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Roberts LH. EDITORIAL COMMENT ON "CHARACTERISTICS AND RISK ACTORS OF WORKPLACE VIOLENCE: EXPERIENCES OF UROLOGISTS WORKING IN TURKEY". Urology 2024:S0090-4295(24)00649-6. [PMID: 39128631 DOI: 10.1016/j.urology.2024.07.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Accepted: 07/31/2024] [Indexed: 08/13/2024]
Affiliation(s)
- Ly Hoang Roberts
- Temporary Clinical Assistant Professor, Cleveland Clinic Lerner College of Medicine, Patient Experience Officer, Department of Urology, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44915.
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2
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DePorre AG, Staggs V, Hudson Z, Larson I, Nadler C. Patient and Visitor-Associated Violence Toward Health Care Workers in a Children's Health System. Pediatrics 2024; 154:e2023065041. [PMID: 38973356 DOI: 10.1542/peds.2023-065041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 07/09/2024] Open
Affiliation(s)
- Adrienne G DePorre
- Division of Hospital Medicine
- Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | | | | | | | - Cy Nadler
- Division of Developmental and Behavioral Health, Children's Mercy Kansas City, Kansas City, Missouri
- Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
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3
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Sethi R, Lyver B, Gorla J, Singh B, Hanagan T, Haines J, Toppings M, Schulz-Quach C. Developing a customised set of evidence-based quality indicators for measuring workplace violence towards healthcare workers: a modified Delphi method. BMJ Open Qual 2024; 13:e002855. [PMID: 38964885 PMCID: PMC11227823 DOI: 10.1136/bmjoq-2024-002855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 06/22/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Workplace violence (WPV) is a complex global challenge in healthcare that can only be addressed through a quality improvement initiative composed of a complex intervention. However, multiple WPV-specific quality indicators are required to effectively monitor WPV and demonstrate an intervention's impact. This study aims to determine a set of quality indicators capable of effectively monitoring WPV in healthcare. METHODS This study used a modified Delphi process to systematically arrive at an expert consensus on relevant WPV quality indicators at a large, multisite academic health science centre in Toronto, Canada. The expert panel consisted of 30 stakeholders from the University Health Network (UHN) and its affiliates. Relevant literature-based quality indicators which had been identified through a rapid review were categorised according to the Donabedian model and presented to experts for two consecutive Delphi rounds. RESULTS 87 distinct quality indicators identified through the rapid review process were assessed by our expert panel. The surveys received an average response rate of 83.1% in the first round and 96.7% in the second round. From the initial set of 87 quality indicators, our expert panel arrived at a consensus on 17 indicators including 7 structure, 6 process and 4 outcome indicators. A WPV dashboard was created to provide real-time data on each of these indicators. CONCLUSIONS Using a modified Delphi methodology, a set of quality indicators validated by expert opinion was identified measuring WPV specific to UHN. The indicators identified in this study were found to be operationalisable at UHN and will provide longitudinal quality monitoring. They will inform data visualisation and dissemination tools which will impact organisational decision-making in real time.
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Affiliation(s)
- Rickinder Sethi
- University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
- University Health Network, Toronto, Ontario, Canada
| | | | - Jaswanth Gorla
- University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | | | | | | | | | - Christian Schulz-Quach
- University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
- University Health Network, Toronto, Ontario, Canada
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4
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Yürümezoğlu HA, Çamveren H. Why are Turkish nurses migrating? A mixed-methods study. Int Nurs Rev 2024. [PMID: 38957105 DOI: 10.1111/inr.13019] [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: 09/26/2023] [Accepted: 06/16/2024] [Indexed: 07/04/2024]
Abstract
AIM This study aimed to identify the factors influencing nurses' migration patterns in Turkey. BACKGROUND The flow of nurse migration from developing countries to developed countries is steadily increasing. As a result, countries that are sources of migration tend to develop domestic inequities with respect to the population's ability to access health services. In particular, fragile economic conditions and the pandemic triggered the migration of nurses from Turkey, a developing country. METHODS This study employed a mixed-method explanatory sequential design and was conducted in Turkey between April and November 2022. The decision to migrate was the focus of both the quantitative aspect, involving 237 participants, and the qualitative aspect, with 20 participants. Quantitative data were gathered through a questionnaire, and qualitative data were obtained using open-ended questions during in-depth individual interviews. We followed the Strengthening the Reporting of Observational Studies in Epidemiology checklist in the quantitative phase and the Consolidated Criteria for Reporting Qualitative Research checklist in the qualitative phase. Descriptive statistics and thematic analyses were used to analyze the data. RESULTS In the quantitative stage of the study, nurses' reasons for deciding to migrate were identified as economic conditions, working conditions, society's outlook on the profession, political factors, and professional growth opportunities. In the qualitative stage, four major themes influencing nurse migration patterns emerged: devaluation and poor collegiality in nursing; inadequate management support; negative work environment; and health, social, and economic policies. CONCLUSION The results of the study showed that the three factors most influential in the decision to migrate were economic issues, a negative work environment, and political climate. IMPLICATIONS FOR NURSING AND HEALTH POLICY In developing countries, there is an urgent need for nurse administrators and health workforce decision-makers to create healthy working conditions and manage resources efficiently, focusing on improving nurses' economic situations while developing appropriate nationwide and international strategies.
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Affiliation(s)
| | - Hatice Çamveren
- Faculty of Health Sciences, Department of Nursing Management, Kütahya Health Sciences University, Kütahya, Turkey
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5
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Bass GA, Chang CWJ, Winkle JM, Cecconi M, Kudchadkar SR, Akuamoah-Boateng K, Einav S, Duffy CC, Hidalgo J, Rodriquez-Vega GM, Gandra-d'Almeida AJ, Barletta JF, Kaplan LJ. In-Hospital Violence and Its Impact on Critical Care Practitioners. Crit Care Med 2024; 52:1113-1126. [PMID: 38236075 DOI: 10.1097/ccm.0000000000006189] [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: 01/19/2024]
Abstract
OBJECTIVES To provide a narrative review of hospital violence (HV) and its impact on critical care clinicians. DATA SOURCES Detailed search strategy using PubMed and OVID Medline for English language articles describing HV, risk factors, precipitating events, consequences, and mitigation strategies. STUDY SELECTION Studies that specifically addressed HV involving critical care medicine clinicians or their practice settings were selected. The time frame was limited to the last 15 years to enhance relevance to current practice. DATA EXTRACTION Relevant descriptions or studies were reviewed, and abstracted data were parsed by setting, clinician type, location, social media events, impact, outcomes, and responses (agency, facility, health system, individual). DATA SYNTHESIS HV is globally prevalent, especially in complex care environments, and correlates with a variety of factors including ICU stay duration, conflict, and has recently expanded to out-of-hospital occurrences; online violence as well as stalking is increasingly prevalent. An overlap with violent extremism and terrorism that impacts healthcare facilities and clinicians is similarly relevant. A number of approaches can reduce HV occurrence including, most notably, conflict management training, communication initiatives, and visitor flow and access management practices. Rescue training for HV occurrences seems prudent. CONCLUSIONS HV is a global problem that impacts clinicians and imperils patient care. Specific initiatives to reduce HV drivers include individual training and system-wide adaptations. Future methods to identify potential perpetrators may leverage machine learning/augmented intelligence approaches.
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Affiliation(s)
- Gary A Bass
- Division of Trauma, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | - Julie M Winkle
- Emergency Medicine, UC Health, University of Colorado Hospital, Aurora, CO
| | - Maurizio Cecconi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Sapna R Kudchadkar
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Medicine, Baltimore, MD
| | - Kwame Akuamoah-Boateng
- Department of Surgery Acute Care Surgical Services, Mary Baldwin University and Virginia Commonwealth University Health Richmond, Richmond, VA
| | - Sharon Einav
- General Intensive Care Unit of the Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University School of Medicine, Jerusalem, Israel
| | - Caoimhe C Duffy
- Department of Anesthesiology and Critical Care Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Jorge Hidalgo
- Division of Critical Care, Karl Heusner Memorial Hospital, Belize City, Belize
| | - Gloria M Rodriquez-Vega
- Department of Critical Care Medicine - HIMA-San Pablo, Caguas Puerto Rico
- University of Puerto Rico, School of Medicine, Caguas, Puerto Rico
| | | | - Jeffrey F Barletta
- Pharmacy Practice, Midwestern University, College of Pharmacy-Glendale Campus, Glendale, AZ
| | - Lewis J Kaplan
- Division of Trauma, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Istanboulian L, Master T, Devine C, Hamilton L. Relational skill training for patient engagement and the creation of a trauma-informed critical care. Healthc Manage Forum 2024; 37:210-214. [PMID: 37978857 PMCID: PMC11264558 DOI: 10.1177/08404704231215461] [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: 11/19/2023]
Abstract
Patients and families in critical care have a high likelihood of previous and re-experienced trauma. Unaddressed, physical, and psychological impacts of these traumas can worsen outcomes for patients and families. A trauma-informed care approach has been proposed for critical care; however, training programs do not include relational competencies or de-escalation techniques, risking the re-traumatization of patients and families in critical care and negatively impacting clinicians. This article describes a strategy that can be adopted by critical care teams towards the creation of a trauma-informed critical care unit including the use of a framework for relational training. Principles of relationship management and de-escalation are discussed with the use of a fictional exemplar scenario. Key messages include a call to action for relational training for care teams to enhance skilled relational engagement of patients and families. This article also highlights the foundational importance of policies supporting a trauma-informed approach in critical care.
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Affiliation(s)
- Laura Istanboulian
- Toronto Metropolitan University, Toronto, Ontario, Canada
- Michael Garron Hospital, Toronto, Ontario, Canada
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Llego J, Samson MJ, Gabriel E, Corpus J, Bustillo KG, Villar J. Nursing faculty members' response to bullying in the eyes of their students: A pilot study in Pangasinan. NURSE EDUCATION TODAY 2024; 138:106195. [PMID: 38581841 DOI: 10.1016/j.nedt.2024.106195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 03/14/2024] [Accepted: 04/02/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Bullying is a pervasive issue that can occur in any setting, including among nursing students and within the nursing profession. Faculty members have a vital role in resolving bullying. OBJECTIVES To examine the nursing faculty members' responses to incidents of bullying within two nursing institutions in Pangasinan. DESIGN Descriptive- comparative design. SETTINGS Two Colleges of Nursing in a city in Pangasinan, Philippines. PARTICIPANTS Nursing students from first to fourth year BS Nursing students. METHODS An online survey was the main tool in this study, Lynch formula was utilized to calculate the sample size. There are 458 nursing students who participated in this study. Frequency, percentage, mean, standard deviation, one-way ANOVA, and t-test were used to analyze the data. RESULTS It was revealed that faculty members sometimes address bullying by group discussion (M = 3.26, SD = 1.27), and they almost never utilized non-intervention in bullying (M = 2.33, SD = 0.85). There is a variation in terms of group discussion with a one-way ANOVA score of F (2, 455) = 3.22, p = 0.04, when faculty members are grouped according to their degrees. Regarding the difference between the faculty members' responses to bullying when grouped according to gender, there is a significant difference between male and female for mediation (t(457) = 2.10, p = 0.04), group discussion (t(457) = 2.79, p = 0.01), victim support (t(457) = 2.54, p = 0.01), and disciplinary methods (t(457) = 2.66, p = 0.01). CONCLUSION The study emphasizes the complex nature of tackling bullying among nursing students. It highlights the efficacy of several solutions used by faculty members, such as group discussions, mediation, victim assistance, and disciplinary measures. The findings indicate that a comprehensive understanding of the dynamics involved in addressing bullying is necessary. This understanding highlights the significance of a cooperative and compassionate strategy that includes all individuals involved in the educational setting. It is clear that a standardized approach may not be enough, and customized techniques that take into account the particular circumstances and requirements of the persons involved are essential.
