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Martins Irvine A, Moloney W, Jacobs S, Anderson NE. Support mechanisms that enable emergency nurses to cope with aggression and violence: Perspectives from New Zealand nurses. Australas Emerg Care 2024; 27:97-101. [PMID: 37743125 DOI: 10.1016/j.auec.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Although efforts to reduce aggression and violence in emergency departments are important, it is also critical to minimise harm and support staff where this occurs. This research describes support mechanisms emergency nurses value when they experience occupational aggression and violence. METHODS A mixed-methods design including thematic analysis of six interviews and descriptive analysis of fifty-one surveys, with experienced emergency nurse participants and respondents from a single large urban emergency department. RESULTS Four key themes summarised coping with aggression and violence: Minimising exacerbating factors (mental health, lack of understanding of zero tolerance in practice, and wait times); Support before violence (use of huddles and having experienced nurses on each shift); Support during violence (education including restraint, self-defence, de-escalation and legalities); and Support after violence (debriefing, incident reporting and a sense of 'toughness') CONCLUSION: Emergency nurses need preparation and support to competently manage complex mental health presentations, understand legal rights, communicate effectively with patients, families and colleagues and access event debriefing. Security staff are valued team members but also need adequate resourcing and preparation.
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Affiliation(s)
- Alice Martins Irvine
- School of Nursing, University of Auckland, Auckland, New Zealand; Waikato Emergency Department, Te Whatu Ora Waikato, Hamilton, New Zealand
| | | | - Stephen Jacobs
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - Natalie Elizabeth Anderson
- School of Nursing, University of Auckland, Auckland, New Zealand; Auckland Emergency Department, Te Whatu Ora Te Toka Tumai, Auckland, New Zealand.
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Tolera A, Weldesenbet AB, Regassa LD, Tusa BS, Merga BT, Tariku M, Cheru A, Enyew DB, Gemeda AT. Health service providers experience of psycho-emotional violence and associated factors among urban hospitals in Eastern Ethiopia. Front Public Health 2024; 12:1361243. [PMID: 38765488 PMCID: PMC11100414 DOI: 10.3389/fpubh.2024.1361243] [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: 01/25/2024] [Accepted: 04/17/2024] [Indexed: 05/22/2024] Open
Abstract
Background Psycho-emotional violence, a type of workplace violence targeting healthcare workers, varies across countries, occasions, and professions in the healthcare sector. Unfortunately, there is a scarcity of comprehensive studies focusing on violence against healthcare workers in Ethiopia, which may also encompass psycho-gender-based emotional violence against healthcare workers. Therefore, there is a compelling need for in-depth research to address this gap and develop effective strategies to mitigate psycho-emotional violence in the healthcare sector in Ethiopia, especially in the eastern region. Hence, we aimed to identify the prevalence of and factors associated with workplace psycho-emotional violence against healthcare providers in eastern Ethiopia. Methods This institution-based cross-sectional study was conducted among 744 health professionals working in urban public hospitals in eastern Ethiopia. Multistage stratified random sampling was used, and data were collected using a standardized structured tool adopted from the WHO workplace violence assessment tool. Binary and multivariable logistic regression analyses were employed to identify factors associated with psycho-emotional workplace violence. Adjusted odds ratio (OR) with 95% confidence interval (CI) was reported, and a p-value of 0.05 was used as the cut-off point to declare significance. Results Workplace psycho-emotional violence was reported by 57.39% of the healthcare workers. The absence of guidelines for gender-based abuse [AOR = 35.62, 95% CI:17.47, 72.64], presence of measures that improve surroundings (class lighting and privacy) [AOR = 0.58, 95% CI: 0.35, 0.98], training on workplace violence coping mechanism [AOR = 0.16, 95%CI: 0.26, 0.98], spending more than 50% of their time with HIV/AIDS patients [AOR = 1.96, 95%CI:1.05, 3.72], and spending more than 50% of their time with psychiatric patients [AOR = 1.92, 95%CI:1.08, 3.43] were factors significantly associated with workplace violence against health professionals. Conclusion The prevalence of workplace psycho-emotional violence against health professionals in eastern Ethiopia was relatively high. Improving the working environment decreases the chance of workplace violence; however, there is a lack of guidelines for gender-based violence, the absence of training on coping mechanisms, and spending more time with psychiatric and HIV/AIDS patients' increases workplace violence. We recommend that health institutions develop gender abuse mitigation guidelines and provide training on coping mechanisms.
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Affiliation(s)
- Abebe Tolera
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adisu Birhanu Weldesenbet
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemma Demissie Regassa
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Biruk Shalmeno Tusa
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bedasa Taye Merga
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mandaras Tariku
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abera Cheru
- School of Environmental Health Science, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Daniel Birhanie Enyew
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Assefa Tola Gemeda
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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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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Gharaveis A, Hamilton DK, Pati D, Shepley MM, Rodiek S, McCall D. How Visibility May Reduce Security Issues in Community Hospitals' Emergency Departments. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024; 17:135-147. [PMID: 37522704 DOI: 10.1177/19375867231188985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
This research explored the relationship between visibility and the level of security risks as perceived by nurses and physicians in emergency departments (EDs). Security in EDs has been reported as a major global concern, and visibility has been identified as a design factor impacting behavior. However, few previous studies have rigorously investigated the role of visibility in reduction of ED security risks with evidence-based design approach. There is a lot of significant questions about how visibility impacts the reduction of security issues in EDs. METHODS How visibility may influence ED security was explored via qualitative methods in five EDs using semi-structured one-on-one interviews with 17 clinical staff and 48 hr of field observations. The coding process for both interviews and observational notes followed the principles of naturalistic inquiry. RESULTS The findings suggest security risks can be decreased by improving visibility. Medical staff (registered nurses and physicians) felt more secure in the EDs with higher visibility. DISCUSSION This study provides a framework to identify preferable levels of visibility in EDs and proposes design strategies to minimize security issues. Registered nurses and physicians can improve their team's sense of security by considering visibility throughout their daily practices.
