1
|
Liu J, Zheng H, Lu L, Liu H, Xu X, He W. The impact of patients' hostile attribution bias on aggression in doctor-patient interactions. Heliyon 2024; 10:e23971. [PMID: 38268606 PMCID: PMC10805917 DOI: 10.1016/j.heliyon.2024.e23971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 12/06/2023] [Accepted: 01/01/2024] [Indexed: 01/26/2024] Open
Abstract
Background Doctor-patient conflict is trending in social attention research. However, the existing literature rarely explores whether a patient's hostile attribution bias (HAB) in the doctor-patient interaction affects the aggression level against doctors. Objective This study aimed to explore the relationship and mechanism between different types of HAB and aggression in patients. Method In Study 1, 80 patients completed the word sentence association paradigm for hostility (WSAP-Hostility), and their explicit and implicit aggression levels were measured using the hot sauce paradigm and the single-category implicit association test (SC-IAT), respectively. In Study 2, 63 patients were randomly divided into an experimental (rejection) and a control group. Their state hostile attribution bias (SHAB) was activated through social rejection materials. They completed the SHAB questionnaire and anger expression inventory, and their explicit and implicit aggression levels were measured as in Study 1. Results In both studies, results indicated that patients' trait and state HAB were significantly related to explicit aggression but not implicit aggression. Hostile interpretation positively predicted explicit aggression, whereas benign interpretation had a negative predictive effect on explicit aggression. Patients' anger played a mediating role between SHAB and explicit aggression. Conclusions These findings suggest that patients' HAB affects explicit aggression toward doctors and anger plays a mediating role.
Collapse
Affiliation(s)
- Jie Liu
- School of Psychology, Shanghai Normal University, Shanghai, 200234, China
| | - Hong Zheng
- Changning Mental Health Center Affiliated with East China Normal University, Shanghai, China
| | - Lu Lu
- School of Psychology, Shanghai Normal University, Shanghai, 200234, China
| | - Hongying Liu
- Hangzhou Kang Sheng Health Consulting Co., Ltd. Hangzhou 310023, China
| | - Xiongwei Xu
- School of Education, Shanghai Normal University, Shanghai, 200234, China
| | - Wen He
- School of Psychology, Shanghai Normal University, Shanghai, 200234, China
| |
Collapse
|
2
|
Vu LG, Nguyen Hoang L, Le Vu Ngoc M, Nguyen Si Anh H, Nathan N, Trong Dam VA, Vu TMT, Latkin CA, Ho CSH, Ho RCM. Professional Preparedness Implications of Workplace Violence against Medical Students in Hospitals: A Cross-Sectional Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231179894. [PMID: 37318194 DOI: 10.1177/00469580231179894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Workplace violence is an increasing public health concern around the world. In Vietnam, attacks on healthcare workers have become a huge issue in recent years. Our study aims to shed more light on the issue and look at what variables affect acts of violence toward healthcare workers. We conducted this cross-sectional study by surveying 550 medical students from 3 universities in Vietnam. Following this survey on SurveyMonkey's platform (surveymonkey.com), the participants were suggested to invite their associates who met the selection criteria to join in this online survey. The structured questionnaire included demographics and details on the violence. There were 90.5% of respondents were medical students, the mean age was 23.3, and verbal abuse had a prevalence rate of 29.3%. Women respondents are less likely to suffer from violent experiences than men (OR = 0.48, 95% CI = 0.28-0.84), and those specializing in nurse and technician also faced a lower rate of acts of aggression (physical violence: OR = 0.35; 95% CI = 0.19-0.63, sexual harassment: OR = 0.36; 95% CI = 0.15-0.87, and any type of violence: OR = 0.55, 95% CI = 0.37-0.82). Medical students working in Ho Chi Minh City (OR = 0.55; 95% CI = 0.34-0.89), and other regions (OR = 0.40; 95% CI = 0.19-0.85) were significantly less likely to face verbal abuse than those working in Hanoi. The workplace culture needs to be changed to make sure that people feel comfortable reporting, especially those who are younger. Protecting medical students also ensures patient safety since victims of assault in the workplace can have severe aftereffects affecting their ability to provide good patient care. Hence, policies need to be implemented at both the government and hospital administration levels to keep health workers safe.
Collapse
Affiliation(s)
- Linh Gia Vu
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Long Nguyen Hoang
- VNU School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Minh Le Vu Ngoc
- Institute of Health Economics and Technology (iHEAT), Hanoi, Vietnam
| | - Hao Nguyen Si Anh
- Institute of Health Economics and Technology (iHEAT), Hanoi, Vietnam
| | - Nila Nathan
- Quantitative Biomedical Sciences, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | - Vu Anh Trong Dam
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Thuc Minh Thi Vu
- Institute of Health Economics and Technology (iHEAT), Hanoi, Vietnam
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
| |
Collapse
|
3
|
Grant SL, Hartanto S, Sivasubramaniam D, Heritage K. Occupational violence and aggression in urgent and critical care in rural health service settings: A systematic review of mixed studies. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3696-e3715. [PMID: 36165419 PMCID: PMC10086783 DOI: 10.1111/hsc.14039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 07/27/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Rural/remote health services are vulnerable to occupational violence and aggression due to factors such as weapon accessibility, poor network coverage and distance to backup. This systematic review investigated (1) the nature of occupational violence and aggression perpetrated in rural/remote health service urgent care settings and (2) the availability and effectiveness of policies/interventions/recommendations that address occupational violence and aggression in this context. We searched Business Source Complete, CINAHL Complete, Health & Society, APAIS Health, Health Collection, PsycINFO, PubMed, Scopus, SocIndex and Web of Science. Included articles (peer-reviewed, no grey literature and English language) addressed occupational violence and aggression in rural health service urgent care settings. Fifteen articles matched these criteria (total [rural/remote only, where specified] N ~ 2555) and were included in the final analysis. The Mixed Methods Appraisal Tool was applied to assess the risk of bias. A data extraction table and narrative synthesis are presented. The most common occupational violence and aggression type was verbal aggression. The primary perpetrator was patients. Risk factors reflected practitioner age, remoteness, sector, staffing, shift type and area of practice. Precipitating factors were alcohol/drugs, dissatisfaction and mental health conditions. Policy content and limitations and education/training programme effectiveness were not addressed. Community collaboration supported occupational violence and aggression prevention/management. Organisational culture should promote reporting, debriefing and post-incident care for staff well-being. Work environment and job/task design are priorities for safety, but with possible limitations for traumatised clients. Occupational violence and aggression policies/interventions in rural health settings must be systematically evaluated to inform best practices. Co-funded by Swinburne Social Innovation Research Institute Interdisciplinary Seed Funding Scheme and SMART Rural Health Network.
Collapse
Affiliation(s)
- Sharon L. Grant
- Department of Psychological SciencesSwinburne University of TechnologyHawthornVictoriaAustralia
| | | | - Diane Sivasubramaniam
- Department of Psychological SciencesSwinburne University of TechnologyHawthornVictoriaAustralia
| | - Kaye Heritage
- Institute of Health and WellbeingFederation University AustraliaBallaratVictoriaAustralia
| |
Collapse
|
4
|
Chaffkin J, Barnes TA, Avila Quintero VJ, Flores JM, Lin E, Wasser T. Characteristics of Assaultive Patients Whom Inpatient Psychiatric Staff Report to Law Enforcement. Psychiatr Serv 2022; 73:768-773. [PMID: 35172591 DOI: 10.1176/appi.ps.202100140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors sought to identify factors that affect hospital staff's decision to pursue criminal charges against patients who assault staff on inpatient psychiatric units. METHODS Data on assaults occurring on inpatient psychiatric units in one hospital system were collected over 32 months, from November 1, 2016, to July 1, 2019. The events were grouped by whether staff pursued criminal charges after the incident. Descriptive statistics and regression models were used to describe the data and identify predictive variables. RESULTS Data were reviewed from 9,654 admissions, of which 124 patient encounters involved assaults on staff. Overall, 27 (22%) of 124 assaults on staff resulted in staff pursuing criminal charges. Regression models indicated that criminal history (odds ratio [OR]=2.18, 95% CI=1.26-3.78, p=0.006), age (OR=0.92, 95% CI=0.91-0.94, p<0.001), and diagnosis of chronic mental illness with psychotic symptoms (OR=7.23, 95% CI=1.49-35.04, p=0.01) predicted patient assaults resulting in contact with law enforcement. Several variables were not statistically significantly associated with filing of criminal charges, including race, gender, degree of injury from the assault, number of instances of restraint, and number of as-needed medications. CONCLUSIONS This is the largest quantitative study to examine the demographic and clinical factors that may play a role in whether staff pursue criminal charges against patients on inpatient psychiatric units. The results suggest that certain patients are more likely to be reported to law enforcement. Institutions should monitor factors that increase the likelihood of assaults on staff resulting in criminal charges and create policies that mitigate discrepancies in criminal justice involvement.