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Affiliation(s)
- Jordan Llego
- College of Nursing, University of Luzon, Dagupan City, Philippines; Medical-Surgical Nursing Department, College of Nursing, University of Ha'il, Ha'il, Saudi Arabia.
| | - May Jacklyn Samson
- School of Health Sciences, Universidad de Dagupan, Dagupan City, Philippines.
| | - Ellen Gabriel
- College of Nursing, University of Luzon, Dagupan City, Philippines.
| | - Jennie Corpus
- College of Nursing, University of Luzon, Dagupan City, Philippines.
| | | | - Johanna Villar
- College of Nursing, University of Luzon, Dagupan City, Philippines.
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Machul M, Krasucka KN, Pelc D, Dziurka M. Impact of Workplace Bullying on Nursing Care Quality: A Comprehensive Review. Med Sci Monit 2024; 30:e944815. [PMID: 38915191 PMCID: PMC11305058 DOI: 10.12659/msm.944815] [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: 04/12/2024] [Accepted: 05/09/2024] [Indexed: 06/26/2024] Open
Abstract
Workplace bullying, commonly known as mobbing, persists as a significant problem across various industries, including the healthcare sector. To establish effective interventions and protocols for enhancing the well-being of healthcare workers and patients, it is vital to fully grasp the link between workplace bullying and the quality of nursing care. The analysis highlights the complex link between workplace bullying and nursing care quality, stressing the urgency of addressing this issue due to its wide-reaching impact on individuals and healthcare organizations, ultimately affecting patient safety. Emphasizing the significance of addressing workplace bullying across different professional settings is crucial for protecting the mental health and well-being of employees. The research identifies various forms of aggression and emphasizes the need to understand how these behaviors affect patient outcomes. Further investigation is needed to clarify nurses' responses to workplace violence, particularly in specialized settings like mental health facilities. The studies underscore the numerous challenges nurses encounter when trying to report incidents of workplace bullying. This insight is vital for developing effective reporting mechanisms and targeted interventions to combat bullying behaviors in medical environments. Ultimately, establishing a safer working environment for nurses is paramount. This article aims to review the associations between workplace bullying and the quality of nursing care.
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Affiliation(s)
- Michał Machul
- Department of Holistic Care and Nursing Management, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
| | - Kamila N. Krasucka
- Students’ Scientific Association at the Department of Holistic Care and Nursing Management, Medical University of Lublin, Lublin, Poland
| | - Damian Pelc
- Students’ Scientific Association at the Department of Holistic Care and Nursing Management, Medical University of Lublin, Lublin, Poland
| | - Magdalena Dziurka
- Department of Holistic Care and Nursing Management, Faculty of Health Sciences, Medical University of Lublin, Lublin, Poland
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Popčević M, Javorina T, Košiček M, Meštrović A. Exposure of Pharmacists and Pharmacy Technicians to Violence in Community Pharmacies in Southeast Europe: Frequency and Ethical Considerations. PHARMACY 2024; 12:88. [PMID: 38921964 PMCID: PMC11207363 DOI: 10.3390/pharmacy12030088] [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: 01/30/2024] [Revised: 05/24/2024] [Accepted: 06/01/2024] [Indexed: 06/27/2024] Open
Abstract
Pharmacists and pharmacy technicians working in community pharmacies are exposed to the risk of violence in their workplaces. Studies have shown that workplace violence is affecting their job satisfaction, productivity, and mental health. This study aims to identify the frequency of different types of violence, as well as the common perpetrators that community pharmacy staff in SEE (Southeast Europe) are dealing with. A cross-sectional study was conducted using an online questionnaire created for this purpose. Selected community pharmacies in Croatia, Serbia, Bosnia and Herzegovina, and Montenegro participated in this study. In total, 732 responses were collected from 24 pharmacy chains or independent pharmacies including all community pharmacy staff. More than 80% of pharmacists and pharmacy technicians reported having been exposed to verbal violence at the workplace, while more than 20% of them reported physical and sexual violence in the preceding 12 months. There were no statistically significant differences between pharmacists and pharmacy technicians, gender, age groups, or countries in relation to exposure to physical, verbal, and sexual violence. The most common perpetrators were identified as patients/clients. More than 90% of pharmacy staff reported they did not receive any kind of support from their employer nor any other help after experiencing a robbery. There is a need for a structured approach to addressing violence in pharmacies including organized support for pharmacy staff. Achieving quality patient care, despite dealing with violent individuals or situations daily, is one of the greatest ethical challenges for healthcare providers in community pharmacies to be empowered.
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Norful AA, Albloushi M, Zhao J, Gao Y, Castro J, Palaganas E, Magsingit NS, Molo J, Alenazy BA, Rivera R. Modifiable work stress factors and psychological health risk among nurses working within 13 countries. J Nurs Scholarsh 2024. [PMID: 38816945 DOI: 10.1111/jnu.12994] [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: 02/07/2024] [Revised: 05/07/2024] [Accepted: 05/10/2024] [Indexed: 06/01/2024]
Abstract
INTRODUCTION Nurses are identified as having higher work stress and poor mental health risk among health care workforce globally. It remains unclear which modifiable stress factors pose the greatest risk for poor psychological health among nursing workforce and needed to inform targeted practice and policy change. To determine which occupation-related or personal stress factors precipitate higher risk for burnout, depression, anxiety, job satisfaction or intention to leave one's position among nurses globally. DESIGN A cross-sectional anonymous survey was administered via email using a snowball recruitment strategy. METHODS Academic researchers and clinical industry leaders across 3 global regions collaborated to generate an email listserv of professional nursing contacts for survey distribution. The survey included valid and reliable measures to scale stress factors (Work Stress Questionnaire), and screen for burnout (single item), depression (Patient Health Questionnaire-2), anxiety (Generalized Anxiety Disorder-2), resilience (Brief Resilience Scale) and intention to leave one's job (single item). We used logistic regression, first unadjusted and then adjusted for personal and professional characteristics, to determine associations between stress factors and psychological health risk. RESULTS The final sample consisted of responses from 2864 nurses working across 13 countries. Most respondents reported working as a clinical nurse in the Philippines (n = 2275), United States (n = 424) and Saudi Arabia (n = 104). One third of nursing respondents endorsed high burnout and intention to leave their job. Those reporting work conflict had significantly higher odds of burnout (odds ratio 3.18; 95% CI 2.22-4.54) and three times more likely to screen positive for depression (odds ratio 3.02; 95% CI 1.36-6.72) and anxiety (odds ratio 2.92; 95% CI 1.57-5.43). Those endorsing difficulty sleeping were 15 times more likely to screen positive for depression (odds ratio 15.63; 95% CI 2.09-117.06). Lack of social support was significantly associated to higher risk for burnout, job dissatisfaction, depression, anxiety, and intention to leave one's position. CONCLUSIONS Nurses remain at risk for burnout and poor psychological health stemming from work stress. Factors such as clear workplace goals and assignments, increased engagement, good sleep health and social support may serve as protective factors against suboptimal psychological health, and in-turn poor workforce retention. CLINICAL RELEVANCE Nurses reporting conflict in the workplace are three times more likely to screen positive for burnout, depression, and anxiety. Nurses reporting difficulty sleeping are 15 times more likely to screen positive for depression. Several modifiable factors can be targeted to reduce poor psychological health and high workforce turnover among nurses across countries.
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Affiliation(s)
| | | | - Jiawen Zhao
- Columbia University Mailman School of Public Health, New York, New York, USA
| | - Yuandi Gao
- Columbia University Mailman School of Public Health, New York, New York, USA
| | - Janelle Castro
- University of the East Ramon Magsaysay Memorial Medical Center, Inc., Quezon City, Philippines
| | | | | | - Jocelyn Molo
- University of the East Ramon Magsaysay Memorial Medical Center, Inc., Quezon City, Philippines
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Sammut D, Lees-Deutsch L, Ali L, Imasogie J, Nkundo L, Hallett N. Exploring staff experiences and perceptions of patient-perpetrated violence in hospital settings: A qualitative study. J Clin Nurs 2024. [PMID: 38764225 DOI: 10.1111/jocn.17218] [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: 11/29/2023] [Revised: 04/12/2024] [Accepted: 04/29/2024] [Indexed: 05/21/2024]
Abstract
AIMS To explore hospital staff experiences and perceptions of patient-perpetrated violence. DESIGN Descriptive qualitative study. METHODS Twelve semi-structured interviews (June-August 2022) were held with a diverse sample of hospital nurses, doctors, allied health professionals, security and a non-clinical manager. The framework approach was used to organise and analyse data, using Attribution Theory as a theoretical lens. RESULTS Three themes were identified: violence as (un)predictable, violence as (un)preventable and the cumulative toll of violence. In making sense of why patients become violent, participants described different 'types' of aggressive patients and variably attributed behaviours to situation, disposition or a combination of both. Regardless of perceived causal factors, staff overwhelmingly appeared to view violence as predictable. Participants also reflected on the wider structural problems underpinning violence, frequently alluding to their sense of relative powerlessness to initiate change. The cumulative toll of violence was a common thread, with staff describing their acquisition of 'resilience' and reflecting on its role in their responses to escalating situations. CONCLUSIONS Many hospital staff are resigned to the inevitability of violence. The concept of staff 'resilience' following violence is not unproblematic, having the potential to serve as a guise for acceptance and as an additional variable for which staff are held accountable. When designing strategies, organisations should ensure that accountability for violence reduction is distributed across multiple levels. This study makes a novel contribution by exploring the perspectives of multiple staff groups working across diverse hospital settings, and adds to a sparse literature on this subject in the UK. IMPLICATIONS FOR THE PROFESSION Efforts to address violence against healthcare staff need to be power-conscious, ensuring that accountability is distributed across multiple levels. REPORTING METHOD This study is reported in line with the Consolidated Criteria for Reporting Qualitative Studies (COREQ). PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Dana Sammut
- Centre for Healthcare and Communities, Coventry University, Coventry, UK
- School of Nursing and Midwifery, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Liz Lees-Deutsch
- Centre for Healthcare and Communities, Coventry University, Coventry, UK
- Centre for Care Excellence, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Luul Ali
- School of Nursing and Midwifery, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Jennifer Imasogie
- School of Nursing and Midwifery, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Lavinia Nkundo
- School of Nursing and Midwifery, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Nutmeg Hallett
- School of Nursing and Midwifery, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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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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Andersen LP, Jaspers S, Andersen D, Karlsen I, Aust B. A participatory and comprehensive intervention to improve violence prevention in two high-risk occupations: effect and process evaluation of a stepped wedge cluster randomised trial. BMC Public Health 2024; 24:1043. [PMID: 38622564 PMCID: PMC11017600 DOI: 10.1186/s12889-024-18527-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 04/04/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Work-related violence committed by clients, patients, and customers represents a major occupational health risk for employees that needs to be reduced. METHODS We tested a comprehensive violence prevention intervention involving active participation of both employees and managers in the Prison and Probation Service (PPS) and on psychiatric wards in Denmark. We used a stepped wedge cluster randomised controlled trial design. We measured the degree of implementation of the intervention by registration of fidelity, reach, and dose and used a mixed-effects regression analysis to estimate the effects of the intervention. RESULTS We recruited 16 work units for the intervention, but three work units dropped out. The average implementation rate was 73%. In the psychiatric wards, the intervention led to statistically significant improvements in the primary outcome (an increase in the degree to which managers and employees continuously work on violence prevention practices based on their registration and experiences), but none statistically significant improvements in any of the secondary outcomes. In the PPS units, the intervention did not lead to a statistically significant improvement in the primary outcome, but to statistically significant improvements in three secondary outcomes. CONCLUSION Most work units were able to carry out the intervention as planned. The intervention showed mixed results regarding the primary outcome. Nevertheless, the results indicate improvements also in the sector where a change in the primary outcome was not achieved. The results point at that a participatory and comprehensive approach could be a viable way of working with violence prevention in high-risk workplaces. TRIAL REGISTRATION ISRCTN86993466: 20/12/2017.
