]
Abstract
Nursing is often hazardous work. Promoting safety and care requires nurses to apply knowledge, skill and creativity in patient encounters. Nurses' risk exposures are well documented, with research on student nurses' safety more limited. We studied final-year nursing students' risk perceptions using questionnaire-based vignettes involving four patient presentations on patient aggression, manipulating patient and resource risk factors. We found student nurses were most likely to ask for help and wait when managing high-risk patient aggression scenarios. Student nurses placed most importance on their own safety and patient condition in making decisions. Resource risk significantly interacted with gender, with male nurses more likely to seek help when risks were high. There is need to improve student nurse training on managing patient aggression by promoting creative approaches to problem solving and critical thinking using simulation techniques to enhance situation awareness and translate knowledge to practice.
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Affiliation(s)
- Valerie O'Keeffe
- Centre for Workplace Excellence, School of Management, School of Engineering, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
| | - Carolyn Boyd
- School of Engineering, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
| | - Craig Phillips
- School of Nursing, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
| | - Michelle Oppert
- Centre for Workplace Excellence, School of Management, School of Engineering, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
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Case CA. STARS interventions for violence reduction: Safety, technology, activity, relief, and surroundings. Nurs Forum 2020; 56:453-459. [PMID: 33331015 DOI: 10.1111/nuf.12538] [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: 10/10/2020] [Accepted: 12/04/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Caregivers without behavioral health expertise struggle to manage behaviorally challenging patients while providing continuous observation (CO) care. PROBLEM A gap in knowledge exists concerning effective CO interventions to reduce patient violence with limited psychiatric resources. The objectives of this project were to improve safety and engagement among staff providing in-person 1:1 CO for patients and optimize acute care CO utilization. METHODS OR INTERVENTIONS Nurse leaders rounded regularly on CO staff and patients requiring CO and provided the safety, technology, activity, relief, and surroundings interventions tool kit for CO staff, patients, and families. Patient readiness to trial remote video monitoring CO was assessed, and violence prevention and assault reporting education to CO staff was reinforced. RESULTS A survey of 46 CO staff demonstrated positive responses to perceptions of: (1) improved safety (p < .01); (2) violence reduction (p < .001); (3) increased awareness of the importance of the CO role (p < .001); and (4) improved CO care (p < .001). CONCLUSION Nurse leader rounding with an educational tool kit yielded CO staff-endorsed feelings of increased staff safety and engagement.
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Affiliation(s)
- Christina A Case
- Clinical Nurse Manager, Acute Medical Telemetry Unit and Surgical Acute Unit, Providence St. Peter Hospital, Olympia, Washington, USA
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Development and Validation of a Management of Workplace Violence Competence Scale for Nursing Practicum Students. Asian Nurs Res (Korean Soc Nurs Sci) 2020; 15:23-29. [PMID: 33253928 DOI: 10.1016/j.anr.2020.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/17/2020] [Accepted: 10/11/2020] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The aim of this study was to develop a scale to measure nursing students' competence in managing violence from patients and relatives in the hospital where nursing students perform clinical practicum. METHODS Literature review and Delphi expert consultation were utilized to develop the content of the management of workplace violence competence scale (MWVCS). A convenience sample of 797 nursing students responded to the questionnaire. Exploratory factor analysis of the scale was performed. Internal consistency and test-retest reliability were examined. RESULTS The MWVCS consisted of 40 items with a five-point scale. Seven factors explained 63.2% of the total explained variance. The content validity index for the scale was .99. Cronbach's α of the scale was .96, and test-retest correlations were found to be ≥ .76. CONCLUSION The MWVCS is a reliable and valid scale for nursing educators to assess the level of students' competence in violence management and to evaluate the effectiveness of education to enhance their ability to manage workplace violence.