Collapse
Affiliation(s)
- Jessica Chaffkin
- Yale University School of Medicine, New Haven, Connecticut (Chaffkin, Avila Quintero, Flores, Lin, Wasser); Yale-New Haven Psychiatric Hospital, New Haven, Connecticut (Barnes)
| | - Todd A Barnes
- Yale University School of Medicine, New Haven, Connecticut (Chaffkin, Avila Quintero, Flores, Lin, Wasser); Yale-New Haven Psychiatric Hospital, New Haven, Connecticut (Barnes)
| | - Victor J Avila Quintero
- Yale University School of Medicine, New Haven, Connecticut (Chaffkin, Avila Quintero, Flores, Lin, Wasser); Yale-New Haven Psychiatric Hospital, New Haven, Connecticut (Barnes)
| | - Jose M Flores
- Yale University School of Medicine, New Haven, Connecticut (Chaffkin, Avila Quintero, Flores, Lin, Wasser); Yale-New Haven Psychiatric Hospital, New Haven, Connecticut (Barnes)
| | - Eric Lin
- Yale University School of Medicine, New Haven, Connecticut (Chaffkin, Avila Quintero, Flores, Lin, Wasser); Yale-New Haven Psychiatric Hospital, New Haven, Connecticut (Barnes)
| | - Tobias Wasser
- Yale University School of Medicine, New Haven, Connecticut (Chaffkin, Avila Quintero, Flores, Lin, Wasser); Yale-New Haven Psychiatric Hospital, New Haven, Connecticut (Barnes)
| |
Collapse
|
5
|
Naseem M, Shahil Feroz A, Arshad H, Ashraf S, Asim M, Jamali S, Mian A. Perceptions, challenges and experiences of frontline healthcare providers in Emergency Departments regarding Workplace Violence during the COVID-19 pandemic: A protocol for an exploratory qualitative study from an LMIC. BMJ Open 2022; 12:e055788. [PMID: 35135775 PMCID: PMC8830240 DOI: 10.1136/bmjopen-2021-055788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Workplace violence (WPV) against Healthcare Workers (HCWs) has emerged as a global issue. Emergency Department (ED) HCWs as front liners are more vulnerable to it due to the nature of their work and exposure to unique medical and social situations. COVID-19 pandemic has led to a surge in the number of cases of WPV against HCWs, especially against ED HCWs. In most cases, the perpetrators of these acts of violence are the patients and their attendants as families. The causes of this rise are multifactorial; these include the inaccurate spread of information and rumours through social media, certain religious perspectives, propaganda and increasing anger and frustration among the general public,ED overcrowding, staff shortages etc. We aim to conduct a qualitative exploratory study among the ED frontline care providers at the two major EDs of Karachi city. The purpose of this study is to determine the perceptions, challenges and experiences regarding WPV faced by ED healthcare providers during the COVID-19 pandemic. METHODS AND ANALYSIS For this research study, a qualitative exploratory research design will be employed using in-depth interviews and a purposive sampling approach. Data will be collected using in-depth interviews from study participants working at the EDs of Jinnah Postgraduate Medical Centre (JPMC) and the Aga Khan University Hospital(AKUH) Karachi, Pakistan. Thestudy data will be analysed thematically using NVivo V.12 Plus software. ETHICS AND DISSEMINATION The ethical approval for this study was obtained from the Aga Khan University Ethical Review Committee and from Jinnah postgraduate Medical Center (JPMC). The results of the study will be disseminated to the scientific community and to the research subjects participating in the study.The findings of this study will help to explore the perceptions of ED healthcare providers regarding WPV during the COVID-19 pandemic and provide a better understanding of study participant's' challenges concerning WPV during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Maleeha Naseem
- Community Health Sciences, The Aga Khan University, Karachi, Pakistan
| | - Anam Shahil Feroz
- Community Health Sciences, The Aga Khan University, Karachi, Pakistan
- Dalla Lana School of Public Health, Institute of Health Policy Management and Evaluation, Toronto, Ontario, Canada
| | - Hajra Arshad
- Medical College, The Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Sarah Ashraf
- Medical College, The Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Muhammad Asim
- Community Health Sciences, The Aga Khan University, Karachi, Pakistan
| | - Seemin Jamali
- Emergency Department, Jinnah Post Graduate Medical Centre, Karachi, Pakistan
| | - Asad Mian
- Emergency Medicine, The Aga Khan University Hospital, Karachi, Sindh, Pakistan
| |
Collapse
|
6
|
SAHİP T, GAMSIZKAN Z, CANGÜR Ş. Exposure of Violence and its Effects on Health Care Workers. KONURALP TIP DERGISI 2021. [DOI: 10.18521/ktd.861057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
7
|
Al‐Qadi MM. Workplace violence in nursing: A concept analysis. J Occup Health 2021; 63:e12226. [PMID: 33960074 PMCID: PMC8103077 DOI: 10.1002/1348-9585.12226] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/15/2021] [Accepted: 04/05/2021] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES To clarify the concept of workplace violence in nursing and propose an operational definition of the concept. METHODS The review method used was Walker and Avant's eight-step method. RESULTS Identification of the key attributes, antecedents, consequences, and empirical referents of the concept resulted in an operational definition of the concept. The proposed operational definition identifies workplace violence experienced by nurses as any act or threat of verbal or physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the worksite with the intention of abusing or injuring the target. CONCLUSIONS Developing insights into the concept will assist in the design of new research scales that can effectively measure the underlying issues, provide a framework that facilitates nursing interventions, and improve the validity of future studies.
Collapse
|
8
|
Senz A, Ilarda E, Klim S, Kelly AM. Development, implementation and evaluation of a process to recognise and reduce aggression and violence in an Australian emergency department. Emerg Med Australas 2020; 33:665-671. [PMID: 33336468 DOI: 10.1111/1742-6723.13702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 11/25/2020] [Accepted: 11/28/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE In 2018, we developed and implemented a novel approach to recognition and response to occupational violence and aggression (OVA). It included routine use of the Brøset Violence Checklist for all ED patients integrated with a score-based notification and response framework. The present study evaluated the impact of the new process on staff knowledge, perceptions and confidence regarding OVA in ED and the rate of security events related to OVA. METHODS The present study was conducted in a metropolitan hospital ED in Australia. Evaluation was by online before and after survey of nursing staff, point prevalence study of risk classification and comparison of OVA-related events involving security in the year before implementation and the year after the programme was embedded. RESULTS One percent of patients were assessed as high violence risk with a further 4% at moderate risk. The introduction of the Brøset Violence Checklist increased documentation of violence risk assessment. It also improved staff perception of organisational support and awareness of behaviours associated with the risk of violence. There was a statistically significant reduction in unplanned OVA-related security responses (relative risk 0.75, 95% confidence interval 0.62-0.89). There was also a statistically significant shift to proactive management through early detection and intervention (relative risk 2.22, 95% confidence interval 1.85-2.66). CONCLUSION A process including routine OVA risk assessment and a notification and response framework reduced unplanned security events due to OVA and increased staff confidence in recognition and management of OVA. This approach may be suitable for use more broadly in ED.