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Affiliation(s)
- Lars Peter Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Goedstrup Hospital, Hospitalsparken 15, 7400, Herning, Denmark.
| | - S Jaspers
- The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
| | - D Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Goedstrup Hospital, Hospitalsparken 15, 7400, Herning, Denmark
| | - I Karlsen
- The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
| | - B Aust
- The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
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Tutan A, Kökalan Ö. The mediation role of work-family conflict in the effect of workplace violence on job satisfaction and intention to leave: a study on health care workers in Turkey. Front Psychol 2024; 15:1322503. [PMID: 38650903 PMCID: PMC11033917 DOI: 10.3389/fpsyg.2024.1322503] [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: 10/20/2023] [Accepted: 03/25/2024] [Indexed: 04/25/2024] Open
Abstract
Background This study aims to determine how workplace violence experienced by healthcare workers in Turkey affects their job satisfaction and intention to leave. It also examines the mediating role of employees' work-family conflict between these effects. Methods The PROCESS method was used in the study. The research was conducted on 595 health workers in three public hospital affiliated with the Istanbul Provincial Health Directorate. The convenience sampling method was used in the selection of the participants. Results As a result of the analysis, it was determined that there is a positive, significant, moderate (R = 0.35, p < 0.01) relationship between workplace violence and work-family conflict, and a negative, significant and weak relationship between workplace violence and job satisfaction (R = -0.27, p < 0.01), there is a positive, significant, and weak (R = 0.26, p < 0.01) relationship between workplace violence and intention to leave. In addition, there is a negative, significant, and weak (R = -0.27, p < 0.01) relationship between work-family conflict and job satisfaction, and a positive, significant, and weak (R = 0.28, p < 0.01) relationship between work-family conflict and intention to leave. Workplace violence had significant and negative effects on the employees' job satisfaction and significant and positive effects on the intention to leave and work-family conflicts. Discussion As a result of the mediating variable analysis, it was determined that work-family conflict has a partial mediator role in the relationship between workplace violence, job satisfaction, and intention to leave. The results are very important, especially for managers working in the healthcare sector. Reducing workplace violence against healthcare personnel will contribute to increasing productivity in the sector and providing better quality service to the healthcare sector.
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Affiliation(s)
- Abdulhamit Tutan
- Graduate Education Institute, Istanbul Sabahattin Zaim University, Istanbul, Türkiye
| | - Özgür Kökalan
- Department of Business Administration, Istanbul Sabahattin Zaim University, Istanbul, Türkiye
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Malpass AG, Carroll K. The Neuman Systems Model: A Framework for Aggression and Violence Prevention. Nurs Sci Q 2024; 37:118-124. [PMID: 38491890 DOI: 10.1177/08943184231224436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
Aggression and violence influence nurse-client relationships and the quality of care provided, and just as important, they also influence the nurses' physical and emotional well-being. The Neuman systems model is utilized to define and understand factors that contribute to aggressive and violent behavior and for the purposes of providing a systematic approach to the prevention and management of stressors leading to aggression and violence.
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Affiliation(s)
| | - Karen Carroll
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
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Newman C, Roche M, Elliott D. Exposure to patient aggression and health outcomes for forensic mental health nurses: A cross-sectional survey. J Adv Nurs 2024; 80:1201-1211. [PMID: 37771198 DOI: 10.1111/jan.15885] [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: 05/04/2023] [Revised: 08/23/2023] [Accepted: 09/05/2023] [Indexed: 09/30/2023]
Abstract
AIMS The aims of the study were to determine the types and prevalence of forensic mental health nurse exposure to patient aggression and explore the impact of these exposures on their physical and mental health and work absences. DESIGN Cross-sectional survey conducted January to April 2020. METHODS All 205 nurses working in an Australian high-security inpatient forensic mental health hospital were invited to participate. An online survey included the Perception of Prevalence of Aggression Scale to measure respondent exposure to types of patient aggression, and the SF-36v2 to measure mental and physical health. Absence from work and other work and individual characteristics were also explored. RESULTS Sixty-eight respondents completed the survey. Verbal abuse was the most experienced aggression type, followed by physical violence and observing violence, patient self-harming behaviours and sexual violence. Nurses who worked in acute units experienced significantly more exposure to overall aggression than nurses in non-acute units. Higher level of aggression was associated with number of days sick leave taken and days off due to aggression or violence. Higher level of aggression was associated with poorer mental health, and patient self-harming behaviour was associated with poorer physical health. CONCLUSIONS Nurses in acute units experience higher levels of inpatient aggression and are therefore at increased risk of being impacted by the exposure. Findings indicate a psychological impact of exposure to frequent aggression and potential for an accumulative effect of exposure to traumatic events on nurse well-being. Nurses who are victim of, or witness, physical violence are most likely to take time off work. IMPACT This study provides further evidence that forensic mental health nurses are frequently exposed to various forms of patient aggression. For some nurses, this exposure to patient aggression negatively impacted their mental and physical health. Employing organizations should therefore prioritize provision of formal support for nurses. No patient or public contribution.
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Affiliation(s)
- Claire Newman
- University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Michael Roche
- University of Technology Sydney, Ultimo, New South Wales, Australia
- University of Canberra, Bruce, Australian Capital Territory, Australia
| | - Doug Elliott
- University of Technology Sydney, Ultimo, New South Wales, Australia
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McLaughlin L, Khemthong U. The Prevalence of Type II Workplace Violence in US Nurses 2000 to 2022: A Meta-Analysis. West J Nurs Res 2024; 46:248-255. [PMID: 38229584 DOI: 10.1177/01939459231222449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND Physical violence against nurses is a concern in the United States; however, its prevalence is not well quantified. OBJECTIVE We sought to describe the prevalence of workplace violence against nurses in the United States over a 22-year period. METHODS A meta-analysis was performed following a literature search of English texts through Scopus, CINAHL Plus, and Ovid MEDLINE. Inclusion criteria included the following: (1) primary reports of workplace violence incidents in the United States against nurses, (2) perpetrator was a patient, family member, or visitor, and (3) publications between January 1, 2000, and June 21, 2022. Reports where prevalence rates for nurses could not be calculated were excluded. Study quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist. RESULTS Thirty-seven studies met the inclusion criteria; 27 030 nurses were included. The pooled prevalence of workplace violence was 0.35 (95% confidence interval [CI]: 0.29-0.42; Q = 3189.40; I2 = 98.87). Pooled rates of workplace violence increased from 30% in 2000 to 2004 to 43% in 2020 to 2022; however, the overlapping CIs indicate that the increase may not be statistically significant. The mean prevalence of reported workplace violence among nurses who work in the emergency department, in corrections, and psychiatric mental health settings (pooled prevalence = 0.59, 95% CI: 0.46-0.71) was higher than that of nurses who worked in all other settings (pooled prevalence = 0.24, 95% CI: 0.18-0.30). CONCLUSIONS Workplace violence is a significant and potentially increasing problem for nurses in the United States. This critical problem requires an effective response from nurse policymakers.
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Affiliation(s)
| | - Usa Khemthong
- School of Nursing, Saint Louis University, St. Louis, MO, USA
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18
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Luck L, Kaczorowski K, White M, Dickens G, McDermid F. Medical and surgical nurses' experiences of modifying and implementing contextually suitable Safewards interventions into medical and surgical hospital wards. J Adv Nurs 2024. [PMID: 38414101 DOI: 10.1111/jan.16102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 01/14/2024] [Accepted: 02/06/2024] [Indexed: 02/29/2024]
Abstract
AIM To explore general nurses' experiences of modifying and implementing contextually suitable Safewards interventions into medical and surgical hospital wards. DESIGN Qualitative action research was used working with nurses as co-researchers. METHODS Pre-implementation focus groups were conducted in April 2022 to understand and explore the current strategies nurses utilized to avert, respond to or decrease violence. Following this, two Safewards interventions were modified by the nurses on the wards. Post-implementation focus groups were conducted in October 2022, to explore the nurses' experience of implementing Safewards interventions and the effect on their nursing practice. Data were analysed using Braun and Clarke's framework for thematic analysis. RESULTS Three themes emerged from the analysis of the pre-implementation focus groups that reflected the type of violence experienced by these nurses and the context within which they occurred: 'the space is hectic'; 'it can feel like a battlefield'; and 'the aftermath'. These themes encompass the nurses' experience of violence from patients and their visitors. Following the implementation of two modified Safewards interventions, the analysis of the focus groups reflected a change in nursing skills to avert or respond to violence: 'Safewards in action'; 'empathy and self-reflection'; and 'moving forward'. CONCLUSION Safewards interventions can be successfully modified and used in general hospital wards and influence nursing practice to manage patient and visitor violence. IMPLICATIONS FOR THE PROFESSION In the interests of safety, successful interventions to reduce violence towards general hospital nurses should be a priority for managers and healthcare organizations. Averting, mitigating and managing violence can decrease the negative professional and personal effect on nurses and ultimately improve well-being, job satisfaction and retention rates. Furthermore, decreasing violence or aggressive incidents leads to a safer patient experience and decreased number of nursing errors ultimately improving patient experiences and outcomes. Understanding nurses' experiences of violence and working with them to explore and develop contextually relevant solutions increases their capacity to respond to and avert violent incidents. Contextually modified Safewards interventions offer one such solution and potentially has wider implications for healthcare settings beyond the specific wards studied. IMPACT This study addressed the implementation of modified Safewards strategies in medical and surgical wards to prevent violence. Three themes emerged from the analysis of the pre-implementation focus groups that reflected the type of violence experienced by these nurses and the context within which they occurred. Following the implementation of two modified Safewards interventions, the post-implementation focus groups reported positive changes to their practices using the modified resources to prevent violence from patients and their visitors. Mental health interventions, such as those used in the Safewards model can be modified and provide a tool kit of interventions that can be used by medical and surgical nurses. REPORTING METHOD This paper has adhered to the COREQ guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: This paper outlines and discusses the action research approach undertaken to work with general hospital nurses to modify mental health nurses' Safewards interventions into their clinical practice. This paper provides evidence of the 'real world' application of Safewards interventions by medical and surgical nurses in general hospital wards. This paper presents qualitative findings based on focus group methods to highlight the narratives of general nurses and their experiences of violence.
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Affiliation(s)
- Lauretta Luck
- Western Sydney University, Rydalmere, New South Wales, Australia
- Nepean Blue Mountains Local Health District, Penrith, New South Wales, Australia
| | - Kellie Kaczorowski
- Nepean Blue Mountains Local Health District, Penrith, New South Wales, Australia
| | - Melissa White
- Western Sydney University, Rydalmere, New South Wales, Australia
| | | | - Fiona McDermid
- Western Sydney University, Rydalmere, New South Wales, Australia
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Hou Y, Corbally M, Timmins F. Violence against nurses by patients and visitors in the emergency department: An integrative review. J Adv Nurs 2024; 80:430-445. [PMID: 37658637 DOI: 10.1111/jan.15837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/10/2023] [Accepted: 08/14/2023] [Indexed: 09/03/2023]
Abstract
AIM This integrative review explored violence against emergency nurses by patients/visitors, examining its nature, contributing factors and consequences. DESIGN Integrative review. DATA SOURCES Articles were obtained from PubMed, CINAHL, EMBASE, Web of Science and PsycInfo databases, up until December 2021. REVIEW METHODS 26 articles were reviewed, evaluating study quality with the Crowe Critical Appraisal Tool and synthesizing conclusions through theme development and coding. RESULTS This review delves into the issue of violence perpetrated against emergency nurses by patients and visitors. It elucidates three overarching themes: the nature of violence, the contributing factors and the consequences of such acts. CONCLUSION The findings inform healthcare policy for the development of prevention approaches while identifying research gaps and emphasizing the need for alternative study designs and methodologies. IMPACT This review has implications for nursing practice, policymaking and research, emphasizing the need for stakeholder engagement and tailored interventions for at-risk emergency nurses. NO PATIENT OR PUBLIC CONTRIBUTION This project was an integrative review of the literature therefore no patient or public contribution was necessary. WHAT ALREADY IS KNOWN Violence by patients and visitors in healthcare settings, especially in emergency departments, has garnered considerable attention. WHAT THIS PAPER ADDS This review specifically examines violence-targeting emergency department nurses from patients and visitors, assessing its characteristics, contributing factors and consequences. IMPLICATIONS FOR PRACTICE/POLICY The findings will guide stakeholder engagement in developing interventions to support vulnerable emergency nurses.