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Jia H, Chen R, Wei L, Zhang G, Jiao M, Liu C, Sha Z, Zhou S, Wang Y, Li J, Jia X, Ismael OY, Mao J, Wu Q. What is the impact of restricted access policy on workplace violence in general hospital? A before-after study in a CHINESE tertiary hospital. BMC Health Serv Res 2020; 20:936. [PMID: 33046067 PMCID: PMC7549238 DOI: 10.1186/s12913-020-05757-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 09/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the impact of a restricted access policy on workplace violence in a healthcare setting. METHODS We surveyed healthcare workers before and after the implementation of a restricted-access policy at a tertiary hospital in north-eastern China. Data were collected in April 2017 and January 2019. Fisher's exact test were used to compare the difference in workplace violence prevalence between responses to two surveys. Survey 1 (S1) collected data from 345 healthcare professionals who had worked in the inpatient ward for at least 12 months. Survey 2 (S2) included 338 healthcare workers from the same ward who had been employed for more than two years. The effective response rates for the two studies was 79.31 and 83.25%, respectively. All 18 female security guards were included in the investigation in S2. RESULTS The prevalence of psychological violence was 62.03% in S1 and 34.62% in S2, the difference in prevalence showing statistical significance (P = 0.000), while the prevalence of physical violence was 3.77 and 4.73% respectively, showing no statistical significance (P = 0.573). The change in the rate of injury caused by physical violence was also statistically significant at 76.92 and 31.25% (P = 0.025), respectively. Security guards were at high risk of workplace violence under the policy. Most healthcare professionals thought this policy ameliorated treatment order, the sense of security, anxiety about workplace violence, and so forth, but one-third of the respondents thought that it caused patient dissatisfaction. CONCLUSION While the restricted access policy may be effective for healthcare professionals in avoiding or dealing with violence, such policy could contribute to new problems regarding the safety of security guards and the potential dissatisfaction of patients. The policy should be further developed to alleviate this phenomenon.
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Affiliation(s)
- Haonan Jia
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China
| | - Ruohui Chen
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China
- Department of Human Resources, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lifeng Wei
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China
- Heilongjiang Infectious Disease Prevention and Control Hospital, Harbin, China
| | - Gangyu Zhang
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China
- Heilongjiang Infectious Disease Prevention and Control Hospital, Harbin, China
| | - Mingli Jiao
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China.
- Institute of Quantitative& Technical Economics, Chinese Academy of Social Science, Beijing, China.
| | - Chao Liu
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China
- Heilongjiang Infectious Disease Prevention and Control Hospital, Harbin, China
| | - Zhuowa Sha
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China
- Heilongjiang Infectious Disease Prevention and Control Hospital, Harbin, China
| | - Shuang Zhou
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China
- Heilongjiang Infectious Disease Prevention and Control Hospital, Harbin, China
| | - Yameng Wang
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China
- Heilongjiang Infectious Disease Prevention and Control Hospital, Harbin, China
| | - Jingqun Li
- Department of Cardiology, No.1 People's Hospital of Heihe, Heihe, China
| | - Xiaowen Jia
- Department of General Surgery, No.1 People's Hospital of Heihe, Heihe, China
| | - Omar Yacouba Ismael
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, No.157 Baojian Road, Nangang District, Harbin, 150086, Heilongjiang, China
- Heilongjiang Infectious Disease Prevention and Control Hospital, Harbin, China
| | - Jingfu Mao
- Department of Human Resource Management, School of Public Health, Harbin Medical University, Harbin, China
| | - Qunhong Wu
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, China
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Asikainen J, Louheranta O, Vehviläinen-Julkunen K, Repo-Tiihonen E. Use of coercion prevention tools in Finnish psychiatric wards. Arch Psychiatr Nurs 2020; 34:412-420. [PMID: 33032767 DOI: 10.1016/j.apnu.2020.07.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/13/2020] [Accepted: 07/03/2020] [Indexed: 10/23/2022]
Abstract
Inpatient violence is a widespread problem in psychiatric wards and has often serious consequences. Literature indicates that de-escalation techniques are the recommended first-line intervention for managing violence, are widely used to reduce it, and restrictive practices in mental health settings. However, these techniques and models are not used at the optimum frequency and/or important factors are limiting their use and effectiveness. We aimed to determine what kind of de-escalation methods are used to reduce violence and coercion in Finnish psychiatric hospitals. Descriptive qualitative research using semi-structured questionnaires and Framework Analysis was used. The results of the study are reported in quantitative terms. A survey of psychiatric wards (N = 65) in Finland's hospital districts (n = 16) was conducted in the Autumn of 2019 to find out which de-escalation models are used. Finnish psychiatric wards use both the Safewards and Six Core Strategies models to reduce violence and the use of restrictive practices. Half of the hospitals used interventions and strategies from both models. Violence preventive methods are widely used in mental health settings in Finland. These interventions and models cover the organization, leadership, and patient perspectives to improve safety and decrease coercion actions in psychiatric wards.