Collapse
Affiliation(s)
- Ainslie Senz
- Department of Emergency Medicine, Footscray Hospital, Melbourne, Victoria, Australia
| | - Elisa Ilarda
- Occupational Violence and Aggression Prevention, Safety, Risk and Emergency Management, Western Health, Melbourne, Victoria, Australia
| | - Sharon Klim
- Joseph Epstein Centre for Emergency Medicine Research, Western Health, Melbourne, Victoria, Australia
| | - Anne-Maree Kelly
- Joseph Epstein Centre for Emergency Medicine Research, Western Health, Melbourne, Victoria, Australia.,School of Medicine, Western Clinical School, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
9
|
Zoleo M, Della Rocca F, Tedeschi F, Zucchetto M, Maddalena G, Vettore G. Violence against health workers: findings from three emergency departments in the teaching hospital of Padua, Italy. Intern Emerg Med 2020; 15:1067-1074. [PMID: 32072369 DOI: 10.1007/s11739-020-02290-7] [Citation(s) in RCA: 4] [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: 08/03/2019] [Accepted: 01/30/2020] [Indexed: 11/26/2022]
Abstract
Emergency departments (EDs) are high-risk places for Workplace Violence (WPV). In Italy, this phenomenon is scarcely investigated. The aim of this study is to evaluate the incidence, experiencing and perception of WPV in the general ED (GED), paediatric ED (PED) and obstetric-gynaecological ED (OGED) of the teaching hospital Azienda Ospedaliera in Padua (AOP). We led a cross-sectional study among the GED, OGED and PED staffs, submitting an anonymous questionnaire, regarding personal information, verbal and physical aggression experiences, risk factors and proposals for corrective actions. Our sample consists of 73 people from GED, 45 from OGED and 53 from PED. Aggressions are common. Verbal aggressions are almost never recorded, even in the case of physical aggressions, 41% did not signal the event. Both in GED and in OGED, most of the staff (68.9% and 75.0%, respectively) underwent aggression by neither psychiatric nor substance abuser patients (PSAPs). Physical aggressions are more common in GED than in OGED and in PED; most of professionals were assaulted by PSAPs. In all EDs, verbal or physical assault has been lived through by anger, resignation or fear, rarely by indifference. Professionals think there are structural characteristics and risk factors that could be corrected. They do not know how to manage assaults and would deem it useful training meetings with experts. Our results regarding how staff perceive and experience violence in the ED concern a local situation, that nevertheless reflect current evidence about the topic of WPV which plagues EDs across the globe.
Collapse
Affiliation(s)
- Miranda Zoleo
- Aulss 4 Veneto Orientale Emergency Department Portogruaro, CAP 30026, Portogruaro, Venetia, Italy.
| | - Foscarina Della Rocca
- Pronto Soccorso Azienda Ospedaliera Di Padova, Via Giustiniani 2, 35122, Padua, Italy
| | - Federico Tedeschi
- Section of Psychiatry, Department Neurosciences Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro, 10, 37134, Verona, Italy
| | - Mirka Zucchetto
- Pronto Soccorso Di San Donà Di PiaveULSS 4 Veneto, Orientale Via Nazario Sauro, 25, 30027, San Donà di Piave, Venetia, Italy
| | - Giovanna Maddalena
- Pronto Soccorso VeneziaULSS 3 Veneto, Sestiere Castello, 6777, 30122, Venice, Italy
| | - Gianna Vettore
- Coordinamento Regionale Emergenza Urgenza Regione Veneto, Via Giustiniani 2, Padua, Italy
| |
Collapse
|
10
|
Nurses' perspectives of violence in emergency departments: A metasynthesis. Int Emerg Nurs 2020; 52:100905. [PMID: 32818745 DOI: 10.1016/j.ienj.2020.100905] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 07/03/2020] [Accepted: 07/14/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Workplace violence against nurses in the Emergency Department (ED) is a significant issue worldwide and has received increased attention. Workplace violence against nurses in the ED has increased in recent years. With such a large number of nurses having experienced violence, it is important to understand and elucidate the nurses' perspective of violence in the ED. METHOD Qualitative studies that were published between 2010 and 2019. A metasynthesis of 6 qualitative studies was conducted using Noblit and Hare's metaethnographic methodology. The Critical Appraisal Skills Program (CASP) was used to evaluate the quality of the studies. RESULTS Four overarching themes emerged from the data: the inevitability of violence, invisible wounds and painful memories, post-violence repercussions, and double-sided: physical and verbal abuse. DISCUSSION Findings provide insight into policies actions related to perpetrators and developing violence protections guidelines to support ED nurses in managing workplace violence. CONCLUSION Violence in the ED is an inevitable experience for nurses. Organizations must take a realistic approach to implement violence reduction measures and training programs in the ED.
Collapse
|
11
|
Tomagová M, Zeleníková R, Kozáková R, Žiaková K, Babiarczyk B, Turbiarz A. Violence against nurses in healthcare facilities in the Czech Republic and Slovakia. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2020. [DOI: 10.15452/cejnm.2020.11.0009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
|
12
|
Pariona‐Cabrera P, Cavanagh J, Bartram T. Workplace violence against nurses in health care and the role of human resource management: A systematic review of the literature. J Adv Nurs 2020; 76:1581-1593. [DOI: 10.1111/jan.14352] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 01/25/2020] [Accepted: 03/04/2020] [Indexed: 12/16/2022]
|
13
|
Yeh TF, Chang YC, Feng WH, sclerosis M, Yang CC. Effect of Workplace Violence on Turnover Intention: The Mediating Roles of Job Control, Psychological Demands, and Social Support. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2020; 57:46958020969313. [PMID: 33334214 PMCID: PMC7750754 DOI: 10.1177/0046958020969313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/27/2020] [Accepted: 10/03/2020] [Indexed: 11/16/2022]
Abstract
Exposing nursing staff to workplace violence workplace violence (WV) affects their psychological, emotional, and physical health; engenders increased workload; affects the medical reciprocity between nurses and patients; and ultimately leads to staff turnover intention. To preventing WV, development of intervention strategies and WV prevention measures are crucial. This study discusses the mediating effect of job control, psychological needs, and social support on WV and turnover intention. Through this discussion, this study aims to aid medical institutions in reducing their nursing staff turnover rate and to provide a reference for hospital management and decision making. A cross-sectional research method was adopted and conducted quantitative research to prove the complexity of the relationship between WV and turnover intention. Participants comprised clinical nurses working in 2 regional teaching hospital in central Taiwan. A total of 268 questionnaires were distributed, and 213 completed questionnaires were returned. Of the returned questionnaires, 198 contained valid responses, yielding a response rate of 73.9%. Our results demonstrated the mechanisms through which psychological demands and social support mediate the relationship between WV and turnover intention. This study determined the mediating effects of psychological demands and social support. The results expand the findings of previous research and demonstrate the complexity of the relationship between WV and turnover intention. Hospitals should formulate effective mechanisms for preventing and addressing incidents of WV, improve their ability to address and regulate violent incidents in clinics, reduce the psychological pressure exerted on employees, and establish communication channels for social support.
Collapse
Affiliation(s)
- Te-Feng Yeh
- Central Taiwan University of Science and
Technology, Taichung
| | | | | | | | | |
Collapse
|
14
|
Cai R, Tang J, Deng C, Lv G, Xu X, Sylvia S, Pan J. Violence against health care workers in China, 2013-2016: evidence from the national judgment documents. HUMAN RESOURCES FOR HEALTH 2019; 17:103. [PMID: 31878939 PMCID: PMC6933725 DOI: 10.1186/s12960-019-0440-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 12/02/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Incidents of patient-initiated workplace violence against health care workers have been a subject of substantial public attention in China. Patient-initiated violence not only represents a risk of harm to health care providers but is also indicative of general tensions between doctors and patients which pose a challenge to improving health system access and quality. This study aims to provide a systematic, national-level characterization of serious workplace violence against health care workers in China. METHODS This study extracted data from the China Judgment Online System, a comprehensive database of judgment documents. Three key phrases, "criminal case," "health care institution," and "health care worker" were used to search the China Judgment Online System for relevant cases between January 1, 2013, and December 31, 2016. Data extracted from identified cases was used to document the occurrence, the degree of risk, and the factors associated with serious workplace violence. RESULTS In total, 459 criminal cases involving patient-initiated workplace violence against health care workers in China were reported and processed. The analysis revealed geographic heterogeneity in the occurrence of serious workplace violence, with lower incidence in western provinces compared to central and eastern provinces. Primary hospitals experienced the highest rates of serious workplace violence and emergency departments and doctors were at higher risk compared with other departments and health workers. Perpetrators were primarily male farmers aged 18 to 44 with low levels of education. The most frequently reported reasons of serious patient-initiated workplace violence included perceived medical malpractice by the perpetrator after the death of a patient, death of a patient with no other reason given, failures of the compensation negotiations after the death of a patient, and dissatisfaction with the treatment outcomes. CONCLUSIONS Serious workplace violence against providers varies across regions and types of health care institutions in China. Perception of low-quality care is the most reported reason for violence. Efforts should be made to improve quality of care in the low-level health institutions and strengthen the doctor-patient communication during the whole course of service.