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Affiliation(s)
- Yongchao Hou
- Emergency Department, ShanXi Provincial People's Hospital, Taiyuan, ShanXi, China
- School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - Melissa Corbally
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Fiona Timmins
- School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
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Dziruni TB, Hutchinson AM, Keppich-Arnold S, Bucknall T. Realist synthesis protocol on the effectiveness of a rapid response system in managing mental state deterioration in acute hospital settings. BMJ Open 2024; 14:e077597. [PMID: 38184313 PMCID: PMC10773361 DOI: 10.1136/bmjopen-2023-077597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 12/18/2023] [Indexed: 01/08/2024] Open
Abstract
INTRODUCTION Patient mental state deterioration impacts patient outcomes, staff and increases costs for healthcare organisations. Mental state is broadly defined to include not only mental health but a broad range of cognitive, emotional and psychological well-being factors. Mental state deterioration is inconsistently identified and managed within acute and tertiary medical settings. This protocol aims to synthesise the evidence to test and refine initial programme theories that outline the functioning of a rapid response system. METHODS AND ANALYSIS This synthesis will be guided by Pawson's key steps in realist reviews. We will clarify the scope of synthesis through an initial literature search, focusing on understanding the functioning of rapid response system in managing patients presenting with mental state deterioration in acute hospital settings. Initial programme theories will be refined by developing a search strategy to comprehensively search electronic databases for relevant English language peer-reviewed studies. Additionally, we will search the grey literature for sources to supplement theory testing. An abstraction form will be developed to record the characteristics of literature sources. We will use spreadsheets to code and report contextual factors, underlying mechanisms, and outcome configurations. ETHICS AND DISSEMINATION As this study is a realist synthesis protocol, ethics approval is not required. Synthesis findings will be published in a peer-reviewed journal and presented at scientific conferences.
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Affiliation(s)
- Tendayi Bruce Dziruni
- School of Nursing and Midwifery, Deakin University School of Nursing and Midwifery, Burwood, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
| | - Alison M Hutchinson
- School of Nursing and Midwifery, Deakin University School of Nursing and Midwifery, Burwood, Victoria, Australia
| | - Sandra Keppich-Arnold
- School of Nursing and Midwifery, Deakin University School of Nursing and Midwifery, Burwood, Victoria, Australia
| | - Tracey Bucknall
- School of Nursing and Midwifery, Deakin University School of Nursing and Midwifery, Burwood, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
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21
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Serra-Sastre V. Workplace violence and intention to quit in the English NHS. Soc Sci Med 2024; 340:116458. [PMID: 38101172 DOI: 10.1016/j.socscimed.2023.116458] [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: 08/10/2023] [Revised: 11/19/2023] [Accepted: 11/22/2023] [Indexed: 12/17/2023]
Abstract
NHS job vacancies remain at record levels and an increasing number of staff are leaving the NHS. Work-related violence is an aspect that has received little attention as a possible driving force in dropout rates among NHS workforce. Recent figures indicate that approximately 15% of NHS staff had experienced physical violence while at work (NHS Staff Survey, 2022). Given the prevalence of abuse and the consequences it may have on staff wellbeing, we examine the impact of workplace violence on intention to quit the organisation. We employ data from the NHS Staff Survey, a rich dataset that records the experience and views of staff working in the NHS. We use data from 2018 to 2022 of NHS employees surveyed in all NHS acute hospitals, with a sample size of 1,814,120 observations. We study the impact of experiencing physical or verbal violence in the workplace on the intention to quit the organization, examining differences according to perpetrator type. Our analysis also sheds light on any aggravated effect the pandemic had on intention to leave for those exposed to violence. The results suggest that experiencing physical violence increases the intention to leave by 10 percentage points. The effect of verbal violence is quantitatively greater in magnitude, increasing intention to leave by 21 percentage points. Violence from managers has the largest detrimental effect, followed by exposure to violence from multiple perpetrators and violence from colleagues. Heterogeneous effects exist according to occupational group, gender, age and ethnicity. The pandemic only had a marginal contribution to these effects. Staff health, trust in management and quality of patient care are some of the possible mechanisms through which violence influences the intention to quit. Overall, the results suggest that targeted interventions are needed to improve retention after exposure to violence.
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Affiliation(s)
- Victoria Serra-Sastre
- Department of Economics, City, University of London, UK; Department of Health Policy, London School of Economics and Political Science, UK; Office of Health Economics, UK.
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22
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Van Orne J. Nurse perceptions of caring for pediatric patients with behavioral health needs on non-psychiatric units during the COVID-19 pandemic. J Pediatr Nurs 2024; 74:69-76. [PMID: 38000118 DOI: 10.1016/j.pedn.2023.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/10/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023]
Abstract
PURPOSE The study examined nurses' perceptions of barriers and needs when caring for pediatric patients with behavioral health needs in inpatient non-psychiatric units during the pandemic. DESIGN AND METHODS A quantitative descriptive comparative design was used. Members of Society of Pediatric Nurses and National Pediatric Nurse Scientist Collaborative were recruited. The survey included questions about perceived barriers and needs in caring for children with behavioral health needs in their units. RESULTS A total of 335 nurses across the United States participated. Descriptive statistics, chi-square, and Kruskal-Wallis evaluated responses. Nurses in Southeast/Southwest regions were less fearful when caring for pediatric patients with behavioral health needs (p = .03), more often knew what to do (p = .01), and were supported by a behavioral health team with regular rounding (p = .035). Nurses in adult/pediatric hospitals were less likely to have adequate education to feel competent (p = .012). Nurses in the emergency department were less fearful (p = .02), more confident (p = .025), and more competent (p = .006). Nurses with up to two years of experience were likelier to feel assignments reflected the patient workload (p = .001) and more familiar with trauma-informed care protocols (p = .013). CONCLUSIONS This study illustrated significant variations in competence, readiness, and attitudes among nurses across different regions, hospital types, departments, and experience levels when caring for pediatric patients with behavioral health needs. PRACTICE IMPLICATIONS Results from this study could lead to the development of clinical practice guidelines, protocols, or policies to guide practice.
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Affiliation(s)
- Julie Van Orne
- Director of Nursing Research & EBP, Cook Children's Medical Center, 801 Seventh Avenue, 4(th) Floor, 901 Building, Fort Worth, TX 76104, USA.
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Varty M, Mines M, DelMonte J, Ratliff B. Implementing Evidence-Based Workplace Violence Prevention Education to Support Frontline Staff at Risk for Workplace Violence. J Nurses Prof Dev 2024; 40:4-9. [PMID: 37769007 DOI: 10.1097/nnd.0000000000000966] [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: 09/30/2023]
Abstract
Prior studies assessing workplace violence educational interventions have found positive outcomes including increased frontline staff confidence and reduced restraint utilization. An electronic, evidenced-based educational module was provided to frontline staff across a large healthcare system in response to a gap found during analysis of workplace violence prevention initiatives. This quality improvement project found that education can be feasibly implemented across large healthcare organizations to improve frontline staff vigilance and awareness of workplace violence risks.
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Fricke J, Siddique SM, Douma C, Ladak A, Burchill CN, Greysen R, Mull NK. Workplace Violence in Healthcare Settings: A Scoping Review of Guidelines and Systematic Reviews. TRAUMA, VIOLENCE & ABUSE 2023; 24:3363-3383. [PMID: 36341578 DOI: 10.1177/15248380221126476] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Workplace violence in healthcare settings is alarmingly common and represents significant financial and human cost. The aim of this scoping review was to identify and summarize evidence on strategies to prevent and/or manage workplace violence in healthcare settings. Searches were limited to evidence-based clinical practice guidelines and systematic reviews published between 2015 and 2021. Multiple databases were searched and screened. Quality of the included guidelines and reviews was also assessed. Three guidelines and 33 systematic reviews were included. Both the Occupational Safety and Health Administration 2015 and Registered Nurses' Association of Ontario 2019 guidelines provided useful recommendations for building a comprehensive prevention program. Evidence-based risk assessment, prevention and management, and education and training are all central components. Regular reassessment and adjustment is required. Included reviews (n = 33) were grouped into five main categories: violence toward nurses (n = 10); violence toward healthcare workers in general (n = 8); violence in the emergency department (n = 5); violence related to mental health (n = 5); and measurement related to workplace violence (n = 5). Multicomponent interventions were often more effective than those applied in isolation. We found consistent support for certain strategies including education and training, post-incident debriefing, multidisciplinary rapid response teams, and environmental modifications; however, the strength of evidence and certainty of conclusions were limited across reviews. This scoping review found that strong leadership that cultivates and enforces a culture of inclusivity, support, and respect is a prerequisite for a successful workplace violence prevention program. Rigorous comparative effectiveness research testing interventions are needed.
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Affiliation(s)
- Julie Fricke
- University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Shazia Mehmood Siddique
- University of Pennsylvania Health System, Philadelphia, PA, USA
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- University of Pennsylvania, Philadelphia, PA, USA
| | - Caryn Douma
- University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Alicia Ladak
- University of Pennsylvania Health System, Philadelphia, PA, USA
| | | | - Ryan Greysen
- University of Pennsylvania Health System, Philadelphia, PA, USA
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- University of Pennsylvania, Philadelphia, PA, USA
| | - Nikhil K Mull
- University of Pennsylvania Health System, Philadelphia, PA, USA
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Ose SO, Lohmann-Lafrenz S, Kaspersen SL, Berthelsen H, Marchand GH. Registered nurses' exposure to workplace aggression in Norway: 12-month prevalence rates, perpetrators, and current turnover intention. BMC Health Serv Res 2023; 23:1272. [PMID: 37974173 PMCID: PMC10655393 DOI: 10.1186/s12913-023-10306-z] [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: 05/09/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Identifying occupational health hazards among Registered Nurses (RNs) and other health personnel and implementing effective preventive measures are crucial to the long-term sustainability of health services. The objectives of this study were (1) to assess the 12-month prevalence rates of exposure to workplace aggression, including physical violence, threats of violence, sexual harassment, and bullying; (2) to identify whether the perpetrators were colleagues, managers, subordinates, or patients and their relatives; (3) to determine whether previous exposure to these hazards was associated with RNs' current turnover intention; and (4) to frame workplace aggression from an occupational health and safety perspective. METHODS The third version of the Copenhagen Psychosocial Questionnaire (COPSOQ III) was used to assess RNs' exposure to workplace aggression and turnover intention. A national sample of 8,800 RNs in Norway, representative of the entire population of registered nurses in terms of gender and geography, was analysed. Binary and ordinal logistic regression analyses were conducted, and odds for exposure and intention to leave are presented, with and without controls for RNs' gender, age, and the type of health service they work in. RESULTS The 12-month prevalence rates for exposure were 17.0% for physical violence, 32.5% for threats of violence, 12.6% for sexual harassment, and 10.5% for bullying. In total, 42.6% of the RNs had experienced at least one of these types of exposure during the past 12 months, and exposure to more than one of these hazards was common. Most perpetrators who committed physical acts and sexual harassment were patients, while bullying was usually committed by colleagues. There was a strong statistical association between exposure to all types of workplace aggression and RNs' intention to leave. The strongest association was for bullying, which greatly increased the odds of looking for work elsewhere. CONCLUSIONS Efforts to prevent exposure to workplace aggression should be emphasised to retain health personnel and to secure the supply of skilled healthcare workers. The results indicate a need for improvements. To ensure the sustainability of health services, labour and health authorities should join forces to develop effective workplace measures to strengthen prevention, mitigation, and preparedness regarding incidents of workplace aggression in health services and the response and recovery regarding incidents that could not be prevented.