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Affiliation(s)
- Jaana Asikainen
- Niuvanniemi Hospital, Department of Forensic Psychiatry, University of Eastern Finland, Niuvankuja 65, FI-70240 Kuopio, Finland.
| | - Olavi Louheranta
- Niuvanniemi Hospital, Department of Forensic Psychiatry, University of Eastern Finland, Niuvankuja 65, FI-70240 Kuopio, Finland.
| | | | - Eila Repo-Tiihonen
- Niuvanniemi Hospital, Department of Forensic Psychiatry, University of Eastern Finland, Niuvankuja 65, FI-70240 Kuopio, Finland
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Tölli S, Kontio R, Partanen P, Häggman-Laitila A. Patient safety and staff competence in managing challenging behavior based on feedback from former psychiatric patients. Perspect Psychiatr Care 2020; 56:785-796. [PMID: 32096221 DOI: 10.1111/ppc.12493] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/28/2020] [Accepted: 02/12/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study aimed to describe the perceptions and lived experiences of former psychiatric patients of their own and/or co-patients' behavior that nursing staff has regarded as challenging and that has resulted in behavior management. DESIGN AND METHODS An explorative-descriptive qualitative design with video vignettes, semistructured interviews, and abductive content analysis. FINDINGS Many reasons for different kinds of patient behavior that were considered challenging by staff were identified. Delivering care based on patients' needs was identified as core staff competence. PRACTICE IMPLICATIONS Findings can be utilized when pursuing restraint reduction in psychiatric care by enhancing staff competence.
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Affiliation(s)
- Sirpa Tölli
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Oulu University of Applied Sciences, Health and Social Care, Oulu, Finland
| | - Raija Kontio
- Hyvinkää Hospital, Hyvinkää, Finland.,Helsinki University Hospital, Finland.,Faculty of Medicine, Helsinki University, Helsinki, Finland
| | - Pirjo Partanen
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Arja Häggman-Laitila
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.,Social and Health Care, Helsinki, Finland
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Lickiewicz J, Jagielski P, Hughes PP, Makara-Studzińska M. The Gender-Related Impact of a Violence Management Training Program on Medical School Students-Preliminary Results. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197130. [PMID: 33003429 PMCID: PMC7579454 DOI: 10.3390/ijerph17197130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 09/24/2020] [Accepted: 09/26/2020] [Indexed: 11/18/2022]
Abstract
Phenomenon: Patient aggression directed toward medical personnel, including medical school students during their internships, is an increasingly important issue. To minimize this phenomenon, violence management training programs were carried out. Approach: To assess the efficacy of a violence management training program among medical school students and evaluate changes in the perception of aggressive behavior in relation to the participants’ sense of self-efficacy and self-confidence by sex. A quasi-experimental examination of medical school students was performed before and after completion of a training program. Two hundred seventy-six students, including students of medicine, nursing, emergency medical services, and physiotherapy, participated in the study. Three standardized questionnaires were used: The Perception of Aggression Scale (POAS), the Hope for Success Questionnaire (HSQ), and the General Self -Efficacy Scale (GSES). Findings: The training program had a positive impact on the sense of self-efficacy in both men and women. However, the perception of aggressive behavior changed only in women and the impact of such intervention was higher for women. Further studies should look at the long-term outcomes.