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Affiliation(s)
| | | | | | | | | | - Denise McCall
- Emergency Department, Houston Methodist West Hospital, TX, USA
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Ferrari G, Lwamushi SM, Balaluka GB, Lafta RK, Schindler C, Bugugu D, Lurhangire E, Tediosi F, Mendoza JR, Merten S. Understanding context of violence against healthcare through citizen science and evaluating the effectiveness of a co-designed code of conduct and of a tailored de-escalation of violence training in Eastern Democratic Republic of Congo and Iraq: a study protocol for a stepped wedge randomized controlled trial. Trials 2023; 24:814. [PMID: 38110997 PMCID: PMC10729574 DOI: 10.1186/s13063-023-07839-3] [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: 06/28/2023] [Accepted: 11/28/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Violence against health care workers (HCWs) is a multifaceted issue entwined with broader social, cultural, and economic contexts. While it is a global phenomenon, in crisis settings, HCWs are exposed to exceptionally high rates of violence. We hypothesize that the implementation of a training on de-escalation of violence and of a code of conduct informed through participatory citizen science research would reduce the incidence and severity of episodes of violence in primary healthcare settings of rural Democratic Republic of Congo (DRC) and large hospitals in Baghdad, Iraq. METHODS In an initial formative research phase, the study will use a transdisciplinary citizen science approach to inform the re-adaptation of a violence de-escalation training for HCWs and the content of a code of conduct for both HCWs and clients. Qualitative and citizen science methods will explore motivations, causes, and contributing factors that lead to violence against HCWs. Preliminary findings will inform participatory meetings aimed at co-developing local rules of conduct through in-depth discussion and input from various stakeholders, followed by a validation and legitimization process. The effectiveness of the two interventions will be evaluated through a stepped-wedge randomized-cluster trial (SW-RCT) design with 11 arms, measuring the frequency and severity of violence, as well as secondary outcomes such as post-traumatic stress disorder (PTSD), job burnout, empathy, or HCWs' quality of life at various points in time, alongside a cost-effectiveness study comparing the two strategies. DISCUSSION Violence against HCWs is a global issue, and it can be particularly severe in humanitarian contexts. However, there is limited evidence on effective and affordable approaches to address this problem. Understanding the context of community distrust and motivation for violence against HCWs will be critical for developing effective, tailored, and culturally appropriate responses, including a training on violence de-escalation and a community behavioral change approach to increase public trust in HCWs. This study aims therefore to compare the effectiveness and cost-effectiveness of different interventions to reduce violence against HCWs in two post-crisis settings, providing valuable evidence for future efforts to address this issue. TRIAL REGISTRATION ClinicalTrial.gov Identifier NCT05419687. Prospectively registered on June 15, 2022.
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Affiliation(s)
- Giovanfrancesco Ferrari
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland.
- Universität Basel, Petersplatz, 1, P.O. Box, CH-4001, Basel, Switzerland.
| | - Samuel Makali Lwamushi
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- Universität Basel, Petersplatz, 1, P.O. Box, CH-4001, Basel, Switzerland
- Ecole Régionale de Santé Publique, Université Catholique de Bukavu (ERSP-UCB), Bukavu, Democratic Republic of the Congo
| | - Ghislain Bisimwa Balaluka
- Ecole Régionale de Santé Publique, Université Catholique de Bukavu (ERSP-UCB), Bukavu, Democratic Republic of the Congo
| | - Riyadh K Lafta
- College of Medicine, Al Mustansiriyah University, Baghdad, Iraq
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- Universität Basel, Petersplatz, 1, P.O. Box, CH-4001, Basel, Switzerland
| | - Daniella Bugugu
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
| | - Emmanuel Lurhangire
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
| | - Fabrizio Tediosi
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- Universität Basel, Petersplatz, 1, P.O. Box, CH-4001, Basel, Switzerland
| | | | - Sonja Merten
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- Universität Basel, Petersplatz, 1, P.O. Box, CH-4001, Basel, Switzerland
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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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Reißmann S, Wirth T, Beringer V, Groneberg DA, Nienhaus A, Harth V, Mache S. "I think we still do too little": measures to prevent violence and aggression in German emergency departments - a qualitative study. BMC Health Serv Res 2023; 23:97. [PMID: 36717889 PMCID: PMC9885053 DOI: 10.1186/s12913-023-09044-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/17/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Healthcare workers employed in emergency departments (EDs) are particularly affected by physical and verbal violence. Violent assaults can be committed by both patients and their attendants. Research on interventions for violence prevention is limited and previous studies report that ED employees feel unprepared for violent incidents. Thus, the current study aims to explore ED staff's perceptions regarding available prevention measures, their effectiveness, barriers, and further needs in terms of violence prevention. METHODS In accordance with the qualitative study design, 27 semi-structured interviews were conducted via telephone with doctors and nurses working in direct contact with patients in German EDs. Main subjects were advantages and disadvantages of currently available measures, barriers regarding their implementation, their perceived effectiveness, as well as further needs concerning violence prevention. The transcribed interviews were analysed according to Mayring's qualitative content analysis. RESULTS Participants described environmental (e.g., alarm systems), organisational (e.g., security service), and individual-focused measures (staff training, verbal de-escalation). Measures perceived as effective were, for instance, communication and security service. Both demands and barriers were often related to financial constraints, e.g., staff shortage led to higher workloads and less time to consider violence prevention. In most cases, guidelines or standard operating procedures (SOPs) regarding violence prevention were missing, unknown, or not perceived as helpful in their current form. Furthermore, screening tools were not applied in any of the EDs. CONCLUSIONS The workload in EDs needs to be decreased in order to enable violence prevention, e.g., by reducing patient inflow or by increasing personnel. In addition, violence prevention guidelines tailored to the requirements of the respective ED need to be developed. Hospitals should supply ED staff with such guidelines, e.g., in the form of SOPs, but more importantly, prevention measures have to be practiced and communicated. Furthermore, there is a need for research on the implementation of screening tools for violent behaviour, so that the focus would shift from managing violence to preventing violence.
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Affiliation(s)
- Sonja Reißmann
- grid.13648.380000 0001 2180 3484Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany ,grid.7839.50000 0004 1936 9721Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, 60590 Frankfurt, Germany
| | - Tanja Wirth
- grid.13648.380000 0001 2180 3484Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany
| | - Vanessa Beringer
- grid.13648.380000 0001 2180 3484Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany
| | - David A. Groneberg
- grid.7839.50000 0004 1936 9721Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, 60590 Frankfurt, Germany
| | - Albert Nienhaus
- grid.491653.c0000 0001 0719 9225Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 22089 Hamburg, Germany ,grid.13648.380000 0001 2180 3484Institute for Health Services Research in Dermatology and Nursing (IVDP), Competence Center for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - Volker Harth
- grid.13648.380000 0001 2180 3484Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany
| | - Stefanie Mache
- grid.13648.380000 0001 2180 3484Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), 20459 Hamburg, Germany ,grid.7839.50000 0004 1936 9721Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, 60590 Frankfurt, Germany
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Viking M, Hugelius K, Kurland L. Experiences of exposure to workplace violence among ambulance personnel. Int Emerg Nurs 2022; 65:101220. [DOI: 10.1016/j.ienj.2022.101220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 08/28/2022] [Accepted: 09/14/2022] [Indexed: 11/05/2022]
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Kumari A, Sarkar S, Ranjan P, Chopra S, Kaur T, Baitha U, Chakrawarty A, Klanidhi KB. Interventions for workplace violence against health-care professionals: A systematic review. Work 2022; 73:415-427. [PMID: 35431213 DOI: 10.3233/wor-210046] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Workplace violence (WPV) against health-care professionals has been a concern worldwide as it strains the relationship between the patient and healthcare professionals. Implementing mitigation interventions to help the healthcare professionals to prevent and manage these violent episodes might make the workplaces more secure. OBJECTIVE This study aimed to synthesize the recent evidence on intervention strategies for workplace violence. METHOD Four electronic databases (PubMed, Wiley, Cochrane and Google Scholar) were searched for peer-reviewed intervention studies published in the last 11 years to mitigate workplace violence. A qualitative synthesis of the findings from included studies was done. RESULT A total of 17 studies were identified based on prevention and management of workplace violence. The interventions were mainly educational in nature based on a workshop format. These interventions were found to be effective in improving the perceived ability to deal with situations that lead to violence. CONCLUSION Strategies to mitigate violent episodes could be helpful to health-care professionals and administrators in their attempts to make safer workplaces in the health-care settings.