Collapse
Affiliation(s)
- Ruilie Cai
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17, Section 3, Ren Min Nan Road, Chengdu, 610041 Sichuan China
- West China Research Center for Rural Health Development, Sichuan University, No. 17, Section 3, Ren Min Nan Road, Chengdu, 610041 Sichuan China
| | - Ji Tang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17, Section 3, Ren Min Nan Road, Chengdu, 610041 Sichuan China
- West China Research Center for Rural Health Development, Sichuan University, No. 17, Section 3, Ren Min Nan Road, Chengdu, 610041 Sichuan China
| | - Chenhui Deng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17, Section 3, Ren Min Nan Road, Chengdu, 610041 Sichuan China
- West China Research Center for Rural Health Development, Sichuan University, No. 17, Section 3, Ren Min Nan Road, Chengdu, 610041 Sichuan China
| | - Guofan Lv
- School of Civil Aviation Security, Civil Aviation Flight University of China, NO. 46, Nanchang Road, Guanghan, 618307 Sichuan China
| | - Xiaohe Xu
- School of Public Administration, Sichuan University, Chengdu, China
- Department of Sociology, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249 United States of America
| | - Sean Sylvia
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1101D McGavran-Greenberg Hall, CB#7411, Chapel Hill, NC 27599-7411 United States of America
| | - Jay Pan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 17, Section 3, Ren Min Nan Road, Chengdu, 610041 Sichuan China
- West China Research Center for Rural Health Development, Sichuan University, No. 17, Section 3, Ren Min Nan Road, Chengdu, 610041 Sichuan China
| |
Collapse
|
15
|
Touzet S, Occelli P, Denis A, Cornut PL, Fassier JB, Le Pogam MA, Duclos A, Burillon C. Impact of a comprehensive prevention programme aimed at reducing incivility and verbal violence against healthcare workers in a French ophthalmic emergency department: an interrupted time-series study. BMJ Open 2019; 9:e031054. [PMID: 31492791 PMCID: PMC6731840 DOI: 10.1136/bmjopen-2019-031054] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE AND SETTING Primary prevention, comprising patient-oriented and environmental interventions, is considered to be one of the best ways to reduce violence in the emergency department (ED). We assessed the impact of a comprehensive prevention programme aimed at preventing incivility and verbal violence against healthcare professionals working in the ophthalmology ED (OED) of a university hospital. INTERVENTION The programme was designed to address long waiting times and lack of information. It combined a computerised triage algorithm linked to a waiting room patient call system, signage to assist patients to navigate in the OED, educational messages broadcast in the waiting room, presence of a mediator and video surveillance. PARTICIPANTS All patients admitted to the OED and those accompanying them. DESIGN Single-centre prospective interrupted time-series study conducted over 18 months. PRIMARY OUTCOME Violent acts self-reported by healthcare workers committed by patients or those accompanying them against healthcare workers. SECONDARY OUTCOMES Waiting time and length of stay. RESULTS There were a total of 22 107 admissions, including 272 (1.4%) with at least one act of violence reported by the healthcare workers. Almost all acts of violence were incivility or verbal harassment. The rate of violence significantly decreased from the pre-intervention to the intervention period (24.8, 95% CI 20.0 to 29.5, to 9.5, 95% CI 8.0 to 10.9, acts per 1000 admissions, p<0.001). An immediate 53% decrease in the violence rate (incidence rate ratio=0.47, 95% CI 0.27 to 0.82, p=0.0121) was observed in the first month of the intervention period, after implementation of the triage algorithm. CONCLUSION A comprehensive prevention programme targeting patients and environment can reduce self-reported incivility and verbal violence against healthcare workers in an OED. TRIAL REGISTRATION NUMBER NCT02015884.
Collapse
Affiliation(s)
- Sandrine Touzet
- Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
- Laboratoire Health Services and Performance Research (HESPER) EA 7425, Université de Lyon, Lyon, France
| | - Pauline Occelli
- Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
- Laboratoire Health Services and Performance Research (HESPER) EA 7425, Université de Lyon, Lyon, France
| | - Angelique Denis
- Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Pierre-Loïc Cornut
- Hôpital Edouard Herriot, Service d'ophtalmologie, Hospices Civils de Lyon, Lyon, France
| | - Jean-Baptiste Fassier
- Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
- UMRESTTE, Université de Lyon, Lyon, France
| | - Marie-Annick Le Pogam
- Institute of Social and Preventive Medicine (IUMSP), University Hospital of Lausanne, Lausanne, Switzerland
| | - Antoine Duclos
- Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
- Laboratoire Health Services and Performance Research (HESPER) EA 7425, Université de Lyon, Lyon, France
| | - Carole Burillon
- Hôpital Edouard Herriot, Service d'ophtalmologie, Hospices Civils de Lyon, Lyon, France
| |
Collapse
|
16
|
Cabilan CJ, Johnston ANB. Review article: Identifying occupational violence patient risk factors and risk assessment tools in the emergency department: A scoping review. Emerg Med Australas 2019; 31:730-740. [DOI: 10.1111/1742-6723.13362] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 06/26/2019] [Accepted: 07/01/2019] [Indexed: 12/24/2022]
Affiliation(s)
- CJ Cabilan
- Emergency DepartmentPrincess Alexandra Hospital Brisbane Queensland Australia
- School of Nursing, Midwifery and Social WorkThe University of Queensland Brisbane Queensland Australia
| | - Amy NB Johnston
- Emergency DepartmentPrincess Alexandra Hospital Brisbane Queensland Australia
- School of Nursing, Midwifery and Social WorkThe University of Queensland Brisbane Queensland Australia
| |
Collapse
|
17
|
Senz A, Ilarda E, Klim S, Kelly AM. Introducing routine risk assessment for occupational violence and aggression in the emergency department. Emerg Med Australas 2019; 31:897-898. [PMID: 31342639 DOI: 10.1111/1742-6723.13358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 06/26/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Ainslie Senz
- Emergency Medicine, Footscray Hospital, Melbourne, Victoria, Australia
| | - Elisa Ilarda
- Occupational Violence and Aggression Prevention, Safety, Risk and Improvement, Western Health, Melbourne, Victoria, Australia
| | - Sharon Klim
- Joseph Epstein Centre for Emergency Medicine Research, Western Health, Melbourne, Victoria, Australia
| | - Anne-Maree Kelly
- Joseph Epstein Centre for Emergency Medicine Research, Western Health, Melbourne, Victoria, Australia.,Department of Medicine, Melbourne Medical School - Western Precinct, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
18
|
Kleissl-Muir S, Raymond A, Rahman MA. Analysis of patient related violence in a regional emergency department in Victoria, Australia. Australas Emerg Care 2019; 22:126-131. [PMID: 31042524 DOI: 10.1016/j.auec.2019.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 01/22/2019] [Accepted: 01/22/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Emergency Departments (ED) have been identified as high-risk areas for patient related violence (PRV). The aim of the present study was to analyse recorded events of violence in a regional Victorian hospital ED, and examine the association these events had with substance abuse. METHODS A retrospective cohort study was undertaken to establish the incidence of PRV. Data were obtained from the hospital's incident management system, RiskMan, over a five and a half year period for all violent events categorised as Code Grey (CG) and Code Black (CB). The Haddon Matrix attached to the individual incident record was also reviewed. RESULTS A total of 548 violent events were analysed. The incident rate was 3.4 per 1000 ED presentations. Intoxication was the primary reason for violent escalations. There was no association between the frequency of CG events and the day of the week, month of admission, or shift of the day. Intoxicated men (110, 64.3%) were more likely to be the instigator of a violent event compared with intoxicated females (61, 35.7%) (OR 1.5, 95% CI: 1.19-2.02, p<0.001). A form of restraint, chemical, physical or both, was used in the majority of violent events (376, 68.6%). CONCLUSION This study demonstrated an increasing frequency of violent events in the regional ED. Rates of PRV were comparable to those reported in metropolitan hospitals. Intoxication was the most frequently observed underlying factor for PRV. Regional hospitals are in need of additional resources to instigate policies and procedures that will maximise patient and staff safety.