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Affiliation(s)
- Jakub Lickiewicz
- Department of Health Psychology, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, 31-501 Krakow, Poland;
- Correspondence: ; Tel.: +48-12-430-32-05
| | - Paweł Jagielski
- Department of Nutrition and Drug Research, Jagiellonian University Medical College, 31-501 Krakow, Poland;
| | - Patricia Paulsen Hughes
- College of Education, Health, and Aviation, Oklahoma State University, Stillwater, OK 74078, USA;
| | - Marta Makara-Studzińska
- Department of Health Psychology, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, 31-501 Krakow, Poland;
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Zhang J, Zheng J, Cai Y, Zheng K, Liu X. Nurses' experiences and support needs following workplace violence: A qualitative systematic review. J Clin Nurs 2020; 30:28-43. [PMID: 32936970 DOI: 10.1111/jocn.15492] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 08/23/2020] [Accepted: 08/28/2020] [Indexed: 02/03/2023]
Abstract
AIMS AND OBJECTIVES To systematically identify, appraise and synthesise existing qualitative studies exploring nurses' lived experiences of workplace violence by patients, families and hospital visitors, identifying their support needs following workplace violence. BACKGROUND Workplace violence against nurses is a significant concern globally, as it leads to serious negative consequences for nurses, patients and organisations as a whole. Having adequate support is considered significant. While numerous studies have been conducted on workplace violence, few qualitative reviews have focused on identifying nurses' support needs following episodes of workplace violence. METHODS Four databases (MEDLINE, CINAHL, PsychINFO and Scopus) were systematically searched. Additionally, hand searching of prominent journals, grey literature and reference lists of included studies was also performed to identify additional research. The Critical Appraisal Skills Programme checklist for qualitative studies was used to assess all included articles. Thomas and Harden's three-stage approach to thematic analysis was followed, using the ENTREQ statement for reporting. RESULTS Ten studies published in English, conducted across eight countries, met the inclusion criteria. Four analytical themes relating to nurses' experiences were identified: "inevitable and unpredictable trauma in the career" "higher tolerance and understanding of unintentional violence," "positive learning or passive adjustment" and "struggle with the role and behaviour conflict." In terms of nurses' support needs, the analysis yielded two themes: "informal support needs" and "formal support needs." CONCLUSION Nurses experience significant and lasting psychological trauma due to workplace violence; however, the support for nurses remains seriously inadequate. Establishing an effective and robust support system based on nurses' needs must be viewed as a priority for organisations, as well as researchers. RELEVANCE TO CLINICAL PRACTICE Institutions and managers have a duty to maintain an awareness of nurses' experiences and support needs regarding workplace violence. There is a need for further policymaking and research, based on clinical practice, in order to develop effective preventive and interventive strategies regarding workplace violence.
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Affiliation(s)
- Junfeng Zhang
- Department of Nursing, SSL Central Hospital of Dongguan City, Dongguan, China
| | - Jing Zheng
- School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yingying Cai
- Department of Chemotherapy, Jieyang People's Hospital, Jieyang, China
| | - Kexin Zheng
- Department of Psychiatry, Zhuhai Center for Chronic Disease Control, Zhuhai, China
| | - Xingling Liu
- Department of Nursing, SSL Central Hospital of Dongguan City, Dongguan, China
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Moghadam KN, Chehrzad MM, Masouleh SR, Mardani A, Maleki M, Akhlaghi E, Harding C. Nursing workload in intensive care units and the influence of patient and nurse characteristics. Nurs Crit Care 2020; 26:425-431. [PMID: 32954619 DOI: 10.1111/nicc.12548] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Understanding factors that can potentially influence patient care and nursing workload in intensive care units is important. Previous studies have shown contradictory outcomes about the relationships between nursing workload and patient and nurse characteristics. AIMS AND OBJECTIVES This study aimed to investigate nursing workload in intensive care units and examine the association between this in relation to patient and nurse characteristics. DESIGN A cross-sectional design was conducted. METHODS All nurses who were working in the intensive care units of five hospitals and met the study criteria were enrolled in the study. Two demographic questionnaires collected nurse and patient demographic information. The Nursing Activities Score was applied to determine nursing workload in three shifts (morning, evening, night) for each nurse. Data were analysed using the independent sample t-test, one-way analysis of variance, and multivariable linear regression analysis. RESULTS The Nursing Activities Score was calculated for 509 patients who were under the care of 105 intensive care unit nurses. The mean (SD) Nursing Activities Score was 72.84% (22.07%). Morning shifts, male patients, medical treatments, and referred patients from the emergency ward and other intensive care units imposed a higher workload for nurses. Specifically, female nurses, increased number of patients receiving care, and increased patient length of intensive care unit stay were directly associated with increased Nursing Activities Scores. Work in surgical and burn intensive care units were inversely associated with the Nursing Activities Score. CONCLUSION This study suggests that the workload of nurses in intensive care units can be affected by both nurse and patient characteristics. RELEVANCE TO CLINICAL PRACTICE The findings can be used to ensure appropriate staffing of intensive care units by nurses. However, nurse and patient characteristics should not be considered the only factors that influence nursing workload in intensive care units.