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Affiliation(s)
- Archana Kumari
- Department of Gynaecology and Obstetrics, All India Institute of Medical Sciences, New Delhi, India
| | - Siddharth Sarkar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sakshi Chopra
- Department of Home Science, University of Delhi, India
| | - Tanveer Kaur
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Upendra Baitha
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Avinash Chakrawarty
- Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kamal Bandhu Klanidhi
- Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India
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Effects of Integrated Workplace Violence Management Intervention on Occupational Coping Self-Efficacy, Goal Commitment, Attitudes, and Confidence in Emergency Department Nurses: A Cluster-Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052835. [PMID: 35270527 PMCID: PMC8910583 DOI: 10.3390/ijerph19052835] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/20/2022] [Accepted: 02/25/2022] [Indexed: 11/30/2022]
Abstract
Patient and visitor violence (PVV), the most prevalent source of workplace violence, is largely ignored, underreported, and a persistent problem in emergency departments. It is associated with physical injuries, psychological distress, and occupational stress in nurses. A randomized controlled trial was conducted in Taiwan from January to December 2020. This study aimed to test the efficacy of an integrated Workplace Violence Prevention and Management Training Program on PVV in 75 emergency department (ED) nurses from a hospital. Cluster sampling was used because the policy of subdivision strategy was enforced during the COVID-19 pandemic. ED nurses received either the intervention or 1-hour in-service class. Data were collected from questionnaires. Data were analyzed mainly by the repeated measure analysis of variance and generalized estimating equations. The intervention had positive effects on developing stronger goal commitment, improving occupational coping self-efficacy, increasing confidence in ability to deal with violent situations, and modifying attitudes toward the causes and management of PVV in ED nurses (p < 0.05). The marginal R2 of the generalized estimating equation model for goal commitment, occupational coping self-efficacy, confidence, attitudes toward aggression in ED and aggressive behavior variables was high as 0.54 (p < 0.001), 0.45 (p < 0.001), 0.58 (p < 0.001), 0.29 (p < 0.05), and 0.72 (p < 0.001), respectively. These study models could effectively predict changes in the mean values. The benefit was driven by the effect of the intervention in ED nurses. Thus, the intervention, when applied in conjunction with routine in-service class, could exert synergistic improvements on outcomes measured in nurses.
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Pina D, López-Ros P, Luna-Maldonado A, Luna Ruiz-Caballero A, Llor-Esteban B, Ruiz-Hernández JA, García-Jiménez JJ, Puente-López E, Martínez-Jarreta B. Users' Perception of Violence and Conflicts With Professionals in Primary Care Centers Before and During COVID-19. A Qualitative Study. Front Public Health 2022; 9:810014. [PMID: 34976940 PMCID: PMC8717897 DOI: 10.3389/fpubh.2021.810014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/26/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Workplace violence is a social problem of special interest in both intervention and research. Among the sectors that most perceive this type of violence, health care professionals stand out. The most common type of violence for this professional group is the one perpetrated by the users or patients themselves. It has been reported that one out of every four acts of violence in the workplace occurs in the healthcare setting. Within the health sector, the Mental Health, Emergency and Primary Care services have been widely reported as being among the most vulnerable, with Primary Care being the least addressed of the three. Although the available literature is extensive, there are hardly any studies that explore from a qualitative perspective what are the sources of conflict in this sector from the perspective of the users, the most common being to work with professionals. Objective: The aim of this study is to examine those aspects derived from the organization, the professionals or the users of Primary Care that, from the users' point of view, cause violent situations and how they think these could be avoided. Method: The sample consisted of 80 users of the Primary Care services of the Health Service of Murcia. For data collection, a qualitative study was conducted through 10 focus groups and a subsequent thematic analysis of the data. Results: The results have allowed us to identify that, from an organizational point of view, the uncertainty in waiting times, the need to adapt the telematic or telephone appointment to the different types of users, or the management of emergencies in Primary Care are the aspects that cause most conflicts between users and professionals. In this sense, suggested improvements are aimed at providing information in the mobile application updated on the opening hours or maintaining the telephone appointment for those who need or request it, among many others. As for the professionals, users point out that the medical staff is perceived as distant and sometimes does not provide enough information on the health status of users. Another professional group widely addressed in the focus groups was the administrative staff, being described as lacking in communication skills, assertiveness, or empathy. Users recognize the existence of a demanding/aggressive profile among users, who makes instrumental use of violence to achieve privileges over users in general. We have also identified the profile of the user who makes use of Primary Care as a way of socializing or managing conflicts of a socioemotional nature. As proposals for this thematic block, users suggest group therapies, the use of audiovisual material complementary to the information provided by professionals or community interventions in psychoeducation. Conclusion: This study allows to explore conflicts between users and professionals from the Primary Care patients' perspective. Our results are complementary to the available evidence that has used the professional's approach to study the phenomenon of workplace violence. The identification of sources of conflict and the assessment and contribution of users on possible ways of improvement can serve as a basis for the design of prevention and intervention plans to improve the work environment in Primary Care centers.
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Affiliation(s)
- David Pina
- Department of Socio-Sanitary Sciences, University of Murcia, Murcia, Spain.,Applied Psychology Service (SEPA), University of Murcia, Murcia, Spain
| | - Paloma López-Ros
- Department of Behavioral Sciences and Health, University Miguel Hernández, Elche, Spain
| | | | | | - Bartolomé Llor-Esteban
- Applied Psychology Service (SEPA), University of Murcia, Murcia, Spain.,Department of Nursing, University of Murcia, Murcia, Spain
| | - Jose Antonio Ruiz-Hernández
- Applied Psychology Service (SEPA), University of Murcia, Murcia, Spain.,Department of Social Psychology and Psychiatry, University of Murcia, Murcia, Spain
| | | | | | - Begoña Martínez-Jarreta
- Department of Pathological Anatomy, Forensic and Legal Medicine and Toxicology, University of Zaragoza, Zaragoza, Spain
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12
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Interventions for Workplace Violence Prevention in Emergency Departments: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168459. [PMID: 34444208 PMCID: PMC8392011 DOI: 10.3390/ijerph18168459] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/06/2021] [Accepted: 08/08/2021] [Indexed: 11/17/2022]
Abstract
Emergency departments (EDs) are high-risk settings for workplace violence, but interventions to prevent violent incidents and to prepare staff are not yet consistently implemented, and their effectiveness is often unclear. This study aims to summarise evidence on workplace violence prevention interventions that were implemented in EDs to reduce violent incidents caused by patients/relatives or to increase the knowledge, skills or feelings of safety of ED staff. A systematic review was conducted. The databases MEDLINE, Web of Science, Cochrane Library, CINAHL and PsycINFO were searched for studies dated between January 2010 and May 2021. Interventional and observational studies reporting on behavioural, organisational or environmental interventions among healthcare workers in hospital EDs were included. Studies were assessed for methodological quality using the Johanna Briggs Institute Tools. Key findings of studies were summarised narratively. Fifteen studies were included, of which eleven examined behavioural interventions (classroom, online or hybrid training programmes) on de-escalation skills, violent person management or self-defence techniques. Four studies included in addition, organisational and environmental interventions. Most studies showed that interventions had a positive effect in the form of a reduction of violent incidents or an improvement in how prepared staff were to deal with violent situations; however, evidence is still sparse. Further studies should consider in particular, environmental and organisational interventions and ensure a high methodological quality.