Collapse
Affiliation(s)
- Sabine Kleissl-Muir
- Department of Acute Care Services, Latrobe Regional Hospital, Traralgon, Victoria, Australia; School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.
| | - Anita Raymond
- Department of Research, Education and Training, Latrobe Regional Hospital, Traralgon, Victoria, Australia
| | - Muhammad Aziz Rahman
- Austin Clinical School of Nursing, La Trobe University, Heidelberg, Victoria, Australia
| |
Collapse
|
19
|
Kleissl-Muir S, Raymond A, Rahman MA. Incidence and factors associated with substance abuse and patient-related violence in the emergency department: A literature review. Australas Emerg Care 2018; 21:159-170. [DOI: 10.1016/j.auec.2018.10.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 10/14/2018] [Accepted: 10/15/2018] [Indexed: 12/29/2022]
|
20
|
Li P, Xing K, Qiao H, Fang H, Ma H, Jiao M, Hao Y, Li Y, Liang L, Gao L, Kang Z, Cui Y, Sun H, Wu Q, Liu M. Psychological violence against general practitioners and nurses in Chinese township hospitals: incidence and implications. Health Qual Life Outcomes 2018; 16:117. [PMID: 29871642 PMCID: PMC5989437 DOI: 10.1186/s12955-018-0940-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 05/21/2018] [Indexed: 11/16/2022] Open
Abstract
Background International reports indicating that around 10–50% of health care staff are exposed to violence every year; in certain settings, this rate might reach over 85%. Evidence has shown that people who experience psychological violence are seven times as likely to be victims of physical violence. Although there have been numerous studies on WPV in general hospitals, there is no consensus regarding the current status of psychological violence directed at health care workers in township hospitals in China. The purpose of this study was to estimate the prevalence and the risk factors of psychological violence in Chinese township hospitals. Methods A retrospective cross-sectional survey of township hospitals general practitioners and general nurses was conducted in Heilongjiang Province, China.Descriptive analyses and binary logistic regression analysis were used to estimated the prevalence and the risk factors of psychological violence. Results Regardless of whether the assessment period was the past 12 months, past 36 months, or during their entire career,GPs and nurses reported that verbal abuse was the most common type of psychological violence (28.05, 30.28, 38.69 and 40.45%, 43.86, 54.02%).The main perpetrator was patients’ relatives. Most participants responded to violence with “pretend nothing happened”, 55.63% of GPs and 62.64% of nurses reported that the perpetrator received no punishment. Around 47.62% of respondents reported that their workplace had no procedures for reporting violence. When workplaces did have a reporting system, 57.73% knew how to use them. Only 36.98% had training in managing aggression and violence. General nurses, individuals 35 years or younger, those with higher professional titles and who work in shifts are at greater risk of psychological violence. Conclusions Our results indicate a high prevalence of psychological violence in Chinese township hospitals, which can no longer be ignored. Effective measures should be taken to prevent and respond to workplace violence(WPV), especially psychological violence. Trial registration (Project Identification Code: HMUIRB20160014), Registered May 10, 2016.
Collapse
Affiliation(s)
- Peng Li
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, 150081, China
| | - Kai Xing
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, 150081, China
| | - Hong Qiao
- Endocrine and Metabolic Diseases, the 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150081, China
| | - Huiying Fang
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, 150081, China
| | - Hongkun Ma
- Department of Health Management, Harbin Medical University, Harbin, 150081, China
| | - Mingli Jiao
- Department of Health Policy and Hospital Management, School of Public Health, Harbin Medical University, Harbin, 150081, China. .,Institute of Quantitative and Technical Economics, Chinese Academy of Social Science, Beijing, 100000, China.
| | - Yanhua Hao
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, 150081, China
| | - Ye Li
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, 150081, China
| | - Libo Liang
- Department of Medical Demography, School of Public Health, Harbin Medical University, Harbin, 150081, China
| | - Lijun Gao
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, 150081, China
| | - Zheng Kang
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, 150081, China
| | - Yu Cui
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, 150081, China
| | - Hong Sun
- Department of Medical Demography, School of Public Health, Harbin Medical University, Harbin, 150081, China
| | - Qunhong Wu
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, 150081, China.
| | - Ming Liu
- Otorhinolaryngology, the 2nd Affiliated Hospital of Harbin Medical University, Harbin, 150081, China.
| |
Collapse
|
21
|
Ashton RA, Morris L, Smith I. A qualitative meta-synthesis of emergency department staff experiences of violence and aggression. Int Emerg Nurs 2018; 39:13-19. [PMID: 29326038 DOI: 10.1016/j.ienj.2017.12.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/22/2017] [Accepted: 12/20/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Patient and visitor violence or aggression against healthcare workers in the Emergency Department (ED) is a significant issue worldwide. This review synthesises existing qualitative studies exploring the first-hand experiences of staff working in the ED to provide insight into preventing this issue. METHOD A meta-ethnographic approach was used to review papers. RESULTS Four concepts were identified: 'The inevitability of violence and aggression'; 'Staff judgments about why they face violence and aggression'; 'Managing in isolation'; and 'Wounded heroes'. DISCUSSION Staff resigned themselves to the inevitability of violence and aggression, doing this due to a perceived lack of support from the organisation. Staff made judgements about the reasons for violent incidents which impacted on how they coped and subsequently tolerated the aggressor. Staff often felt isolated when managing violence and aggression. Key recommendations included: Staff training in understanding violence and aggression and clinical supervision. CONCLUSION Violence and aggression in the ED can often be an overwhelming yet inevitable experience for staff. A strong organisational commitment to reducing violence and aggression is imperative.
Collapse
Affiliation(s)
| | - Lucy Morris
- Merseycare NHS Foundation Trust, Whalley, Lancashire BB7 9PE, UK
| | - Ian Smith
- Furness College, Lancaster University, Lancaster LA1 4YG, UK.
| |
Collapse
|
22
|
Smalley CM, O'Neil M, Engineer RS, Simon EL, Snow GM, Podolsky SR. Dangerous weapons confiscated after implementation of routine screening across a healthcare system. Am J Emerg Med 2018; 36:1505-1507. [PMID: 29306648 DOI: 10.1016/j.ajem.2017.12.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 12/19/2017] [Accepted: 12/19/2017] [Indexed: 10/18/2022] Open
Affiliation(s)
- Courtney M Smalley
- Emergency Services Institute, Cleveland Clinic Health System, Cleveland, OH, United States.
| | - Michael O'Neil
- University of Pennsylvania, Philadelphia, PA, United States
| | - Rakesh S Engineer
- Emergency Services Institute, Cleveland Clinic Health System, Cleveland, OH, United States
| | - Erin L Simon
- Emergency Services Institute, Cleveland Clinic Health System, Cleveland, OH, United States
| | - Gordon M Snow
- Cleveland Clinic Protective Services, Cleveland, OH, United States
| | - Seth R Podolsky
- Emergency Services Institute, Cleveland Clinic Health System, Cleveland, OH, United States
| |
Collapse
|
23
|
Najafi F, Fallahi-Khoshknab M, Ahmadi F, Dalvandi A, Rahgozar M. Antecedents and consequences of workplace violence against nurses: A qualitative study. J Clin Nurs 2017; 27:e116-e128. [PMID: 28514533 DOI: 10.1111/jocn.13884] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2017] [Indexed: 02/03/2023]
Abstract
AIMS AND OBJECTIVES To explore Iranian nurses' perceptions of and experiences with the antecedents and consequences of workplace violence perpetrated by patients, patients' relatives, colleagues and superiors. BACKGROUND Workplace violence against nurses is a common problem worldwide, including in Iran. Although many studies have reviewed the antecedents and consequences of workplace violence, limited information is available on this topic. An understanding of the predisposing factors for violence and the consequences of violence is essential to developing programs to prevent and manage workplace violence. DESIGN Qualitative descriptive design. METHODS In this qualitative study, 22 unstructured, in-depth interviews were conducted with registered nurses who had experienced workplace violence and who were selecting using purposive sampling in nine hospitals. Inductive content analysis was used to analyse the data. RESULTS Five categories emerged as predisposing factors: unmet expectations of patients/relatives, inefficient organisational management, inappropriate professional communication, factors related to nurses and factors related to patients, patients' relatives and colleagues. Individual, familial and professional consequences were identified as outcomes of workplace violence against nurses. CONCLUSIONS Workplace violence by patients/their relatives and colleagues/superiors is affected by various complicated factors at the individual and organisational levels. In addition to negatively affecting nurses' individual and family lives, workplace violence may lead to a lower quality of patient care and negative attitudes towards the nursing profession. RELEVANCE TO CLINICAL PRACTICE Identifying factors, which lead to workplace violence, could help facilitate documenting and reporting such incidents as well as developing the necessary interventions to reduce them. Furthermore, native instruments must be developed to predict and monitor violence.