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Affiliation(s)
| | - Minoo Mitra Chehrzad
- Department of Paediatric Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Shademan Reza Masouleh
- Social Determinants of Health Research Centre (SDHRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Abbas Mardani
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Maleki
- School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Elham Akhlaghi
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Celia Harding
- Division of Language and Communication Science, City, University of London, London, UK
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Jia H, Fang H, Chen R, Jiao M, Wei L, Zhang G, Li Y, Wang Y, Wang Y, Jiang K, Li J, Jia X, Ismael OY, Mao J, Wu Q. Workplace violence against healthcare professionals in a multiethnic area: a cross-sectional study in southwest China. BMJ Open 2020; 10:e037464. [PMID: 32907902 PMCID: PMC7482505 DOI: 10.1136/bmjopen-2020-037464] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE The purpose of this study is to examine workplace violence (WPV) towards healthcare professionals in a multiethnic area in China, including prevalence, influencing factors, healthcare professionals' response to WPV, expected antiviolence training measures and content, and evaluation of WPV interventions. DESIGN A cross-sectional study. SETTING A grade III, class A hospital in the capital of Yunnan Province, which is the province with the most diverse ethnic minority groups in China. PARTICIPANTS In total, 2036 healthcare professionals participated, with a response rate of 83.79%. RESULTS The prevalence of physical and psychological violence was 5.5% and 43.7%, respectively. Healthcare professionals of ethnic minority were more likely to experience psychological violence (OR=1.54, 95% CI 1.16 to 2.05). Stratified by gender, male healthcare professionals of ethnic minority suffered from more physical violence (OR=3.31, 95% CI 1.12 to 9.79), while female healthcare professionals suffered from psychological violence (OR=1.71, 95% CI 1.24 to 2.36). We also found a unique work situation in China: overtime duty on-call work (18:00-07:00) was a risk factor for psychological violence (OR=1.40, 95% CI 1.02 to 1.93). Healthcare professionals of ethnic minority are less likely to order perpetrators to stop or to report to superiors when faced with psychological violence. They are also more interested in receiving training in force skills and self-defence. Both Han and ethnic minority participants considered security measures as the most useful intervention, while changing the time of shift the most useless one. CONCLUSION Our study comprehensively described WPV towards healthcare professionals in a multiethnic minority area. More research on WPV conducted in multiethnic areas is needed.