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13
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Cabilan CJ, Eley R, Snoswell CL, Johnston ANB. What can we do about occupational violence in emergency departments? A survey of emergency staff. J Nurs Manag 2021; 30:1386-1395. [PMID: 33723863 DOI: 10.1111/jonm.13294] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/02/2021] [Accepted: 02/19/2021] [Indexed: 11/30/2022]
Abstract
AIMS To explore and collate solutions for occupational violence from emergency department (ED) staff. BACKGROUND Despite publications highlighting the progressively worsening issue of occupational violence in EDs and its detrimental impacts, few strategies aimed to reduce or manage it have been discussed in the literature. METHODS This was a cross-sectional study involving ED staff. Participants completed an electronic survey that prompted interventions for occupational violence. Free-text data were analysed and logically categorized using validated techniques. RESULTS Participants (N = 81) suggested 24 interventions: 12 were classified as prevention strategies, 10 as response strategies and two as recovery strategies. Prevention and response strategies for occupational violence targeted key participants: patients, staff and ED environment. Recovery strategies centred around staff management of the personal impacts of incidences of occupational violence and on systems in place to support them after occupational violence incidents. CONCLUSION Solutions to occupational violence should be multifaceted encompassing prevention, response and recovery for patients, staff and the ED environment. IMPLICATIONS FOR NURSING MANAGEMENT No single, universal intervention can be endorsed to reduce or mitigate the impacts of occupational violence in EDs. However, a combination of the interventions (strategies) discussed in this paper can be recommended.
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Affiliation(s)
- C J Cabilan
- Emergency Department, Princess Alexandra Hospital, Brisbane, Qld, Australia.,School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Qld, Australia
| | - Rob Eley
- Emergency Department, Princess Alexandra Hospital, Brisbane, Qld, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - Centaine L Snoswell
- Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia.,Centre for Online Health, Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - Amy N B Johnston
- Emergency Department, Princess Alexandra Hospital, Brisbane, Qld, Australia.,School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Qld, Australia
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14
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Geoffrion S, Hills DJ, Ross HM, Pich J, Hill AT, Dalsbø TK, Riahi S, Martínez-Jarreta B, Guay S. Education and training for preventing and minimizing workplace aggression directed toward healthcare workers. Cochrane Database Syst Rev 2020; 9:CD011860. [PMID: 32898304 PMCID: PMC8094156 DOI: 10.1002/14651858.cd011860.pub2] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Workplace aggression constitutes a serious issue for healthcare workers and organizations. Aggression is tied to physical and mental health issues at an individual level, as well as to absenteeism, decreased productivity or quality of work, and high employee turnover rates at an organizational level. To counteract these negative impacts, organizations have used a variety of interventions, including education and training, to provide workers with the knowledge and skills needed to prevent aggression. OBJECTIVES: To assess the effectiveness of education and training interventions that aim to prevent and minimize workplace aggression directed toward healthcare workers by patients and patient advocates. SEARCH METHODS CENTRAL, MEDLINE, Embase, six other databases and five trial registers were searched from their inception to June 2020 together with reference checking, citation searching and contact with study authors to identify additional studies. SELECTION CRITERIA Randomized controlled trials (RCTs), cluster-randomized controlled trials (CRCTs), and controlled before and after studies (CBAs) that investigated the effectiveness of education and training interventions targeting aggression prevention for healthcare workers. DATA COLLECTION AND ANALYSIS Four review authors evaluated and selected the studies resulting from the search. We used standard methodological procedures expected by Cochrane. We assessed the certainty of evidence using the GRADE approach. MAIN RESULTS We included nine studies-four CRCTs, three RCTs, and two CBAs-with a total of 1688 participants. Five studies reported episodes of aggression, and six studies reported secondary outcomes. Seven studies were conducted among nurses or nurse aides, and two studies among healthcare workers in general. Three studies took place in long-term care, two in the psychiatric ward, and four in hospitals or health centers. Studies were reported from the United States, Switzerland, the United Kingdom, Taiwan, and Sweden. All included studies reported on education combined with training interventions. Four studies evaluated online programs, and five evaluated face-to-face programs. Five studies were of long duration (up to 52 weeks), and four studies were of short duration. Eight studies had short-term follow-up (< 3 months), and one study long-term follow-up (> 1 year). Seven studies were rated as being at "high" risk of bias in multiple domains, and all had "unclear" risk of bias in a single domain or in multiple domains. Effects on aggression Short-term follow-up The evidence is very uncertain about effects of education and training on aggression at short-term follow-up compared to no intervention (standardized mean difference [SMD] -0.33, 95% confidence interval [CI] -1.27 to 0.61, 2 CRCTs; risk ratio [RR] 2.30, 95% CI 0.97 to 5.42, 1 CBA; SMD -1.24, 95% CI -2.16 to -0.33, 1 CBA; very low-certainty evidence). Long-term follow-up Education may not reduce aggression compared to no intervention in the long term (RR 1.14, 95% CI 0.95 to 1.37, 1 CRCT; low-certainty evidence). Effects on knowledge, attitudes, skills, and adverse outcomes Education may increase personal knowledge about workplace aggression at short-term follow-up (SMD 0.86, 95% CI 0.34 to 1.38, 1 RCT; low-certainty evidence). The evidence is very uncertain about effects of education on personal knowledge in the long term (RR 1.26, 95% CI 0.90 to 1.75, 1 RCT; very low-certainty evidence). Education may improve attitudes among healthcare workers at short-term follow-up, but the evidence is very uncertain (SMD 0.59, 95% CI 0.24 to 0.94, 2 CRCTs and 3 RCTs; very low-certainty evidence). The type and duration of interventions resulted in different sizes of effects. Education may not have an effect on skills related to workplace aggression (SMD 0.21, 95% CI -0.07 to 0.49, 1 RCT and 1 CRCT; very low-certainty evidence) nor on adverse personal outcomes, but the evidence is very uncertain (SMD -0.31, 95% CI -1.02 to 0.40, 1 RCT; very low-certainty evidence). Measurements of these concepts showed high heterogeneity. AUTHORS' CONCLUSIONS Education combined with training may not have an effect on workplace aggression directed toward healthcare workers, even though education and training may increase personal knowledge and positive attitudes. Better quality studies that focus on specific settings of healthcare work where exposure to patient aggression is high are needed. Moreover, as most studies have assessed episodes of aggression toward nurses, future studies should include other types of healthcare workers who are also victims of aggression in the same settings, such as orderlies (healthcare assistants). Studies should especially use reports of aggression at an institutional level and should rely on multi-source data while relying on validated measures. Studies should also include days lost to sick leave and employee turnover and should measure outcomes at one-year follow-up. Studies should specify the duration and type of delivery of education and should use an active comparison to prevent raising awareness and reporting in the intervention group only.