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Affiliation(s)
| | | | | | - Hanne Berthelsen
- Centre for WorkLife and Evaluation Studies, Malmö University, Malmö, Sweden
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Zali M, Rahmani A, Powers K, Hassankhani H, Namdar‐Areshtanab H, Gilani N. Nurses' experiences of provision family-centred care in the postresuscitation period: A qualitative study. Nurs Open 2023; 10:7215-7223. [PMID: 37608460 PMCID: PMC10563420 DOI: 10.1002/nop2.1974] [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: 07/14/2023] [Accepted: 08/11/2023] [Indexed: 08/24/2023] Open
Abstract
AIM This study aimed to explore nurses' experiences of providing family-centred care in the postresuscitation period. DESIGN An exploratory-descriptive qualitative design was used. METHODS In this qualitative study, in-depth, semi-structured interviews were conducted with 22 nurses in three educational hospitals. There were six participants who completed follow-up interviews to resolve questions generated during initial interviews. Data were analysed using conventional content analysis. RESULTS Five main categories were extracted: continuous monitoring, facilitation of attendance, involvement in care, informing and emotional support. Despite the lack of organizational policies and guidelines, nurses explained how they work to provide family-centred care for families, especially those they assessed as having less possibility of aggressive behaviour and those with a better understanding of their loved one's condition. To provide postresuscitation family-centred care, nurses facilitated family attendance, involved them in some basic nursing care, and provided information and emotional support to the family members. CONCLUSION Nurses attempted to follow the basic principles of family-centred care in the postresuscitation period. However, to improve the provision of care by nurses, it is necessary to embed family-centred care principles in institutional policies and guidelines and to conduct training for nurses. IMPLICATIONS FOR THE PROFESSION Iranian nurses are interested in engaged families in the postresuscitation period. Correct implementations of such care that include all families need institutional policies and guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Mahnaz Zali
- Department of Medical‐Surgical, School of Nursing and MidwiferyTabriz University of Medical SciencesTabrizIran
| | - Azad Rahmani
- Department of Medical Surgical Nursing, Faculty of Nursing and MidwiferyTabriz University of Medical SciencesTabrizIran
| | - Kelly Powers
- School of NursingUniversity of North Carolina at CharlotteCharlotteNorth CarolinaUSA
| | - Hadi Hassankhani
- Department of Medical‐Surgical, School of Nursing and MidwiferyTabriz University of Medical SciencesTabrizIran
| | - Hossein Namdar‐Areshtanab
- Department of Psychology Nursing, School of Nursing and MidwiferyTabriz University of Medical SciencesTabrizIran
| | - Neda Gilani
- Department of Statistics and Epidemiology, Faculty of HealthTabriz University of Medical SciencesTabrizIran
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de Raeve P, Xyrichis A, Bolzonella F, Bergs J, Davidson PM. Workplace Violence Against Nurses: Challenges and Solutions for Europe. Policy Polit Nurs Pract 2023; 24:255-264. [PMID: 37475497 PMCID: PMC10563370 DOI: 10.1177/15271544231182586] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
We report the results of a mapping exercise by the European Federation of Nurses (EFN) on challenges and solutions related to violence against nurses. This is an issue of growing international concern, with the problem accentuated during and following the COVID-19 pandemic. Following a cross-sectional observational design, an online questionnaire was distributed among 35 national nurses' associations across Europe in March 2021. Face validity was achieved through an expert panel. Descriptive statistics were used for data analysis, including counts, percentages, and tabulation. Qualitative data analysis followed thematic synthesis techniques. Three main findings are noted. First, violent incidents against nurses are under-reported due to fear of victimization, employer discouragement, and the perception that reporting will not make any difference. Second, perpetrators of violent acts extend beyond patients and families to include health professionals of different ranks. Third, violent incidences have a significant adverse effect on nurses' health and retention, leading to nurses reducing their working hours or opting for part-time work. Violence against nurses is an expression of a broader problem that is rooted in the failure to recognize and manage violence at the level of the healthcare organization, and the absence of appropriate legislation to maintain minimum standards of safe working environments. This is partly the result of inadequate European Union-wide legislation targeting workplace violence in the health professions. Nurses need more institutional support through dedicated funding aimed at targeted interventions, more legislative commitment to ratify policies against discrimination, and an opportunity to voice the needs to the appropriate policymakers with the ability to bring significant change to existing conditions. Given the severity of the situation, inaction could lead to irreplaceable damage to the nursing workforce, compounding pressures resulting from the COVID-19 pandemic. Ultimately, this situation can further drive existing nurses out of the profession, weakening health systems worldwide.
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Affiliation(s)
- Paul de Raeve
- European Federation of Nurses Associations, Ixelles, Brussels, Belgium
| | - Andreas Xyrichis
- Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Francesco Bolzonella
- School of Business and Economics, Maastricht University, Maastricht, Limburg, The Netherlands
| | - Jochen Bergs
- Faculty of Medicine and Life Sciences, Healthcare & Ethics Research Group, UHasselt – Hasselt University, Hasselt, Limburg, Belgium
| | - Patricia M. Davidson
- University of Wollongong, Dean Emerita Johns Hopkins University (US), Wollongong, New South Wales, Australia
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Bauersfeld S, Majers JS. Addressing Workplace Violence With Evidence. J Nurs Adm 2023; 53:615-620. [PMID: 37874877 DOI: 10.1097/nna.0000000000001354] [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: 10/26/2023]
Abstract
AIM The purpose of this article is to describe how regional community assessment survey data specific to healthcare workers' (HCWs') attitudes and actions related to workplace violence (WPV) from 1 participating urban tertiary hospital was compared with current evidence to identify evidence-based interventions to promote a safer work environment. The regional survey assessed real-time data regarding the state of WPV and its impact on HCWs, and to drive proposed interventions to prevent and reduce WPV in the healthcare community. BACKGROUND Incidents of WPV in healthcare continue to increase, resulting in calls for action from staff, leadership, and regulatory organizations. METHODS Data were collected from the HCWs who completed the survey. Experiences with WPV were analyzed. Qualitative data were evaluated for themes. A review of external evidence was conducted to identify best practices in preparing proposed next steps for the organization. RESULTS Healthcare worker attitudes and practices related to WPV were described as unreported and not addressed. Violence was more readily perceived as a part of the job. External evidence indicated that education and training alone seemed to have minimal effect on preventing WPV. Evidence from best practices and staff feedback were recommended to be incorporated into plans for the organization.
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Affiliation(s)
- Sara Bauersfeld
- Author Affiliations: Nurse Manager (Dr Bauersfeld), Miami Valley Hospital, Dayton; Assistant Professor (Dr Majers), University of Cincinnati College of Nursing, Ohio
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Wong S, Müller A. Nurses' use of pro re nata medication in adult acute mental healthcare settings: An integrative review. Int J Ment Health Nurs 2023; 32:1243-1258. [PMID: 37025073 DOI: 10.1111/inm.13148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/06/2023] [Accepted: 03/23/2023] [Indexed: 04/08/2023]
Abstract
This integrative review explores the current pro re nata (PRN) medication practice in acute adult mental health settings. PRN medication is commonly used in acute mental health settings but there is lack of evidence of effectiveness of this practice. PRN medications have a number of adverse effects and increase the risk of morbidity in patients with a mental illness. Articles were identified from MEDLINE, CINAHL, Scopus, PubMed, PsycINFO, and Web of Science database. The STROBE critical appraisal tool was used to evaluate the quality of evidence, and inductive thematic analysis was used to extract main themes. Five themes regarding prescription practices, poor documentation, reasons to administer, medication misuse, and insufficient use of non-pharmacological interventions emerged among the 12 eligible articles. The study identified PRN medication practice gaps in adult mental health settings included insufficient documentation practice, underuse of therapeutic non-pharmacological interventions, and significant variability in PRN medication practice across the mental health professionals due to different levels of knowledge and experience.
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Affiliation(s)
- Susanna Wong
- College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia, 5001, Australia
| | - Amanda Müller
- College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, South Australia, 5001, Australia
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Newnham EA, Mergelsberg ELP, Tearne J, McEvoy P, Stanley S, Celenza A, Kavanagh H, Stevenson T, Mavaddat N, Demore G, Hood S. Mental Health Status, Risk and Protective Factors for Healthcare Staff Prior to the First Major COVID-19 Outbreak in Western Australia. Int J Public Health 2023; 68:1606102. [PMID: 37732330 PMCID: PMC10507727 DOI: 10.3389/ijph.2023.1606102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/16/2023] [Indexed: 09/22/2023] Open
Abstract
Objectives: Western Australia's unique public health response delayed the first wave of community COVID-19 transmission for 2 years. We aimed to determine the status of post-traumatic stress (PTSS), depressive, and anxiety symptoms among healthcare staff in major tertiary hospitals, together with associated risk and protective factors prior to the first substantial outbreak of COVID-19. Methods: A cross-sectional study was conducted with 431 healthcare staff immediately prior to the Western Australian border re-opening in 2022. Staff were recruited via notices in email newsletters, at four tertiary hospitals and a public mental health clinic in metropolitan Perth. Validated and original questionnaires were administered via Qualtrics. Results: Moderate levels of PTSS (22.3%), depression (21.9%), and anxiety (25.9%) were reported. Pathway analyses indicated that sleep difficulties, workplace stressors, and infectious disease training were associated with higher PTSS, depression and anxiety symptoms, and younger age was associated with higher levels of depression and anxiety. Nursing roles were associated with higher PTSS. Social support and workplace support were associated with lower levels of depression and anxiety but were not associated with PTSS. Conclusion: The findings illustrate high levels of resilience, but indicate a need for structural supports within the health system to foster staff mental health prior to the onset of emergencies.