Collapse
Affiliation(s)
- Fereshteh Najafi
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Fazlollah Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Asghar Dalvandi
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mehdi Rahgozar
- Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| |
Collapse
|
24
|
Pich JV, Kable A, Hazelton M. Antecedents and precipitants of patient-related violence in the emergency department: Results from the Australian VENT Study (Violence in Emergency Nursing and Triage). ACTA ACUST UNITED AC 2017; 20:107-113. [PMID: 28705687 DOI: 10.1016/j.aenj.2017.05.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 05/15/2017] [Accepted: 05/20/2017] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Workplace violence is one of the most significant and hazardous issues faced by nurses globally. It is a potentially life-threatening and life-affecting workplace hazard often downplayed as just "part of the job" for nurses. METHODS A cross-sectional design was used and data were collected using a purpose developed survey tool. Surveys were distributed to all members of the College of Emergency Nurses' Australasia (CENA) in 2010 and 537 eligible responses were received (RR=51%). RESULTS Patient-related violence was reported by 87% of nurses in the last six months. Precipitants and antecedents for episodes of violence were reported in three categories: nurse-related; patient-related and emergency-department specific factors. Triaging was identified as the highest risk nursing activity, and the triage area identified as the highest risk location in the department. Patients who presented with alcohol intoxication, substance misuse or mental health issues were identified as the groups at greatest risk for potential violence. DISCUSSION Patient-related violence was reported by the majority of emergency nurses surveyed. A number of precipitants and antecedents perceived to be risk factors by participants were found to be significant and are unavoidable in the working lives of emergency department nurses.
Collapse
Affiliation(s)
- Jacqueline V Pich
- Faculty of Health, University of Technology, Ultimo, NSW, Australia, Australia.
| | - Ashley Kable
- School of Nursing & Midwifery, University of Newcastle, Callaghan, NSW, Australia
| | - Mike Hazelton
- School of Nursing & Midwifery, University of Newcastle, Callaghan, NSW, Australia; Mental Health Nursing, School of Nursing & Midwifery, University of Newcastle, Callaghan, NSW, Australia
| |
Collapse
|
25
|
Considine J, Berry D, Johnson R, Sands N. Vital signs as predictors for aggression in hospital patients (VAPA). J Clin Nurs 2017; 26:2593-2604. [DOI: 10.1111/jocn.13646] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Julie Considine
- School of Nursing and Midwifery; Deakin University; Geelong Vic. Australia
- Centre for Quality and Patient Safety Research; Deakin University; Box Hill Vic. Australia
- Eastern Health - Deakin University Nursing and Midwifery Research Centre; Box Hill Vic. Australia
| | - Debra Berry
- School of Nursing and Midwifery; Deakin University; Geelong Vic. Australia
- Eastern Health - Deakin University Nursing and Midwifery Research Centre; Box Hill Vic. Australia
| | | | - Natisha Sands
- School of Nursing and Midwifery; Deakin University; Geelong Vic. Australia
- Centre for Quality and Patient Safety Research; Deakin University; Box Hill Vic. Australia
| |
Collapse
|
26
|
Purcell N, Shovein E, Hebenstreit C, Drexler M. Violence in a U.S. Veterans Affairs healthcare system: worker perspectives on prevalence, causes, and contributors. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/14773996.2016.1266439] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Natalie Purcell
- Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Eric Shovein
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Claire Hebenstreit
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Michael Drexler
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| |
Collapse
|
27
|
Psychometric properties of the Management of Aggression and Violence Attitude Scale in Hong Kong's emergency care setting. Int Emerg Nurs 2016; 31:46-51. [PMID: 27979607 DOI: 10.1016/j.ienj.2016.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 10/31/2016] [Accepted: 11/07/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Emergency unit is one of the most high-risk areas for patient violence. However, in Hong Kong, little research has been test psychometric properties of assessment tool of Emergency unit nurses' attitude toward violence. METHODS The Management of Aggression and Violence Attitude Scale's (MAVASs) Scale- and Item-Content Validity Index were established by 5-experts panel. A convenience sample of 123 nurses working in 4 public Emergency Department in Hong Kong was recruited. The construct validity was tested using exploratory factor analysis and the reliability was assessed by Cronbach's alpha and test-retest reliability. RESULTS The Scale-Content Validity Index was 97.0% and the Item-Content Validity Indexes ranged from 80.0% to 100.0%. Exploratory factor analysis indicated 4-factors solution (i.e., "importance of communication with patients", "perceived effectiveness of interventions", "pitfalls of interventions" and "perceived need for intervention"). Its' internal consistency was satisfactory (Cronbach's alphas=0.40-0.77) across the 4 subscales and test-retest reliability over 4-week interval was satisfactory (Pearson's coefficient=0.85). CONCLUSION MAVAS was found to be a valid and reliable tool to examine nurses' attitudes towards patients' violence in emergency care setting, and provides useful information to those developing training and intervention programmes for management of aggression.
Collapse
|
28
|
Nurses’ attitudes towards the reporting of violence in the emergency department. ACTA ACUST UNITED AC 2016; 19:75-81. [DOI: 10.1016/j.aenj.2015.03.006] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/21/2015] [Accepted: 03/26/2015] [Indexed: 11/18/2022]
|
29
|
Ramacciati N, Ceccagnoli A, Addey B. Violence against nurses in the triage area: An Italian qualitative study. Int Emerg Nurs 2015; 23:274-80. [DOI: 10.1016/j.ienj.2015.02.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 02/11/2015] [Accepted: 02/16/2015] [Indexed: 11/26/2022]
|
30
|
Hamdan M, Abu Hamra A. Workplace violence towards workers in the emergency departments of Palestinian hospitals: a cross-sectional study. HUMAN RESOURCES FOR HEALTH 2015; 13:28. [PMID: 25948058 PMCID: PMC4435901 DOI: 10.1186/s12960-015-0018-2] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Accepted: 04/18/2015] [Indexed: 05/20/2023]
Abstract
BACKGROUND Workplace violence (WPV) in hospital emergency departments (EDs) is a common problem. The objective of this study was to assess the characteristics (level and type), associated risk factors, causes, and consequences of WPV against workers in Palestinian EDs. METHODS A cross-sectional study was conducted in 14 out of the available 39 EDs in Palestine: 8 from the West Bank and 6 from the Gaza Strip. Data were collected using a self-administered questionnaire between July-September 2013. Multivariate logistic regression models were used to examine risk factors associated with exposure to WPV. RESULTS A total of 444 participants (response rate 74.5%): 161 (32.0%) nurses, 142 (32%) physicians, and 141 (31.7%) administrative personnel. The majority (76.1%) experienced a type of WPV in the past 12 months: 35.6% exposed to physical and 71.2% to non-physical assaults (69.8% verbal abuses, 48.4% threats, and 8.6% sexual harassments). Perpetrators of physical and non-physical violence were mainly patients' families/visitors (85.4% and 79.5%, respectively). Waiting time, lack of prevention measures, and unmet expectations of patients and their families are the main reasons for WPV. The multivariate regression analysis showed that younger personnel (OR = 2.29 CI 95% 1.309-4.036), clinicians (nurses and physicians) (OR = 1.65 CI 95% 0.979-2.797) comparing with administrative, and less experienced ED personnel (OR = 2.39 CI 95% 1.141-5.006) are significantly at higher risk of exposure to WPV (P < 0.05). Low level (40%) of violence reporting is evident, largely attributed to not enough actions being taken and fear of consequences. Violence has been shown to have considerable consequences for workers' well-being, patient care, and job retention. CONCLUSIONS Violence against workers in Palestinian EDs is highly common. The effects of violence are considerable. Multiple factors cause violence; however, EDs' internal-system-related factors are the most amenable to change. Attention should be given to strengthening violence prevention policy and measures and improving incident-reporting system.
Collapse
Affiliation(s)
- Motasem Hamdan
- School of Public Health, Al-Quds University, Jerusalem, occupied Palestinian territory.
| | | |
Collapse
|
31
|
Pich J, Kable A. Patient-related violence against nursing staff working in emergency departments: a systematic review. ACTA ACUST UNITED AC 2014. [DOI: 10.11124/jbisrir-2014-1596] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
32
|
Impact of a program to prevent incivility towards and assault of healthcare staff in an ophtalmological emergency unit: study protocol for the PREVURGO On/Off trial. BMC Health Serv Res 2014; 14:221. [PMID: 24885544 PMCID: PMC4055169 DOI: 10.1186/1472-6963-14-221] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 05/14/2014] [Indexed: 11/10/2022] Open
Abstract
Background The emergency department has been identified as an area within the health care sector with the highest reports of violence. The best way to control violence is to prevent it before it becomes an issue. Ideally, to prevent violent episodes we should eliminate all triggers of frustration and violence. Our study aims to assess the impact of a quality improvement multi-faceted program aiming at preventing incivility and violence against healthcare professionals working at the ophthalmological emergency department of a teaching hospital. Methods/Design This study is a single-center prospective, controlled time-series study with an alternate-month design. The prevention program is based on the successive implementation of five complementary interventions: a) an organizational approach with a standardized triage algorithm and patient waiting number screen, b) an environmental approach with clear signage of the premises, c) an educational approach with informational videos for patients and accompanying persons in waiting rooms, d) a human approach with a mediator in waiting rooms and e) a security approach with surveillance cameras linked to the hospital security. The primary outcome is the rate of incivility or violence by patients, or those accompanying them against healthcare staff. All patients admitted to the ophthalmological emergency department, and those accompanying them, will be enrolled. In all, 45,260 patients will be included in over a 24-month period. The unit analysis will be the patient admitted to the emergency department. Data analysis will be blinded to allocation, but due to the nature of the intervention, physicians and patients will not be blinded. Discussion The strengths of this study include the active solicitation of event reporting, that this is a prospective study and that the study enables assessment of each of the interventions that make up the program. The challenge lies in identifying effective interventions, adapting them to the context of care in an emergency department, and thoroughly assessing their efficacy with a high level of proof. The study has been registered as a cRCT at clinicaltrials.gov (identifier: NCT02015884).