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Affiliation(s)
- Steve Geoffrion
- École de psychoéducation, Université de Montreal, Montreal, Canada
| | - Danny J Hills
- School of Health, Federation University, Ballarat, Australia
| | - Heather M Ross
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Jacqueline Pich
- Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - April T Hill
- College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | | | - Sanaz Riahi
- Ontario Shores Centre for Mental Health Sciences, Whitby, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | | | - Stéphane Guay
- School of Criminology, University of Montreal, Montreal, Canada
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15
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Richardson SK, Ardagh MW, Morrison R, Grainger PC. Management of the aggressive emergency department patient: non-pharmacological perspectives and evidence base. Open Access Emerg Med 2019; 11:271-290. [PMID: 31814780 PMCID: PMC6861170 DOI: 10.2147/oaem.s192884] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 08/29/2019] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Aggression in the Emergency Department (ED) remains an ongoing issue, described as reaching epidemic proportions, with an impact on staff recruitment, retention, and ability to provide quality care. Most literature has focused on the definition (or lack of) core concepts, efforts to quantify the phenomenon or provide an epidemiological profile. Relatively little offers evidence-based interventions or evaluations of the same. AIM To identify the range of suggested practices and the evidence base for currently recommended actions relating to the management of the aggressive Emergency Department patient. METHODS A meta-synthesis of existing reviews of violence and aggression in the acute health-care setting, including management of the aggressive patient, was undertaken. This provided the context for critical consideration of the management of this patient group in the ED and implications for clinical practice. RESULTS An initial outline of issues was followed by a systematic search and 15 reviews were further assessed. Commonly identified interventions are grouped around educational, interpersonal, environmental, and physical responses. These actions can be focused in terms of overall responses to the wider issues of violence and aggression, targeted at the pre-event, event, or post-event phase in terms of strategies; however, there is a very limited evidence base to show the effectiveness of strategies suggested. CLINICAL IMPLICATIONS The lack of evidence-based intervention strategies leaves clinicians in a difficult situation, often enacting practices based on anecdote rather than evidence. Local solutions to local problems are occurring in a pragmatic manner, but there needs to be clarification and integration of workable processes for evaluating and disseminating best practice. CONCLUSION There is limited evidence reporting on interventional studies, in addition to identification of the need for high quality longitudinal and evaluation studies to determine the efficacy of those responses that have been identified.
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Affiliation(s)
- Sandra K Richardson
- Emergency Department, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand
- Centre for Postgraduate Nursing Studies, University of Canterbury, Christchurch, New Zealand
| | - Michael W Ardagh
- Emergency Department, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand
- Department of Surgery, University of Otago, Christchurch, New Zealand
| | - Russell Morrison
- Well-being Health and Safety Team, Canterbury District Health Board, Christchurch, New Zealand
| | - Paula C Grainger
- Emergency Department, Christchurch Hospital, Canterbury District Health Board, Christchurch, New Zealand
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16
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Honarvar B, Ghazanfari N, Raeisi Shahraki H, Rostami S, Lankarani KB. Violence against Nurses: A Neglected and Health-threatening Epidemic in the University Affiliated Public Hospitals in Shiraz, Iran. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2019; 10:111-123. [PMID: 31325294 PMCID: PMC6708406 DOI: 10.15171/ijoem.2019.1556] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 04/03/2019] [Indexed: 02/05/2023]
Abstract
Background:
Nurses are more likely to be exposed to violence at their workplace in comparison with other employees.
Objective:
To determine various aspects of violence against nurses in Shiraz public hospitals.
Methods:
This cross-sectional study was conducted from 2017 to 2018, using a multistage random sampling method. Violence including verbal threats, verbal abuse, physical and sexual abuse as well as ethnical types, violence from patients, patients' companions and coworkers, and causes of violence were investigated using a checklist.
Results:
405 nurses with a mean age of 30.2 (SD 7.1) years and female to male ratio of 4.2 were interviewed. 363 (89.6%) nurses had experienced at least one kind of violence; 68.4% suffered from more than one type of violence. Verbal abuse (83.9%), verbal threats (27.6%), physical violence (21.4%), sexual abuse (10.8%), and ethnical harassment (6.1%) were the most common types of violence experienced by the nurses. Patients' companions, patients, and physicians were reported as the sources of violence in 70.6%, 43.1%, and 4.1% of cases, respectively. Nurses with non-official employment status and non-Farsi ethnicity, having a disease, with non-evening shift work, and those with short or long employment period were more affected. Unrealistic expectations by patients' companions and long working hours were the most common attributing factors.
Conclusion:
Violence against nurses, as a strenuous and health-threatening crisis, has become epidemic in public hospitals in our region. Effective interventions are warranted to sort out these problems.
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Affiliation(s)
- Behnam Honarvar
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nima Ghazanfari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hadi Raeisi Shahraki
- Department of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Sara Rostami
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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17
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Edward KL, Giandinoto JA, Weiland TJ, Hutton J, Reel S. Brief interventions to de-escalate disturbances in emergency departments. ACTA ACUST UNITED AC 2019; 27:322-327. [PMID: 29561674 DOI: 10.12968/bjon.2018.27.6.322] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This study aimed to systematically review evidence to assess the efficacy of non-pharmacological brief interventions in the emergency department to reduce the incidence, severity and impact of acute behavioural disturbances. The literature search was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A total of 18 articles were identified as meeting the inclusion criteria and read in full. Following a full read and a consensus discussion, it was subsequently considered the studies chosen had not met the inclusion criteria. Research into the use of non-pharmacological brief interventions in the management of acute behavioural disturbance in the emergency department is warranted given the absence of evidence found by this systematic review.