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Affiliation(s)
- Elizabeth A. Newnham
- School of Population Health, Curtin University, Perth, WA, Australia
- Curtin enAble Institute, Perth, WA, Australia
- François-Xavier Bagnoud Center for Health and Human Rights, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | | | - Jessica Tearne
- Department of Clinical Psychology and Clinical Neuropsychology, Fiona Stanley Hospital, Perth, WA, Australia
- State Major Trauma Unit, Royal Perth Hospital, Perth, WA, Australia
| | - Peter McEvoy
- School of Population Health, Curtin University, Perth, WA, Australia
- Curtin enAble Institute, Perth, WA, Australia
- Centre for Clinical Interventions, North Metropolitan Health Service, Perth, WA, Australia
| | - Susanne Stanley
- Division of Psychiatry, School of Medicine, The University of Western Australia, Perth, WA, Australia
| | - Antonio Celenza
- Emergency Medicine, School of Medicine, University of Western Australia, Perth, WA, Australia
- Emergency Department, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Hyranthi Kavanagh
- Department of Clinical Psychology and Clinical Neuropsychology, Fiona Stanley Hospital, Perth, WA, Australia
| | - Teresa Stevenson
- Peel and Rockingham Kwinana Mental Health Service, Rockingham, WA, Australia
| | - Nahal Mavaddat
- Discipline of General Practice, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Gavin Demore
- Emergency Medicine, School of Medicine, University of Western Australia, Perth, WA, Australia
- Western Australia Country Health Service, Perth, WA, Australia
| | - Sean Hood
- Division of Psychiatry, School of Medicine, The University of Western Australia, Perth, WA, Australia
- Sir Charles Gairdner Hospital Mental Health Unit, North Metropolitan Health Service Mental Health, Public Health and Dental Services (MHPHDS), Perth, WA, Australia
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López-Ros P, López-López R, Pina D, Puente-López E. User violence prevention and intervention measures to minimize and prevent aggression towards health care workers: A systematic review. Heliyon 2023; 9:e19495. [PMID: 37809629 PMCID: PMC10558594 DOI: 10.1016/j.heliyon.2023.e19495] [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: 03/24/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 10/10/2023] Open
Abstract
Workplace violence in the health care setting is a social problem of great interest both at the health care level and in research in recent decades. The most common type of violence is the one coming from the user towards the professional. Although the bibliography includes multiple preventive actions focused on working with professionals, there are hardly any studies that explore and collect actions aimed at the user. The aim of this study is to analyze the results of the literature to provide an overview of the current evidence. Specifically, it aims to describe the various user-directed strategies or interventions aimed at reducing workplace violence experienced by professionals within the healthcare sector. A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), methodology of publications published up to December 2022 in the main databases. Studies that met the previously established eligibility criteria were identified. A peer review of the risk of bias was performed and the data were extracted from a previously elaborated template. The search yielded 5231 articles of which 11 were finally included in the review. Of these, 3 had a quantitative design, 7 had a qualitative design and one had a combined design. Of these, 38 measures or actions aimed at the user were compiled, grouped into four blocks according to the attitudinal objective pursued: Improvement of communication and creation of links, involvement of the user in joint decisions with the staff, informing and training the user, and other independent proposals. This study makes it possible to explore actions aimed at users with the objective of reducing violence towards health professionals. It collects and makes available to the scientific community a set of measures aimed at making a change of attitude in the perpetrator themselves, with the involvement of the perpetrator in the health system. This set of collected measures provides researchers with a basis to be taken into account for the implementation of future prevention plans according to the new multicomponent prevention models and with the involvement of the perpetrator themselves.
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Affiliation(s)
- Paloma López-Ros
- Department of Behavioral Sciences and Health, University Miguel Hernández, Elche, Spain
| | - Reyes López-López
- Applied Psychology Service (SEPA), University of Murcia, Murcia, Spain
| | - David Pina
- Applied Psychology Service (SEPA), University of Murcia, Murcia, Spain
- Department of Socio-Sanitary Sciences, University of Murcia, Murcia, Spain
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Carvalho KV, de Araujo PN, dos Santos FL, de Oliveira PS, da Silva JP, Santos KDS, Viana AL, Fortuna CM. Violence in the Nursing Workplace in the Context of Primary Health Care: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6693. [PMID: 37681833 PMCID: PMC10487648 DOI: 10.3390/ijerph20176693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/16/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023]
Abstract
Violence demands considerable attention due to its complexity and social consequences. The objective of this study was to analyze violence in the nursing professional workplace in the context of primary health care in Brazil. It is a qualitative study with theoretical and methodological reference to institutional analysis. It was carried out in basic health units in Brazil. Nursing professionals (N = 11) participated in semi-structured interviews and discussion groups, in addition to a research diary and participant observation. Data collection took place from October to December 2021. The results are presented in five categories: types of violence and aggressors from the perspective of nursing professionals; the causes of violence reported by professionals; strategies for the management of violence; professionals' proposals for preventing violence in health contexts; the consequences of violence in the workplace. Nursing professionals make up a large part of the workforce and have reported verbal, physical, moral, and psychological violence. The main causes are associated with user access to services. For the prevention of violence, professionals do not see themselves as protagonists of change. The consequences are the loss of quality of work and the health of professionals who requested sick leave and transfers. The study's findings can help in the development of public policies and educational and management actions.
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Affiliation(s)
- Kisa Valladão Carvalho
- Public Health Nursing Graduate Program, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil; (K.V.C.); (P.N.d.A.); (F.L.d.S.); (P.S.d.O.); (J.P.d.S.); (K.d.S.S.)
| | - Priscila Norié de Araujo
- Public Health Nursing Graduate Program, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil; (K.V.C.); (P.N.d.A.); (F.L.d.S.); (P.S.d.O.); (J.P.d.S.); (K.d.S.S.)
| | - Felipe Lima dos Santos
- Public Health Nursing Graduate Program, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil; (K.V.C.); (P.N.d.A.); (F.L.d.S.); (P.S.d.O.); (J.P.d.S.); (K.d.S.S.)
- Laboratoire École-Mutations-Apprentissages, CY Cergy Paris Université, 92230 Gennevilliers, France
| | - Poliana Silva de Oliveira
- Public Health Nursing Graduate Program, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil; (K.V.C.); (P.N.d.A.); (F.L.d.S.); (P.S.d.O.); (J.P.d.S.); (K.d.S.S.)
| | - Janaina Pereira da Silva
- Public Health Nursing Graduate Program, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil; (K.V.C.); (P.N.d.A.); (F.L.d.S.); (P.S.d.O.); (J.P.d.S.); (K.d.S.S.)
- Laboratoire Interdisciplinaire de Recherche sur les Transformations des Pratiques Educatives et des Pratiques Sociales, Université Paris-Est-Créteil-Val-de-Marne, 94010 Créteil, France
| | - Karen da Silva Santos
- Public Health Nursing Graduate Program, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil; (K.V.C.); (P.N.d.A.); (F.L.d.S.); (P.S.d.O.); (J.P.d.S.); (K.d.S.S.)
- Laboratoire Éducation et Diversité en Espaces Francophones, Université de Limoges, 87036 Limoges, France
| | - Angelina Lettiere Viana
- Public Health Nursing Graduate Program, Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil;
| | - Cinira Magali Fortuna
- Public Health Nursing Graduate Program, Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto 14040-902, SP, Brazil;
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Fang IL, Hsu MC, Ouyang WC. Lived Experience of Violence Perpetrated by Treated Patients and Their Visitors in Intensive Care Units: A Qualitative Study of Nurses. J Nurs Res 2023; 31:e284. [PMID: 37252848 DOI: 10.1097/jnr.0000000000000562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Patient and visitor violence (PVV) is a widespread problem for health professionals. Nurses working in intensive care units (ICUs) face a relatively high risk of experiencing PVV, which significantly impacts both the health of nurses and the institution as a whole. The subjective perceptions of ICU nurses regarding PVV are inadequately explored in the literature. PURPOSE The purpose of this study was to explore the perspectives, experiences, and perceptions of PVV in ICU nurses and to better understand the precipitating factors of violence. METHODS A phenomenological qualitative design and purposive sampling were used. A semistructured interview guide was used to conduct in-depth interviews with 12 ICU nurses with PVV experiences. Giorgi's method of analysis was used to discover and identify the essential categories of experience. RESULTS Five main experience categories were identified: family and patient factors as flashpoints, managing suppressed emotions by weathering the emotional storm, spiritual awakening after violence, and strategies for surviving further violence. The participants' experiences with PVV included a range of caring and mental health difficulties. In ICU settings, patient progress is often unpredictable, resulting in discrepancies between patient/family expectations and reality. Because feelings of frustration and powerlessness can eventually cause exhaustion in ICU nurses, implementing effective emotional management, stress adjustment, psychological counseling, team support, and violence intervention programs are crucial. CONCLUSIONS/IMPLICATIONS FOR PRACTICE This study provides new information on the process by which nurses can progress from inner trauma to self-recovery, moving from a negative affectivity disposition to a better understanding of threat appraisals and coping response options. Nurses should increase their awareness of the complexity of the phenomenon and of the interplay among the factors underlying PVV. The results of this study suggest that routine confusion and delirium assessments to rule out patients with ICU delirium in ICUs are important to preventing PVV. This study considers some of the implications of the research findings for nursing managers. Interventions, training programs, and/or management action should be used to ensure psychological and mental support is extended to all witnesses of PVV events and not only to those targeted by violence.
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Affiliation(s)
- I-Lu Fang
- MSN, RN, Head Nurse, Department of Nursing, E-DA Hospital, Kaohsiung City, Taiwan
| | - Mei-Chi Hsu
- PhD, RN, Professor, Department of Nursing, I-Shou University, Kaohsiung City, Taiwan
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Thompson HG, Askelson NM, Bucklin R, Gauthreaux N, Faber E, Ball C, Yang S, Steere E. Organization-Level Factors Associated With Burnout: Guided Discussions With Micropolitan Public Health Workers During COVID-19. J Occup Environ Med 2023; 65:580-583. [PMID: 36893056 PMCID: PMC10329979 DOI: 10.1097/jom.0000000000002837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
OBJECTIVE To understand how micropolitan public health workers (PHWs) experienced burnout antecedents during the COVID-19 pandemic. METHODS We conducted in-depth guided discussions with 34 representatives from 16 micropolitan public health departments using semistructured, open-ended questions about departments' experiences during the COVID-19 pandemic. We coded discussion transcripts to develop themes according to the Six Areas of Worklife model. RESULTS PHWs described antecedents of burnout that stemmed from organizational and external forces, most notably within the workload, control, reward, and values dimensions of the Six Areas of Worklife model, as well as instances of workplace violence. CONCLUSIONS Our findings support organization-level approaches to reducing and preventing burnout in the micropolitan public health workforce. We discuss addressing specific dimensions of the Six Areas of Worklife model when designing burnout solutions for this essential workforce.
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Smith MA. A Clinical Nurse Leader-Guided Behavior Management Consult Team to Impact Workplace Violence Against Nurses. J Nurs Care Qual 2023; 38:272-277. [PMID: 36827687 DOI: 10.1097/ncq.0000000000000696] [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: 02/26/2023]
Abstract
BACKGROUND Violence against nurses is a growing problem. Minimizing violence against nurses will contribute to a safer clinical environment. LOCAL PROBLEM An increase in violence against nurses was identified at a regional medical center in the Midwest. METHODS A clinical nurse leader (CNL)-led behavior management consult team was developed to support the clinical team with aggressive, disruptive, or violent patients. The team consulted, assigned interventions to address potential source(s) of agitation, provided clinical support and guidance, and developed clinical tools to manage future patients with similar behavior patterns. RESULTS Between April 2019 and January 2023, a total of 108 behavior management consults were completed. Staff appreciated the additional support from the team. CONCLUSIONS Implementation of a CNL-led behavior management consult team was found to be beneficial; other health care systems should consider implementing a similar consult team.
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Affiliation(s)
- Michelle A Smith
- Emergency Department, Bronson Methodist Hospital, Kalamazoo, Michigan
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Yosep I, Mardhiyah A, Hendrawati H, Hendrawati S. Interventions for Reducing Negative Impacts of Workplace Violence Among Health Workers: A Scoping Review. J Multidiscip Healthc 2023; 16:1409-1421. [PMID: 37251104 PMCID: PMC10216865 DOI: 10.2147/jmdh.s412754] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/18/2023] [Indexed: 05/31/2023] Open
Abstract
Workplace violence on health workers in the workplace causes physical and psychological problems. Negative impacts on victims of workplace violence such as physical problems, anxiety, depression, stress, and risk of death or risk of suicide. This problem needs to be addressed immediately so as not to impact post-traumatic stress disorder and reduce the work performance of health workers. The purpose of this study is to explore interventions to reduce the negative impact of workplace violence on health workers. This study used scoping review design with a descriptive approach to data analysis. The CINAHL, PubMed, and Scopus databases were used in this investigation. This study used PCC's framework (Population, Content, Context). The keywords are workplace violence, healthcare personnel, interventions, and programs were used by the authors. Search strategy used PRISMA Extension for Scoping Reviews. The sample are health workers, original research used a randomized control trial or quasi-experiment design, and the publication time had to be within the previous ten years (2014-2023). The JBI assessment was used to assess the quality of the article. We found 11 articles who discuss about interventions to reduce negative effects of workplace violence among health workers. This study shows that there is a decrease in psychological problems in victims of workplace violence such as anxiety, depression, and incidents of workplace violence. The range of sample in this study are 30-440 respondents. The authors discovered three different types of interventions: training programs, cognitive behavior therapy, and workplace violence programs. Interventions must focus on both the physical and psychological needs of the victims of workplace violence, psychiatric nurses and psychologists carried out interventions in a thorough manner. Interventions carried out by psychiatric nurses and psychologists can reduce the negative impact of workplace violence on health workers such as anxiety, depression and other psychological problems.