Collapse
|
33
|
Verbal, Physical and Sexual Abuse Status Against Operating Room Nurses in Turkey. SEXUALITY AND DISABILITY 2014. [DOI: 10.1007/s11195-014-9339-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
34
|
Cutcliffe JR, Riahi S. Systemic perspective of violence and aggression in mental health care: towards a more comprehensive understanding and conceptualization: part 1. Int J Ment Health Nurs 2013; 22:558-67. [PMID: 23750881 DOI: 10.1111/inm.12029] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Aggression and violence (A/V) in mental health care are all too frequent occurrences; they produce a wide range of deleterious impacts on the individual client, staff, organizations, and the broader community. A/V is a multifaceted and highly-complex problem, and is associated empirically with a wide range of phenomena. However, most attempts to reduce A/V in mental health care have invariably focused on one or two aspects of the problem at the expense of a more comprehensive, systemic approach; these have produced inconclusive results. As a result, this two-part paper seeks to: (i) recognize the wide range of phenomena that have been found to have an association with A/V in mental health care; (ii) synthesize these propositions according to fit or congruence into a systemic model of A/V; (iii) explore empirical evidence pertaining to these propositions; and (iv) begin to consider the application of this model to better inform our individual and/or organizational responses to A/V in mental health care. The paper advances a systemic model of these phenomena comprised of four thematic categories, with Part 1 of this paper focusing on the first two categories: environmental and intrapersonal (client-related) phenomena.
Collapse
Affiliation(s)
- John R Cutcliffe
- Faculty of Health Sciences, University of Ottawa, Ottawa; School of Nursing, University of Coimbra, Coimbra, Portugal; Department of Nursing, University of Malta, Msida, Malta; Cutcliffe Consulting, Hampden, Maine, USA
| | | |
Collapse
|
35
|
Nurse initiated reinsertion of nasogastric tubes in the emergency department: a randomised controlled trial. ACTA ACUST UNITED AC 2013; 16:136-43. [PMID: 24199898 DOI: 10.1016/j.aenj.2013.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 08/30/2013] [Accepted: 08/31/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND Patients sometimes present to the Emergency Department (ED) for reinsertion of nasogastric tubes (NGT) because of tube dislodgement. They usually need to wait for a long time to see a doctor before the NGT can be reinserted. This study aimed at investigating the feasibility of nurse initiated NGT insertion for these patients in order to improve patient outcome. METHODS This is a prospective randomised controlled trial. Patients requiring NGT reinsertion were randomised to receive treatment by either nurse initiated reinsertion of NGT (NIRNGT) or the standard NGT insertion protocol. Questionnaires were given to both groups of patients, relatives and ED nurses afterwards. Outcome measures included door-to-treatment time, total length of stay (LoS) in the ED and the satisfaction of patients, relatives and nurses. RESULTS Twenty-two patients were recruited to the study and randomised: 12 in the standard NGT insertion protocol and 10 in the NIRNGT protocol. The door-to-treatment time of the NIRNGT group (mean=45.6 min) was significantly shorter than the standard NGT insertion group (mean=123.08 min; p=0.003). No statistically significant difference was detected between the total ED LoS (p=0.575). Patients, relatives and nurses were generally satisfied with the new treatment protocol. CONCLUSION Patients can undergo NGT reinsertion significantly faster by adopting a nurse initiated reinsertion of NGT (NIRNGT) protocol.
Collapse
|
36
|
Pich J, Hazelton M, Kable A. Violent behaviour from young adults and the parents of paediatric patients in the emergency department. Int Emerg Nurs 2012; 21:157-62. [PMID: 23063841 DOI: 10.1016/j.ienj.2012.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 08/27/2012] [Accepted: 08/29/2012] [Indexed: 10/27/2022]
Abstract
Violence in healthcare is a significant issue and one that is increasing in prevalence globally. Nurses have been identified as the professional group at most risk, with patients the main source of this violence. The aim of this study was to describe the experiences of Australian ED nurses with episodes of patient-related violence from young adults (16-25years of age) and the parents of paediatric patients. Data analysis of semi-structured interviews led to the identification of antecedents to episodes of violence and behaviours specific to these two groups of interest. These behaviours included: "performing" and attention-seeking behaviours and violent behaviours including both verbal and physical abuse. Antecedents discussed by participants included: parental emotions and alcohol and substance abuse. Overall the results speak to a working environment where participants regularly feel unsafe. Violence in the ED is perceived to occur frequently and to such an extent that participants have become resigned to expect and accept it as part of their job. The role played by distinct groups such as young adults and the parents of paediatric patients must be acknowledged and this knowledge used along with other known risk factors to help identify patients at risk of potential violence.
Collapse
Affiliation(s)
- Jacqueline Pich
- RW 2.15, Richardson Bldg., School of Nursing and Midwifery, The University of Newcastle, Callaghan, NSW 2308, Australia.
| | | | | |
Collapse
|
37
|
An Association Between Occupancy Rates in the Emergency Department and Rates of Violence Toward Staff. J Emerg Med 2012; 43:736-44. [DOI: 10.1016/j.jemermed.2011.06.131] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 04/04/2011] [Accepted: 06/05/2011] [Indexed: 11/20/2022]
|
38
|
Hahn S, Hantikainen V, Needham I, Kok G, Dassen T, Halfens RJG. Patient and visitor violence in the general hospital, occurrence, staff interventions and consequences: a cross-sectional survey. J Adv Nurs 2012; 68:2685-99. [PMID: 22381080 DOI: 10.1111/j.1365-2648.2012.05967.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
UNLABELLED AIM.: This study focuses on the experience of healthcare staff with regard to patient and visitor violence in a general hospital. The occurrence of patient and visitor violence, staffs' interventions and the consequences of violence for different professions are investigated. BACKGROUND There is a lack of studies describing the factors influencing the occurrence of patient and visitor violence, intervention strategies and consequences. Existing studies often focus on nurses' experiences and single interactive factors between staff and patients/visitors involved. DESIGN A cross-sectional survey. METHOD The survey was conducted in 2007 including 2495 staff working on different wards in a Swiss university general hospital. The questionnaire used was the Survey of Violence Experienced by Staff German Version-Revised. FINDINGS Half of the staff experienced patient and visitor violence in the past 12 months and 11% in the past week. The age of the staff and the length of experience in their present workplace influenced the exposure to patient and visitor violence. Violence occurred mainly when staff carried out tasks involving close personal contact. Only 16% of the staff was trained in aggression management. The feeling of confidence in managing patient and visitor violence depended significantly on the organizational attitude towards violence. The principal interventions used were calming and informative discussion. CONCLUSION To prevent patient and visitor violence and improve management strategies, training which focuses on communication skills, which is specific to the professional context and which emphasizes patient centeredness, need to be designed and implemented. A strong organizational commitment is imperative to reduce violence.