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Affiliation(s)
- Karen-Leigh Edward
- Professor of Nursing and Practice Based Research, Faculty of Health, Arts and Design, Swinburne University of Technology; Visiting Professor, St Vincent's Private Hospital, Melbourne, Australia; Visiting Professor, School of Human and Health Sciences, University of Huddersfield
| | | | - Tracey J Weiland
- Professor, Emergency Medicine, University of Melbourne, Australia
| | - Jennie Hutton
- Emergency Physician, St Vincent's Hospital, Melbourne and the University of Melbourne, Australia
| | - Sarah Reel
- Senior Lecturer in Podiatry, School of Human and Health Sciences, University of Huddersfield
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18
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Andersen LPS, Hogh A, Gadegaard C, Biering K. Employees exposed to work-related threats and violence in human services sectors: Are any employees members particularly exposed to violence and threats and what role do supervisors play? Work 2019; 63:99-111. [PMID: 31127748 DOI: 10.3233/wor-192911] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The frequency of being exposed to work-related violence and threats is high in employees working in the human service sector. The question is whether certain employees are particularly exposed to violence and threats than others. OBJECTIVE This study examined whether particular employees were especially exposed to work-related violence and threats due to personal characteristics, coping styles, attitudes or participating in violence prevention training. We also examined the role played by supervisors. METHODS Questionnaire data were collected in 2010 and 2011. In all, 3584 employees from special schools, psychiatric wards, eldercare and the Prison and Probation Service participated. We used multivariate logistic regression analyses. RESULTS We found persons high on the extroversion and introversion scales were associated with statistical significant increased risk for work-related threats. Furthermore, accepting attitudes concerning work-related violence were also statistical significant associated with increased the risk for both work-related threats and violence. Associations between coping styles and work-related threats and violence were very small and statistically non-significant and we found no effect of violence prevention training. The risk for work-related threats for persons high on the extroversion scale was decreased if supervisor violence prevention behaviour was high. Furthermore, if supervisor prevention behaviour was high, prevention training decreased the risk for work-related violence. However, these associations weren't statistically significant. CONCLUSION The results stress that effective prevention requires involvement of both employees and supervisors.
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Affiliation(s)
- Lars Peter Sønderbo Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine - University Research Clinic, Regional Hospital West Jutland, Herning, Denmark
| | - Annie Hogh
- Department of Psychology, Copenhagen University, Copenhagen, Denmark
| | - Charlotte Gadegaard
- Danish Ramazzini Centre, Department of Occupational Medicine - University Research Clinic, Regional Hospital West Jutland, Herning, Denmark
| | - Karin Biering
- Danish Ramazzini Centre, Department of Occupational Medicine - University Research Clinic, Regional Hospital West Jutland, Herning, Denmark
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19
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Jaspers SØ, Jakobsen LM, Gadegaard CA, Dyreborg J, Andersen LPSØ, Aust B. Design of a tailored and integrated violence prevention program in psychiatric wards and prisons. Work 2019; 62:525-541. [PMID: 31104039 DOI: 10.3233/wor-192888] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Violence and threats of violence against personnel at psychiatric wards as well as in the prison service is a major work environment problem. To date results from interventions to prevent violence and threats in these sectors have been inconclusive or of small effect. One of the reasons may be that violence and threats of violence occur as a consequence of a complex interaction between employee-level and management-level factors. OBJECTIVE To design a tailored and theory-based intervention program directed at violence prevention in psychiatric wards and prisons that integrates the employee-level and management-level, and development of an evaluation design building on the Context, Process, and Outcome Evaluation Model. METHODS The study follows a stepped-wedged design with 16 work units entering the intervention in four groups with differing start dates from September 2017 to January 2019. The context and process evaluation includes: calculating the implementation degree; mapping of contextual factors; interviews with unit-leaders and employees before and after the intervention. The outcome evaluation includes performing multi-level statistical analysis on data from a three-monthly questionnaire to employees at the participating workplaces. RESULTS The first results will be available in 2020. CONCLUSIONS The comprehensive evaluation of the intervention will give insight into the processes and effects of the intervention.
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Affiliation(s)
- Sofie Østergaard Jaspers
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark.,National Research Center for the Working Environment, Copenhagen, Denmark
| | - Louise Meinertz Jakobsen
- Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
| | | | - Johnny Dyreborg
- National Research Center for the Working Environment, Copenhagen, Denmark
| | - Lars Peter SØnderbo Andersen
- Department of Occupational Medicine - University Research Clinic, Danish Ramazzini Centre, Regional Hospital West Jutland, Herning, Denmark
| | - Birgit Aust
- National Research Center for the Working Environment, Copenhagen, Denmark
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20
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Havaei F, MacPhee M, Lee SE. The effect of violence prevention strategies on perceptions of workplace safety: A study of medical-surgical and mental health nurses. J Adv Nurs 2019; 75:1657-1666. [PMID: 30644125 DOI: 10.1111/jan.13950] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/30/2018] [Accepted: 11/13/2018] [Indexed: 11/27/2022]
Abstract
AIMS To explore associations between specific violence prevention strategies and nurses' perceptions of workplace safety in medical-surgical and mental health settings. BACKGROUND Workplace violence is on the rise globally. Nurses have the highest risk of violence due to the nature of their work. Violence rates are particularly high among USA and Canadian nurses. Although multiple violence prevention strategies are currently in place in public healthcare organizations in British Columbia, Canada, it is unknown whether these approaches are associated with nurses' perceptions of workplace safety. DESIGN This is an exploratory correlational design using secondary data. METHODS Using data obtained from a province-wide survey of nurses between March 2017 - January 2018, this study included 771 nurses from medical-surgical and 189 nurses from mental health settings. Data were analysed using ordinal logistic regressions. RESULTS For medical-surgical and mental health nurses, greater perceptions of workplace safety were related to employers listening to them with respect to violence prevention strategies. Nurses in both settings were more likely to feel safe when they were not expected to physically intervene during a code white situation. Medical-surgical nurses were more likely to feel safe when code white incident reviews were conducted and fixed alarms were used. Mental health nurses were more likely to report feeling safe when they had enough properly trained code white responders on their unit. CONCLUSION Nurse-employer engagement is critical to nurses' perceptions of feeling safe at work. Engagement opportunities include nurses' involvement in discussions about appropriate violence prevention strategies, collaborative debriefing after violent incidents and co-development and updates of patients' behavioural care plans.