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Affiliation(s)
- Iyus Yosep
- Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
| | - Ai Mardhiyah
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
| | - Hendrawati Hendrawati
- Department of Mental Health, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
| | - Sri Hendrawati
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
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Marett BE, Nadworny D, Robinson K, Allen-Thompson W. Workplace Violence Emergency Nursing Review Questions: May 2023. J Emerg Nurs 2023; 49:333-335. [PMID: 37150559 DOI: 10.1016/j.jen.2023.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 05/09/2023]
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Wolf LA, Burchill CN. Researching Workplace Violence: Challenges for Emergency Nursing Researchers. J Emerg Nurs 2023; 49:330-332. [PMID: 37150558 DOI: 10.1016/j.jen.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/15/2023] [Accepted: 01/19/2023] [Indexed: 05/09/2023]
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Carr MA, Derouin A. Staff Duress Alarms for Workplace Violence in the Emergency Department: A Mixed-Methods Evaluation. J Emerg Nurs 2023; 49:387-394. [PMID: 37150562 DOI: 10.1016/j.jen.2023.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/18/2023] [Accepted: 01/26/2023] [Indexed: 05/09/2023]
Abstract
INTRODUCTION Complex personal duress alarms may be implemented as part of a multicomponent approach to preventing and mitigating workplace violence in emergency departments. Evaluation of duress alarms after implementation has been identified as a gap in the literature. The purpose of this quality improvement project was to examine the impact of a duress alarm system on workplace violence and user experience in an urban emergency department. METHODS A comprehensive system evaluation was performed using a mixed-methods approach, which included retrospective data review, key informant interviews, observations, and a survey. Forty clinical staff at an emergency department in North Carolina were interviewed and provided feedback on the duress system. RESULTS Findings indicated that the duress system was not associated with a decrease in workplace violence, and that the majority of clinical staff did not even wear the duress alarm. Staff indicated that the primary barriers to use of the alarm were the bulky design of the alarm badge, inadequate education about the alarm device and process, and the lack of a reliable and timely response from security. DISCUSSION Ongoing engagement of clinical staff is critical to the success of health care technology implementations. Staff feedback, periodic re-education, and recurring process evaluations are vital to ensuring the continued relevance of systems, especially when staff safety is the intended purpose.
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Recsky C, Moynihan M, Maranghi G, Smith OM, PausJenssen E, Sanon PN, Provost SM, Hamilton CB. Evidence-Based Approaches to Mitigate Workplace Violence From Patients and Visitors in Emergency Departments: A Rapid Review. J Emerg Nurs 2023:S0099-1767(23)00059-4. [PMID: 37074250 DOI: 10.1016/j.jen.2023.03.002] [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: 01/31/2023] [Revised: 03/11/2023] [Accepted: 03/19/2023] [Indexed: 04/20/2023]
Abstract
INTRODUCTION This is a rapid review of the published evidence on the effectiveness of interventions for mitigating workplace violence against staff in hospital emergency departments. Focused on the specific needs of an urban emergency department in Canada, this project sought to address the question, "What interventions have evidence regarding effectiveness for addressing workplace patient/visitor violence toward staff in the emergency department?" METHODS Following Cochrane Rapid Review methods, 5 electronic databases (MEDLINE via PubMed, Cochrane CENTRAL, Embase, PsycINFO, CINAHL) and Google Scholar were searched in April 2022 for intervention studies to reduce or mitigate workplace violence against staff in hospital emergency departments. Critical appraisal was conducted using Joanna Briggs Institute tools. Key study findings were synthesized narratively. RESULTS Twenty-four studies (21 individual studies, 3 reviews) were included in this rapid review. A variety of strategies for reducing and mitigating workplace violence were identified and categorized as single or multicomponent interventions. Although most studies reported positive outcomes on workplace violence, the articles offered limited descriptions of the interventions and/or lacked robust data to demonstrate effectiveness. Insights from across the studies offer knowledge users information to support the development of comprehensive strategies to reduce workplace violence. DISCUSSION Despite a large body of literature on workplace violence, there is little guidance on effective strategies to mitigate workplace violence in emergency departments. Evidence suggests that multicomponent approaches targeting staff, patients/visitors, and the emergency department environment are essential to addressing and mitigating workplace violence. More research is needed that provides robust evidence on effective violence prevention interventions.
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Sinclair RR, Sawhney G, Jones KO, Pittman MA, Watson GP, Bitner M. Resilience-Related Resources Predict Physicians' Fatigue, Job Search Behavior, and Productivity Outcomes. J Occup Environ Med 2023; 65:292-299. [PMID: 36728183 DOI: 10.1097/jom.0000000000002793] [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: 02/03/2023]
Abstract
OBJECTIVE The objective of this research was to assess the relative contribution of three resilience-related dispositional resources (trait mindfulness, core self-evaluations, and optimism) to emergency medicine physicians' fatigue, retention, and productivity. METHODS We surveyed emergency physicians employed by a national (US) medical staffing organization. The survey included measures of work stressors, resilience resources, job search behavior, and fatigue. We linked the survey responses to objective demographic and productivity measures from the organization's records. RESULTS A total of 371 respondents completed the survey. Multiple regression analyses demonstrated support for each of the three resilience-related resources as predictors. Relative weights analyses showed that resilience accounted for 14% and 62% of the outcome variance, whereas work demands accounted for between 32% and 56%. CONCLUSIONS Multiple facets of dispositional resilience are important predictors of emergency medicine physicians' occupational health, retention, and productivity.
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Affiliation(s)
- Robert R Sinclair
- From the Department of Psychology, Clemson University, Clemson, South Carolina (R.R.S., G.P.W.); Department of Psychological Sciences, Auburn University, Auburn, Alabama (G.S.); School of Nursing, Clemson University, Clemson, South Carolina (K.O.J.); Department of Emergency Medicine, Prisma Health, Greenville, South Carolina (M.A.P., M.B.)
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Gallen K, Sonnenberg J, Loughran C, Smith MJ, Sheppard M, Schuster K, Kaufman E, Song JS, Hall EC. Health Effects of Policing in Hospitals: a Narrative Review. J Racial Ethn Health Disparities 2023; 10:870-882. [PMID: 35267188 DOI: 10.1007/s40615-022-01275-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 11/25/2022]
Abstract
IMPORTANCE Law enforcement activity, in the form of outside agencies or hospital security forces, is increasingly common in American healthcare. Little is known about the potential effects of this prevalent, modifiable exposure on hospital staff and patient health. This narrative review characterizes existing evidence on the direct and indirect health effects of law enforcement activity in hospitals. OBSERVATIONS Law enforcement activity in hospitals can affect health outcomes through four mechanisms: (1) physical health effects related to workplace violence, restraint use, excessive force, and weapon use; (2) mental health effects involving perceptions of safety and psychological distress; (3) social effects related to the patient-provider relationship, mistrust, and bias and discrimination; and (4) legal and ethical considerations affecting overall well-being. CONCLUSIONS AND RELEVANCE Unchecked law enforcement activity in hospitals may risk patient physical and mental health, reduce patient trust, result in bias and discrimination, and contribute to legal and ethical rights violations. Importantly, law enforcement activity in hospitals may also contribute to staff perceptions of safety. To fill knowledge gaps on the measurable impact of law enforcement activity in the hospital on staff and patients, hospitals should collect and publicly share robust data on law enforcement activity in their facilities, create and adopt patient-centered policies to ensure safety and protect patient health and privacy, and implement evidence-based interventions that safely reduce law enforcement involvement with patients.
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Affiliation(s)
- Kate Gallen
- Division of Trauma, Department of Surgery, Georgetown University School of Medicine, Washington, DC, USA
| | - Jake Sonnenberg
- University of California San Francisco School of Medicine, San Francisco, CA, USA
| | | | | | - Mildred Sheppard
- Community Violence Intervention Program, MedStar Washington Hospital Center, Washington, DC, 20010, USA
| | - Kirsten Schuster
- Division of Trauma, Department of Surgery, Georgetown University School of Medicine, Washington, DC, USA
| | - Elinore Kaufman
- Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Ji Seon Song
- School of Law, University of California, Irvine, CA, USA
| | - Erin C Hall
- Division of Trauma, Department of Surgery, Georgetown University School of Medicine, Washington, DC, USA.
- Community Violence Intervention Program, MedStar Washington Hospital Center, Washington, DC, 20010, USA.
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Reducing Violence in Riyadh’s Emergency Departments: The Critical Role of Healthcare Providers. Healthcare (Basel) 2023; 11:healthcare11060823. [PMID: 36981480 PMCID: PMC10048218 DOI: 10.3390/healthcare11060823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/05/2023] [Accepted: 03/09/2023] [Indexed: 03/16/2023] Open
Abstract
Emergency department staff are at high risk of experiencing violence and aggression from patients and visitors, which can have negative impacts on healthcare providers in the ED. The aim of this study was to explore the role of healthcare providers in addressing local violence in Riyadh EDs and investigate their preparedness for managing violent incidents. We used a descriptive, correlational design with survey methodology to collect data from a convenience sample of nurses, ED technicians, physicians, and advanced practice providers in Riyadh city’s EDs. To examine the associations, we used an analysis of variance (ANOVA) for unadjusted relationships and an analysis of covariance (ANCOVA) for adjusted associations. Measures included a demographic survey, and clinicians responded to an online survey. A total of 206 ED staff participated in the questionnaire, and 59% reported experiencing physical violence during an ED shift, with 61% of incidents being caused by relatives. Additionally, 32% of the participants witnessed workplace violence. Our findings revealed that male healthcare workers, physicians, and those working in the governmental sector were at the highest risk of experiencing violence. We also found a statistically significant association between the rate of patients seen in the ED and the frequency of assault (physical or verbal) in the ED. Our results suggest that the rate of workplace violence in Riyadh EDs is high, and more efforts are needed to protect the health and well-being of healthcare providers. Senior management should take a position against ED domestic violence and reinforce managerial and healthcare provider resources by adopting policies and procedures that protect healthcare workers’ safety. This study provides valuable insights into the nature and prevalence of violence in Riyadh EDs and highlights the critical role of healthcare providers in reducing violence in EDs.