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Affiliation(s)
- Haonan Jia
- Department of Medical Affairs, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Health Policy and Hospital Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Huiying Fang
- President's Office, Qingdao Women and Children's Hospital, Qingdao, Shandong, China
| | - Ruohui Chen
- Department of Health Policy and Hospital Management, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Human Resources, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Mingli Jiao
- Department of Health Policy and Hospital Management, Harbin Medical University, Harbin, Heilongjiang, China
- Institue of Quantitative & Technological Economics, Chinese Academy of Social Sciences, Chaoyang District, Beijing, China
| | - Lifeng Wei
- Department of Health Policy and Hospital Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Gangyu Zhang
- Department of Health Policy and Hospital Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yuanheng Li
- Department of Health Policy and Hospital Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ying Wang
- Department of Health Policy and Hospital Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yameng Wang
- Department of Health Policy and Hospital Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Kexin Jiang
- Medical Department, General Hospital of Heilongjiang Agricultural Reclamation, Harbin, Heilongjiang, China
| | - Jingqun Li
- Department of Cardiology, No 1 People's Hospital of Heihe, Heihe, Heilongjiang, China
| | - Xiaowen Jia
- Department of General Surgery, No 1 People's Hospital of Heihe, Heihe, Heilongjiang, China
| | - Omar Yacouba Ismael
- Department of Health Policy and Hospital Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jingfu Mao
- Department of Human Resource Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Qunhong Wu
- Department of Social Medicine, Harbin Medical University, Harbin, Heilongjiang, China
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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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Mitchell M, Newall F, Sokol J, Heywood M, Williams K. Simulation-based education to promote confidence in managing clinical aggression at a paediatric hospital. Adv Simul (Lond) 2020; 5:21. [PMID: 32817808 PMCID: PMC7425032 DOI: 10.1186/s41077-020-00139-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 07/22/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND An increasing number of incidents involving aggressive behaviour in acute care hospitals are being witnessed worldwide. Acute care hospital staff are often not trained or confident in managing aggression. Competent management of clinical aggression is important to maintain staff and patient safety. Training programmes for acute care staff are infrequently described in the literature and rarely reported for paediatric staff. Simulation training allows practice of skills without patient risk and may be more effective than traditional teaching formats for aggression management. AIM AND DESIGN The aim of this proof of concept study was to develop a simulation-based education session on aggression management for acute care paediatric staff based on best practice principles, to evaluate the acceptability of this training programme and to gain an understanding of the impact of the training on participants' perceived confidence in managing clinical aggression. Two separate simulation exercises were delivered as a 2-h component of a hospital management of clinical aggression (MOCA) training day. Participants completed a written survey immediately prior to, at completion of the simulation-based group training, and at 3-6 months following the simulation training. FINDINGS Nine training days were conducted in 2017 for nursing, medical, allied health, education and security staff with a total of 146 participants (83% were acute care nurses). Two thirds (68%) of participants had experienced clinical aggression as part of their routine work, with 51% overall reporting a lack of confidence managing these patients. Immediately following the simulation training, 80% of all participants reported feeling more confident in managing clinical aggression, 47% reported a 1-point increase in confidence, whilst 33% of participants reported a 2- or 3-point increase. At 3-6 months post-training, 66% of respondents (N = 44) reported continued confidence in managing aggression with 100% of participants stating they would recommend simulation training to colleagues. CONCLUSIONS Simulation training is an acceptable method of training and shows promise to improve staff-perceived confidence for managing behavioural emergencies in acute paediatric health care settings. In addition, there were potential enduring positive impacts at 3 months after the study. Whilst resource and time intensive, further research assessing the benefits of utilising simulation training in this setting is warranted in order to minimise staff burn-out and improve outcomes for these very vulnerable patients.