Collapse
Affiliation(s)
- Sabine Hahn
- Section of Health, Bern University of Applied Sciences, Switzerland.
| | | | | | | | | | | |
Collapse
|
39
|
Alameddine M, Kazzi A, El‐Jardali F, Dimassi H, Maalouf S. Occupational Violence at Lebanese Emergency Departments: Prevalence, Characteristics and Associated Factors. J Occup Health 2011; 53:455-64. [DOI: 10.1539/joh.11-0102-oa] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mohamad Alameddine
- Health Management and Policy, Faculty of Health SciencesAmerican University of Beirut
| | - Amin Kazzi
- Department of Emergency MedicineAmerican University of Beirut Medical Center
| | - Fadi El‐Jardali
- Health Management and Policy, Faculty of Health SciencesAmerican University of Beirut
| | - Hani Dimassi
- School of Pharmacy, Lebanese American UniversityLebanon
| | - Salwa Maalouf
- Health Management and Policy, Faculty of Health SciencesAmerican University of Beirut
| |
Collapse
|
40
|
Kable A, Guest M, McLeod M. Organizational risk management of resistance to care episodes in health facilities. J Adv Nurs 2011; 68:1933-43. [DOI: 10.1111/j.1365-2648.2011.05874.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
41
|
Pich J, Hazelton M, Sundin D, Kable A. Patient-related violence against emergency department nurses. Nurs Health Sci 2011; 12:268-74. [PMID: 20602701 DOI: 10.1111/j.1442-2018.2010.00525.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In a finding that reflects international experiences, nurses in Australia have been identified as the occupation at most risk of patient-related violence in the health-care sector. A search of the literature was undertaken to explore this concept, with a focus on the emergency department and triage nurses. Significant findings included the fact that nurses are subjected to verbal and physical abuse so frequently that, in many instances, it has become an accepted part of the job. This attitude, combined with the chronic under-reporting of violent incidents, perpetuates the normalization of violence, which then becomes embedded in the workplace culture and inhibits the development of preventative strategies and the provision of a safe working environment. Nurses are entitled to a safe workplace that is free from violence under both the occupational health and safety legislation and the zero-tolerance policies that have been adopted in many countries including Australia, the UK, Europe, and the USA. Therefore, policy-makers and administrators should recognize this issue as a priority for preventative action.
Collapse
Affiliation(s)
- Jacqueline Pich
- School of Nursing and Midwifery, The University of Newcastle, Callaghan, New South Wales, Australia.
| | | | | | | |
Collapse
|
42
|
Hahn S, Müller M, Needham I, Dassen T, Kok G, Halfens RJG. Factors associated with patient and visitor violence experienced by nurses in general hospitals in Switzerland: a cross-sectional survey. J Clin Nurs 2010; 19:3535-46. [DOI: 10.1111/j.1365-2702.2010.03361.x] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
43
|
Hahn S, Müller M, Needham I, Dassen T, Kok G, Halfens RJG. Factors associated with patient and visitor violence experienced by nurses in general hospitals in Switzerland: a cross-sectional survey. J Clin Nurs 2010. [DOI: 10.1111/j.1365-2702.2010.03361.x 10.1111/j.1365-2702.2010.03361.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
44
|
Anderson L, FitzGerald M, Luck L. An integrative literature review of interventions to reduce violence against emergency department nurses. J Clin Nurs 2010; 19:2520-30. [DOI: 10.1111/j.1365-2702.2009.03144.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
45
|
Patient-related violence at triage: A qualitative descriptive study. Int Emerg Nurs 2010; 19:12-9. [PMID: 21193163 DOI: 10.1016/j.ienj.2009.11.007] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Revised: 11/05/2009] [Accepted: 11/13/2009] [Indexed: 11/20/2022]
Abstract
AIM The aim of the study was to describe the experiences of a group of triage nurses with patient-related workplace violence during the previous month. BACKGROUND Globally and within the Australian health industry, nurses have been reported to be the occupation at most risk of patient-related violence, with triage nurses identified as a high risk group for both verbal and physical violence. METHOD The study took place in the Emergency Department of a tertiary referral and teaching hospital in regional New South Wales, Australia. Data were collected from August to September 2008, and a qualitative descriptive methodology was employed. FINDINGS The participants all reported experiencing episodes of patient related violence that were perceived as inevitable and increasing in intensity and frequency. Themes included identification of precipitating factors such as long waiting times and alcohol and substance misuse. Organisational issues included lack of aggression minimisation training; lack of formal debriefing following episodes of violence and frustration at lengthy reporting processes. CONCLUSION In the context of the Emergency Department where patients present with a range of diagnoses and behaviours, it is unlikely that the issue of patient-related violence can be totally eliminated. However it can be prevented or managed more effectively on many occasions. Strategies to support staff and prevent and manage violence effectively should be a priority to provide a safe working environment and occupational health and safety for staff.
Collapse
|
46
|
Luck L, Jackson D, Usher K. Conveying caring: Nurse attributes to avert violence in the ED. Int J Nurs Pract 2009; 15:205-12. [DOI: 10.1111/j.1440-172x.2009.01749.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
47
|
Stubbs B, Winstanley S, Alderman N, Birkett-Swan L. The risk of assault to physiotherapists: beyond zero tolerance? Physiotherapy 2009; 95:134-9. [DOI: 10.1016/j.physio.2008.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Accepted: 12/21/2008] [Indexed: 11/29/2022]
|
48
|
Luck L, Jackson D, Usher K. STAMP: components of observable behaviour that indicate potential for patient violence in emergency departments. J Adv Nurs 2007; 59:11-9. [PMID: 17543010 DOI: 10.1111/j.1365-2648.2007.04308.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM This paper is the report of a study to explicate the components of observable behaviour that indicate a potential for violence in patients, their family and friends when presenting at an emergency department. BACKGROUND Violence towards nurses is a contemporary, multifaceted problem for the healthcare workforce globally. International literature identifies emergency departments as having high levels of violence. METHOD A mixed method case study design was adopted, and data were collected by means of 290 hours of participant observation, 16 semi-structured interviews and 13 informal field interviews over a 5-month period in 2005. Thematic analysis of textual data was undertaken using NVivo2. Frequency counts were developed from the numerical data. FINDINGS Five distinctive elements of observable behaviour indicating potential for violence in patients, their families and friends were identified. These elements can be conceptualized as a potential nursing violence assessment framework and described through the acronym STAMP: Staring and eye contact, Tone and volume of voice, Anxiety, Mumbling and Pacing. CONCLUSION Staring and eye contact, Tone and volume of voice, Anxiety, Mumbling and Pacing provides a useful, practical nursing violence assessment framework to assist nurses to quickly identify patients, families and friends who have a potential for violence.
Collapse
Affiliation(s)
- Lauretta Luck
- School of Nursing, Midwifery and Nutrition, James Cook University, Queensland, Australia.
| | | | | |
Collapse
|
49
|
Luck L, Jackson D, Usher K. Innocent or culpable? Meanings that emergency department nurses ascribe to individual acts of violence. J Clin Nurs 2007; 17:1071-8. [PMID: 17419792 DOI: 10.1111/j.1365-2702.2006.01870.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES The purpose of the study was to explore the meaning(s) that emergency department nurses ascribe to acts of violence from patients, their family and friends and what impact these meaning(s) have upon how they respond to such acts. BACKGROUND Violence in the health sector is of international concern. In high acuity areas such as emergency departments, nurses have an increased risk of violence. The literature further suggests that violence towards nurses in emergency departments is under-reported. DESIGN AND METHODS This study was undertaken in 2005, at a regional Australian Emergency Department with 20 consenting registered nurses. Using an instrumental case study design, both qualitative and quantitative data were generated. Qualitative data were collected using participant observation, semi-structured interviews, informal field interviews and researcher journaling. Quantitative data of violent events were generated using a structured observational guide. Textual data were analysed thematically and numeric data were analysed using frequency counts. Mixed methods and concurrent data analysis contributed to the rigour of this study. FINDINGS Emergency department nurses made judgments about the meaning of violent events according to three factors: (i) perceived personalization of the violence; (ii) presence of mitigating factors; and (iii) the reason for the presentation. The meanings that were ascribed to individual acts of violence informed the responses that nurses initiated. CONCLUSIONS; The findings show that violence towards emergency department nurses is interpreted in a more systematic and complex way than the current definitions of violence make possible. The meanings given to violence were contextually constructed and these ascribed meaning(s) and judgments informed the actions that the nurses took in response to both the act of violence and the agent of violence. Relevance to clinical practice. Understanding the meaning(s) of violence towards nurses contributes to the discussions surrounding why nurses under-report violence. Further, these findings bring insights into how nurses can and do, handle violence in the workplace.
Collapse
Affiliation(s)
- Lauretta Luck
- School of Nursing Sciences, James Cook University, Cairns, Qld, and School of Nursing, College of Health and Science, University of Western Sydney, Sydney, NSW, Australia
| | | | | |
Collapse
|
50
|
Zero tolerance: A policy in conflict with current opinion on aggression and violence management in health care. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.aenj.2006.07.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|