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Affiliation(s)
- Farinaz Havaei
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Maura MacPhee
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Seung Eun Lee
- College of Nursing, Yonsei University, Seoul, Korea.,School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts
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21
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Wressell JA, Rasmussen B, Driscoll A. Exploring the workplace violence risk profile for remote area nurses and the impact of organisational culture and risk management strategy. Collegian 2018. [DOI: 10.1016/j.colegn.2018.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Hills D, Lam L, Hills S. Workplace aggression experiences and responses of Victorian nurses, midwives and care personnel. Collegian 2018. [DOI: 10.1016/j.colegn.2018.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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23
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Morphet J, Griffiths D, Beattie J, Velasquez Reyes D, Innes K. Prevention and management of occupational violence and aggression in healthcare: A scoping review. Collegian 2018. [DOI: 10.1016/j.colegn.2018.04.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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24
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Violence towards emergency nurses: A narrative review of theories and frameworks. Int Emerg Nurs 2018; 39:2-12. [DOI: 10.1016/j.ienj.2017.08.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/09/2017] [Accepted: 08/30/2017] [Indexed: 11/15/2022]
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25
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Pihl P, Grytnes R, Andersen LPS. Violence prevention in special education schools - an integrated practice? RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 77:87-97. [PMID: 29709782 DOI: 10.1016/j.ridd.2018.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 03/26/2018] [Accepted: 04/18/2018] [Indexed: 06/08/2023]
Abstract
Research has shown that employees in special education settings are at high risk for work-related threats and violence. Previous research has not yet been able to identify the essential components of training programs that offer protection from work-related threats and violence. Therefore, the aim of this study was to explore how employees in special education schools deal with prevention of work-related threats and violence. Group interviews were conducted with 14 employees working at 5 special education schools. Results show that employees use a wide range of prevention strategies drawing on specific violence prevention techniques as well as professional pedagogical approaches. We propose that the prevention of threats and violence in special education schools can be understood as an integrated pedagogical practice operating on three interrelated levels.
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Affiliation(s)
- Patricia Pihl
- Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland, Herning, Denmark.
| | - Regine Grytnes
- Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland, Herning, Denmark.
| | - Lars Peter S Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland, Herning, Denmark.
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26
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Violence towards Emergency Nurses. The Italian National Survey 2016: A qualitative study. Int J Nurs Stud 2018; 81:21-29. [DOI: 10.1016/j.ijnurstu.2018.01.017] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 01/29/2018] [Accepted: 01/31/2018] [Indexed: 11/22/2022]
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Deriving a Framework for a Systems Approach to Agitated Patient Care in the Emergency Department. Jt Comm J Qual Patient Saf 2018; 44:279-292. [PMID: 29759261 DOI: 10.1016/j.jcjq.2017.11.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 11/13/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND The rising agitated patient population presenting to the emergency department (ED) has caused increasing safety threats for health care workers and patients. Development of evidence-based strategies has been limited by the lack of a structured framework to examine agitated patient care in the ED. In this study, a systems approach from the patient safety literature was used to derive a comprehensive theoretical framework for addressing ED patient agitation. METHODS A mixed-methods approach was used with ED staff members at an academic site and a community site of a regional health care network. Participants consisted of resident and attending physicians, physician assistants/nurse practitioners, nurses, technicians, and security officers. After a simulated agitated patient encounter to prime participants, uniprofessional and interprofessional focus groups were conducted, followed by a structured thematic analysis using a grounded theory approach. Quantitative data consisted of surveys of violence exposure and attitudes toward patient aggression and management. RESULTS Data saturation was reached with 57 participants. Violence exposure was higher for technicians, nurses, and officers. Conflicting priorities and management challenges occurred due to four main interconnected elements: perceived complex patient motivations; a patient care paradox between professional duty and personal safety; discordant interprofessional dynamics mitigated by respect and trust; and logistical challenges impeding care delivery and long-term outcomes. CONCLUSION Using a systems approach, five interconnected levels of ED agitated patient care delivery were identified: patient, staff, team, ED microsystem, and health care macrosystem. These care dimensions were synthesized to form a novel patient safety-based framework that can help guide future research, practice, and policy.
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Martinez AJS. Managing Workplace Violence With Evidence-Based Interventions: A Literature Review. J Psychosoc Nurs Ment Health Serv 2018; 54:31-6. [PMID: 27576226 DOI: 10.3928/02793695-20160817-05] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 06/15/2016] [Indexed: 11/20/2022]
Abstract
Workplace violence in health care settings is an occupational issue concerning nurses and other health care professionals. Patient aggression against nurses is often the most common form of violence in clinical settings, occurring in emergency departments, inpatient psychiatric settings, and nursing homes. Physical and verbal assaults are the major forms of workplace violence encountered by nurses. Current research has identified staff, environmental, and patient risk factors as the major precursors of workplace violence initiated by patients. Nurses often experience significant physical and psychological negative consequences after an episode of workplace violence. A review of the evidence was conducted to identify current evidence-based interventions that can help nurses minimize the incidence of workplace violence. [Journal of Psychosocial Nursing and Mental Health Services, 54(9), 31-36.].
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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: 54] [Impact Index Per Article: 9.0] [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.
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Affiliation(s)
| | - Lucy Morris
- Merseycare NHS Foundation Trust, Whalley, Lancashire BB7 9PE, UK
| | - Ian Smith
- Furness College, Lancaster University, Lancaster LA1 4YG, UK.
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30
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Halm M. Aggression Management Education for Acute Care Nurses: What's the Evidence? Am J Crit Care 2017; 26:504-508. [PMID: 29092876 DOI: 10.4037/ajcc2017984] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Margo Halm
- Margo A. Halm is associate chief nurse executive, nursing research and evidence-based practice, VA Portland HealthCare System, Portland, Oregon
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31
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Worksite Walkthrough Intervention: Data-driven Prevention of Workplace Violence on Hospital Units. J Occup Environ Med 2017; 59:875-884. [PMID: 28692010 DOI: 10.1097/jom.0000000000001081] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to describe the implementation of a data-driven, unit-based walkthrough intervention shown to be effective in reducing the risk of workplace violence in hospitals. METHODS A structured worksite walkthrough was conducted on 21 hospital units. Unit-level workplace violence data were reviewed and a checklist of possible prevention strategies and an Action Plan form guided development of unit-specific intervention. Unit supervisor perceptions of the walkthrough and implemented prevention strategies were reported via questionnaires. Prevention strategies were categorized as environmental, behavioral, or administrative. RESULTS A majority of units implemented strategies within 12 months' postintervention. Participants found the walkthrough useful, practical, and worthy of continued use. CONCLUSIONS Structured worksite walkthroughs provide a feasible method for workplace violence reduction in hospitals. Core elements are standardized yet flexible, promoting fidelity and transferability of this intervention.
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Weiland TJ, Ivory S, Hutton J. Managing Acute Behavioural Disturbances in the Emergency Department Using the Environment, Policies and Practices: A Systematic Review. West J Emerg Med 2017; 18:647-661. [PMID: 28611886 PMCID: PMC5468071 DOI: 10.5811/westjem.2017.4.33411] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 03/04/2017] [Accepted: 04/20/2017] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Effective strategies for managing acute behavioural disturbances (ABDs) within emergency departments (EDs) are needed given their rising occurrence and negative impact on safety, psychological wellbeing, and staff turnover. Non-pharmacological interventions for ABD management generally fall into four categories: environmental modifications; policies; practice changes; and education. Our objective was to systematically review the efficacy of strategies for ABD management within EDs that involved changes to environment, architecture, policy and practice. METHODS We performed systematic searches of CINAHL Plus with Full Text, PsycINFO, MEDLINE, and EMBASE, as well as reference lists of relevant review articles to identify relevant studies published between January 1985 - April 2016. We included studies written in English, which reported management of behavioural disturbances in adults associated with the ED through the use of environmental modifiers (including seclusion, restraint, specialised rooms, architectural changes), policy, and practice-based interventions excepting education-only interventions. Efficacy outcomes of interest included incidence, severity, and duration of ABD, incidence of injuries, staff absenteeism, restraint use, restraint duration, and staff and patient perceptions. Two reviewers independently screened titles and abstracts, and assessed the relevancy and eligibility of studies based on full-text articles. Two authors independently appraised included studies. A narrative synthesis of findings was undertaken. RESULTS Studies reporting interventions for managing ABDs within the ED are limited in number and quality. The level of evidence for efficacy is low, requiring caution in conclusions. While there is preliminary evidence for environmental change in the form of specialised behavioural rooms, security upgrades and ED modifications, these are not supported by evidence from controlled studies. Many of these "common sense" environmental changes recommended in many guidelines have been widely implemented in EDs. CONCLUSION There is an unambiguous gap in the literature regarding the efficacy of interventions for ABD management in EDs involving environmental, policy or practice-based changes. With growing demand on EDs, and with increasing numbers of ABDs, identification of robust evidence-based interventions for safe and effective ABD management is vital.