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Evans WR, Mullen DM, Burke-Smalley L. Coworker abuse in healthcare: voices of mistreated workers. J Health Organ Manag 2023; ahead-of-print. [PMID: 36690595 DOI: 10.1108/jhom-05-2022-0131] [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: 01/25/2023]
Abstract
PURPOSE The appalling abuse healthcare workers have endured from patients is long documented in the popular press and social media. Less explored in the healthcare management literature is workplace abuse that professional nurses experience from their coworkers. DESIGN/METHODOLOGY/APPROACH The authors use text-based first-hand accounts from nurses posting on Reddit (N = 75) to better understand the types and context of abusive acts endured by their coworkers in the contemporary healthcare setting. Each account is content analyzed using two raters, and thematic analysis is utilized to summarize findings. FINDINGS Findings indicate that nurse workplace abuse frequently targets new entrants to a work unit (e.g. recent grads), typically is ongoing, takes verbal and nonverbal forms, mainly stems from coworkers (i.e. lateral mistreatment), and frequently takes place in front of other coworkers, mainly in hospital settings. PRACTICAL IMPLICATIONS By applying the lens of mindfulness, healthcare organizations can transform these harmful interactions within the nursing profession. The authors offer administrators and frontline workers practical implications for mitigating workplace abuse, including reshaping the culture, bystander interventions and explicit leadership support. ORIGINALITY/VALUE First-hand accounts from nurses in the frontlines of healthcare provide a rich voice that reveals the reality of ongoing verbal and nonverbal peer abuse in hospitals and healthcare settings.
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Affiliation(s)
- W Randy Evans
- Department of Management, Gary W. Rollins College of Business, The University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
| | - Deborah M Mullen
- Department of Management, Gary W. Rollins College of Business, The University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
| | - Lisa Burke-Smalley
- Department of Management, Gary W. Rollins College of Business, The University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
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Andersen DR, Karlsen IL, Jaspers SØ, Pedersen AHM, Andersen LPS, Aust B. Experiences of preventing violence in two high-risk sectors: A qualitative study of front-line workers. Work 2023:WOR220151. [PMID: 36710701 DOI: 10.3233/wor-220151] [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: 01/25/2023] Open
Abstract
BACKGROUND Exposure to workplace violence is associated with physical and/or psychological trauma. Despite its significant impact, little is known about front-line workers' experiences of preventing workplace violence. OBJECTIVE This study aimed to identify what workers identify as important to preventing workplace conflicts from escalating into violence. METHODS We conducted seventeen qualitative focus-group interviews with fifty-eight workers at the Danish Prison and Probation Service and psychiatric hospitals. We applied thematic analysis to identify types of violence-prevention practices, and prerequisites for successfully preventing workplace violence. RESULTS We identified two main categories of violence-prevention practices, and one main category of prerequisites for violence-prevention practices. Main category A), "the individual worker's violence-prevention practices" included the sub-categories, 1) identify the causes of workplace violence and potentially violent situations, 2) establish relationships, state rules, and set clear boundaries and 3) display empathy and communicate respectfully. Main category B), "collaborative practices for preventing workplace violence" included 4) communicate with co-workers, and share information and observations, 5) coordinate work, avoid being played off against colleagues, and support colleagues. Main category C), "prerequisites for violence-prevention practices" included 6) managing one's emotions, and 7) having sufficient time to do the job, and being a part of a stable team, whose members know each other and the inmates/patients". CONCLUSION This study contributes to a better understanding of the interplay among individual, collaborative, and contextual aspects of preventing workplace violence. We believe that an increased understanding of the complexity of preventing workplace violence in high-risk sectors is useful when designing comprehensive violence-prevention strategies.
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Affiliation(s)
- Dorte R Andersen
- Department of Occupational Medicine - University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Herning, Denmark
| | - Iben L Karlsen
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Sofie Ø Jaspers
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Anna Helene M Pedersen
- Department of Occupational Medicine - University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Herning, Denmark
| | - Lars Peter S Andersen
- Department of Occupational Medicine - University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Herning, Denmark
| | - Birgit Aust
- The National Research Centre for the Working Environment, Copenhagen, Denmark
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Cybulska AM, Weymann A, Rachubińska K, Grochans S, Wójcik G, Grochans E. Factors Associated with Insomnia and Aggression among Healthcare Workers during COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1433. [PMID: 36674188 PMCID: PMC9859312 DOI: 10.3390/ijerph20021433] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
(1) Healthcare workers are exposed to increased risks of insomnia and aggression during the COVID-19 pandemic. The aim of the study was to assess insomnia, sleep disturbances, and aggression and identify the associated risk factors among healthcare workers during the COVID-19 pandemic. (2) A total of 264 healthcare workers participated in the study. The study was conducted with the diagnostic survey method, using the Buss−Perry Aggression Questionnaire, the Athens Insomnia Scale, the Pittsburgh Sleep Quality Index, and a self-administered questionnaire. (3) The vast majority of the respondents (81.06%) suffered from insomnia and had poor sleep quality (78.03%). Education (p = 0.038), marital status (p = 0.043), and working with patients suffering from COVID-19 (p = 0.024) were statistically significant contributors to insomnia. Age was found to significantly correlate with total aggression (r = −0.133 p = 0.031), verbal aggression (r = −0.138 p = 0.025), and anger (r = −0.151 p = 0.014). The analysis demonstrated statistically significant relationships between gender and physical aggression (p = 0.017), anger (p = 0.032), and hostility (p = 0.002). A statistically significant positive correlation between the quality of sleep as per the PSQI and all subscales of the BPAQ was found (p < 0.001). (4) A considerable proportion of HCWs experienced sleep disturbances during the outbreak, stressing the need to establish ways to reduce long-term adverse outcomes associated with chronic insomnia and mental health problems and adjust interventions under pandemic conditions.
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Affiliation(s)
- Anna Maria Cybulska
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
| | - Agnieszka Weymann
- Independent Clinical Public Hospital No. 2 in Szczecin, Pomeranian Medical University in Szczecin, Powstancow Wielkopolskich 72, 72-111 Szczecin, Poland
| | - Kamila Rachubińska
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
| | - Szymon Grochans
- Department of Clinical Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
| | - Grzegorz Wójcik
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
| | - Elżbieta Grochans
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
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Grill M. On the Road Again – Using Rule-Oriented and Participative Leadership to Reduce Threats and Violence in the Construction Industry. SCANDINAVIAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2022. [DOI: 10.16993/sjwop.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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Molero Jurado MDM, Gázquez Linares JJ, Pérez‐Fuentes MDC, Martos Martínez Á. Aggression and burnout in nurses during COVID-19: A cross-sectional study. Nurs Health Sci 2022; 25:130-140. [PMID: 36495247 PMCID: PMC9877851 DOI: 10.1111/nhs.13001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/27/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022]
Abstract
Workplace violence against nurses, an ever-present problem in the healthcare workplace, has been increasing with COVID-19 and affects occupational health. This study analyzed the consequences of COVID-19 on violence against nurses, identifying its association with burnout, emphasizing the importance of work-related variables. A total of 1013 actively employed nurses in Spain with a mean age of 34.71 years filled out a computer-assisted web interviewing survey. Aggression as a consequence of their work was reported by 73.44% of the nurses. Those most affected were in primary care, and verbal aggression by patients and their families was the most frequent. Nurses who were attacked scored significantly higher in emotional exhaustion and depersonalization. Furthermore, 83.22% said that COVID-19 was an important factor in the increase in violence toward healthcare workers. Analysis showed that a perceived secure environment was a mediator between the belief that COVID-19 was an influential factor in the increase of violence and the depersonalization dimension of burnout. Increasing perceived security in the work environment among nurses can be effective in promoting well-being, work performance, and commitment to the profession.
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Affiliation(s)
| | | | - María del Carmen Pérez‐Fuentes
- Department of Psychology, Faculty of PsychologyUniversity of AlmeríaAlmeríaSpain,Department of PsychologyUniversidad Politécnica y Artística del ParaguayAsunciónParaguay
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Hu Y, Luo Q, Li R, Zhang M, Wang Y, Su P, Sun J, Li Y, Liu Y, Chen N, Huang Y. Anti-violence measures developed by ILO and WHO: Analysis of the prevalence of workplace violence and the effects of implementation in a general hospital in China. Front Public Health 2022; 10:1049832. [PMID: 36589930 PMCID: PMC9794770 DOI: 10.3389/fpubh.2022.1049832] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022] Open
Abstract
Objective Workplace violence (WPV) not only affects workers' physical and mental health but also increases turnover rates and social costs. There are no studies that have consistently followed the prevalence of WPV and the effectiveness of anti-violence measures in cross-sectional studies of the same hospital. The main aim of this study was to understand the prevalence of WPV among medical staff in a hospital in China and the effectiveness of implemented anti-violence measures. Methods A cross-sectional survey, which was conducted by using a questionnaire developed by the International Labor Organization and the World Health Organization, was administered in a tertiary hospital in China in 2022 to investigate the occurrence of violence in the past year. Valid data were collected from 1,195 respondents via cell phone. WPV was compared between this survey and a baseline survey conducted at the same hospital in 2017 using the same questionnaire. The relationship between years and gender and occupation was explored using the Cochran-Armitage trend test. Descriptive statistics and chi-square tests were used to respond to the effects of the anti-violence interventions. Results After the implementation of anti-violence measures, the prevalence of WPV decreased from 48.47 in 2017 to 33.95% in 2021. The recognition of safety measures increased from 80.16 in 2017 to 87.70% in 2021(P < 0.001), improvement of the work environment increased from 56.57 in 2017 to 65.10% in 2021(P < 0.001), restricted of public access increased from 34.36 in 2017 to 55.60% in 2021(P < 0.001), the patient protocols increased from 37.42 in 2017 to 38.40% in 2021, patient screening increased from 32.11 in 2017 to 41.90% in 2021(P < 0.001), and strict restrictions on workplace cash activities from 29.65% in 2017 to 36.00% in 2021(P < 0.05). The percentage of health workers who felt that anti-violence measures were not at all helpful to their current work decreased from 2017 to 2021. Conclusions The prevalence of workplace violence has decreased, recognition of interventions has increased, and the proportion of interventions that are perceived by HWs as not helpful at all has decreased. This study demonstrates that the 12 anti-violence measures recommended by the International Labor Organization are applicable in China. Based on this, hospitals should focus on the improvement of the intervention effect of the following measures to further prevent violence.
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Affiliation(s)
- Yubing Hu
- Institute of Nursing and Health, Henan University, Kaifeng, China,Department of Nursing, The Third People's Hospital of Zhengzhou, Zhengzhou, China
| | - Qianqian Luo
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rui Li
- Department of Nursing, The Third People's Hospital of Zhengzhou, Zhengzhou, China,*Correspondence: Rui Li
| | - Min Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,Min Zhang
| | - Yuming Wang
- Scientific Research Division, Henan Provincial People's Hospital, Zhengzhou, China
| | - Peipei Su
- Rheumatology Immunology Department, The First Affiliated Hospital of Henan University of CM, Zhengzhou, China
| | - Jing Sun
- Department of Nursing, Central Hospital of Zhengzhou University, Zhengzhou, China
| | - Ying Li
- Out-patient Department, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yujie Liu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Na Chen
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yiming Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Prepandemic Mental Health and Well-being: Differences Within the Health Care Workforce and the Need for Targeted Resources. J Occup Environ Med 2022; 64:1025-1035. [PMID: 36472564 PMCID: PMC9722331 DOI: 10.1097/jom.0000000000002630] [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: 12/12/2022]
Abstract
BACKGROUND Occupational stress and diminished well-being among health care workers were concerning even before the coronavirus disease 2019 pandemic exacerbated existing stressors and created new challenges for this workforce. Research on the mental health of health care workers has focused on physicians and nurses, with less attention to other occupations. METHODS To assess pre-coronavirus disease mental health and well-being among workers in multiple health care occupations, we used 2017 to 2019 data from the Behavioral Risk Factor Surveillance System. RESULTS Across the health care workforce, insufficient sleep (41.0%) and diagnosed depression (18.9%) were the most common conditions reported. Counselors had the highest prevalence of diagnosed depression. Health care support workers had elevated prevalences for most adverse health conditions. CONCLUSIONS Ensuring a robust health care workforce necessitates identifying and implementing effective occupation-specific prevention, intervention, and mitigation strategies that address organizational and personal conditions adversely affecting mental health.
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