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Affiliation(s)
- Marijke Mitchell
- Neurodevelopment & Disability, Royal Children’s Hospital, 50 Flemington Road, Parkville, Victoria, 3052 Australia
- Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville, Victoria, 3052 Australia
- Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, Victoria, 3052 Australia
| | - Fiona Newall
- Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville, Victoria, 3052 Australia
- Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, Victoria, 3052 Australia
- Department of Nursing, The University of Melbourne, 50 Flemington Road, Parkville, Victoria 3052 Australia
- Nursing Research, Nursing Education, Royal Children’s Hospital, 50 Flemington Road, Parkville, Victoria 3052 Australia
| | - Jennifer Sokol
- Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville, Victoria, 3052 Australia
- The RCH Simulation Program, Royal Children’s Hospital, 50 Flemington Road, Parkville, Victoria 3052 Australia
| | - Melissa Heywood
- The RCH Simulation Program, Royal Children’s Hospital, 50 Flemington Road, Parkville, Victoria 3052 Australia
| | - Katrina Williams
- Department of Paediatrics, The University of Melbourne, 50 Flemington Road, Parkville, Victoria, 3052 Australia
- Murdoch Children’s Research Institute, 50 Flemington Road, Parkville, Victoria, 3052 Australia
- Department of Paediatrics, Education and Research, Monash Children’s Hospital, Monash University, 246 Clayton Road, Clayton, Victoria, 3168 Australia
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48
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Bakker EJM, Kox JHAM, Boot CRL, Francke AL, van der Beek AJ, Roelofs PDDM. Improving mental health of student and novice nurses to prevent dropout: A systematic review. J Adv Nurs 2020; 76:2494-2509. [PMID: 32538480 PMCID: PMC7540364 DOI: 10.1111/jan.14453] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 05/07/2020] [Accepted: 05/15/2020] [Indexed: 01/03/2023]
Abstract
Aims To provide: (a) an overview of interventions aimed at improving mental health of student or novice nurses; and (b) an evaluation of their effectiveness on dropout‐related outcomes. Design Systematic review. Data sources Research papers published between January 1971–February 2019 were identified from the following databases: Embase, Medline, PsycInfo, CINAHL, ERIC, the Cochrane Library, Web of Science, and Google Scholar. Review methods We followed the procedures recommended by the Editorial Board of the Cochrane Collaboration Back Review Group. We included peer‐reviewed articles with a quantitative research design, examining interventions aimed at improving mental health of student and novice nurses and their effect on dropout‐related outcomes. The large variation in studies prohibited statistical pooling and a synthesis without meta‐analysis of studies was performed. Results We identified 21 studies with three areas of focus: managing stress or stressors (N = 4); facilitating the transition to nursing practice (N = 14); and a combined approach (N = 3). Five studies showed a statistically significant effect on dropout‐related outcomes. The overall risk of bias was high. Conclusion A wide range of interventions are available, but the evidence for their effectiveness is limited. There is a need for high‐quality studies in this field, preferably with a randomized controlled design.
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Affiliation(s)
- Ellen J M Bakker
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jos H A M Kox
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Department of General Practice, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Anneke L Francke
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,NIVEL Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pepijn D D M Roelofs
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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49
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Rodríguez-Bolaños R, Cartujano-Barrera F, Cartujano B, Flores YN, Cupertino AP, Gallegos-Carrillo K. The Urgent Need to Address Violence Against Health Workers During the COVID-19 Pandemic. Med Care 2020; 58:663. [PMID: 32520840 PMCID: PMC7314357 DOI: 10.1097/mlr.0000000000001365] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Brenda Cartujano
- Department of Psychiatry, Maimonides Medical Center, Brooklyn, NY
| | - Yvonne N Flores
- Epidemiology and Health Services Research Unit, Mexican Institute of Social Security, Cuernavaca, Morelos, Mexico
- UCLA Department of Health Policy and Management, Fielding School of Public Health, Los Angeles, CA
| | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute University of Rochester Medical Center Rochester, NY
| | - Katia Gallegos-Carrillo
- Epidemiology and Health Services Research Unit, Mexican Institute of Social Security, Cuernavaca, Morelos, Mexico
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50
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Schnelli A, Karrer M, Mayer H, Zeller A. Aggressive behaviour of persons with dementia towards professional caregivers in the home care setting—A scoping review. J Clin Nurs 2020. [DOI: 10.1111/jocn.15363] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 05/06/2020] [Accepted: 05/24/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Angela Schnelli
- Department of Nursing Science University of Vienna Vienna Austria
- Department of Health Center for Dementia Care Institute of Applied Nursing Sciences St. Gallen University of Applied Sciences St. Gallen Switzerland
| | - Melanie Karrer
- Department of Nursing Science University of Vienna Vienna Austria
- Department of Health Center for Dementia Care Institute of Applied Nursing Sciences St. Gallen University of Applied Sciences St. Gallen Switzerland
| | - Hanna Mayer
- Department of Nursing Science University of Vienna Vienna Austria
| | - Adelheid Zeller
- Department of Health Center for Dementia Care Institute of Applied Nursing Sciences St. Gallen University of Applied Sciences St. Gallen Switzerland
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