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Affiliation(s)
- Tracey J. Weiland
- St Vincent’s Hospital Melbourne, Emergency Practice Innovation Centre, Melbourne, Victoria, Australia
- The University of Melbourne, Melbourne School of Population and Global Health, Neuroepidemiology Unit, Victoria, Australia
| | - Sean Ivory
- St Vincent’s Hospital Melbourne, Emergency Practice Innovation Centre, Melbourne, Victoria, Australia
- The University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia
| | - Jennie Hutton
- St Vincent’s Hospital Melbourne, Department of Emergency Medicine, Melbourne, Victoria, Australia
- The University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia
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Nikathil S, Olaussen A, Gocentas RA, Symons E, Mitra B. Review article: Workplace violence in the emergency department: A systematic review and meta analysis. Emerg Med Australas 2017; 29:265-275. [PMID: 28406572 DOI: 10.1111/1742-6723.12761] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 12/24/2016] [Accepted: 01/28/2017] [Indexed: 11/30/2022]
Abstract
Patient or visitor perpetrated workplace violence (WPV) has been reported to be a common occurrence within the ED. No universal definition of violence or recording of such events exists. In addition ED staff are often reluctant to report violent incidents. The true incidence of WPV is therefore unclear. This systematic review aimed to quantify WPV in EDs. The association of WPV to drug and alcohol exposure was explored. The databases MEDLINE, Embase, PsycInfo and the Cochrane Library were searched from their commencement to 10 March 2016. MeSH terms and text words for ED, violence and aggression were combined. A meta-analysis was conducted on the primary outcome variable-proportion of violent patients among total ED presentations. A secondary meta-analysis used studies reporting on proportion of drug and alcohol affected patients occurring within the violent population. The search yielded a total of 8720 records. A total of 7235 were unique and underwent abstract screening. A total of 22 studies were deemed relevant according to inclusion and exclusion criteria. Retrospective study design predominated, analysing mainly security records and incident reports. The rates of violence from individual studies ranged from 1 incident to 172 incidents per 10 000 presentations. The pooled incidence suggests there are 36 violent patients for every 10 000 presentations to the ED (95% confidence interval 0.0030-0.0043). WPV in the ED was commonly reported. There is wide heterogeneity across the study methodology, definitions and rates. More standardised recording and reporting may inform preventive measures and highlight effective management strategies.
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Affiliation(s)
- Shradha Nikathil
- Emergency and Trauma Centre, National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alexander Olaussen
- Emergency and Trauma Centre, National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,National Trauma Research Institute, Monash University, Melbourne, Victoria, Australia.,Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Victoria, Australia
| | - Robert A Gocentas
- Emergency and Trauma Centre, National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Evan Symons
- Department of Psychiatry, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Biswadev Mitra
- Emergency and Trauma Centre, National Trauma Research Institute, The Alfred Hospital, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,National Trauma Research Institute, Monash University, Melbourne, Victoria, Australia
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Workplace Violence and Perceptions of Safety Among Emergency Department Staff Members: Experiences, Expectations, Tolerance, Reporting, and Recommendations. J Trauma Nurs 2017; 24:65-77. [DOI: 10.1097/jtn.0000000000000269] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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35
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Hassankhani H, Soheili A. Zero-Tolerance Policy: The Last Way to Curb Workplace Violence against Nurses in Iranian Healthcare System. J Caring Sci 2017; 6:1-3. [PMID: 28299292 PMCID: PMC5348658 DOI: 10.15171/jcs.2017.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 01/15/2017] [Indexed: 02/03/2023] Open
Affiliation(s)
- Hadi Hassankhani
- Department of Medical-Surgical Nursing, Student Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amin Soheili
- Department of Medical-Surgical Nursing, Student Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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36
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Arnetz JE, Hamblin L, Russell J, Upfal MJ, Luborsky M, Janisse J, Essenmacher L. Preventing Patient-to-Worker Violence in Hospitals: Outcome of a Randomized Controlled Intervention. J Occup Environ Med 2017; 59:18-27. [PMID: 28045793 PMCID: PMC5214512 DOI: 10.1097/jom.0000000000000909] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the effects of a randomized controlled intervention on the incidence of patient-to-worker (Type II) violence and related injury in hospitals. METHODS Forty-one units across seven hospitals were randomized into intervention (n = 21) and control (n = 20) groups. Intervention units received unit-level violence data to facilitate development of an action plan for violence prevention; no data were presented to control units. Main outcomes were rates of violent events and injuries across study groups over time. RESULTS Six months post-intervention, incident rate ratios of violent events were significantly lower on intervention units compared with controls (incident rate ratio [IRR] 0.48, 95% confidence interval [CI] 0.29 to 0.80). At 24 months, the risk for violence-related injury was lower on intervention units, compared with controls (IRR 0.37, 95% CI 0.17 to 0.83). CONCLUSIONS This data-driven, worksite-based intervention was effective in decreasing risks of patient-to-worker violence and related injury.
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Affiliation(s)
- Judith E. Arnetz
- Dept. of Family Medicine, Michigan State University, East Lansing, Michigan, USA
- Dept. of Public Health and Caring Sciences, Uppsala University, Sweden
- Dept. of Family Medicine and Public Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Lydia Hamblin
- Dept. of Family Medicine and Public Health Sciences, Wayne State University, Detroit, Michigan, USA
- Dept. of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Jim Russell
- Detroit Medical Center Occupational Health Services, Detroit, Michigan, USA
| | - Mark J. Upfal
- Detroit Medical Center Occupational Health Services, Detroit, Michigan, USA
- Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, Michigan
| | - Mark Luborsky
- Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
- Dept. of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Sweden
| | - James Janisse
- Dept. of Family Medicine and Public Health Sciences, Wayne State University, Detroit, Michigan, USA
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Tarquinio C, Rotonda C, Houllé WA, Montel S, Rydberg JA, Minary L, Dellucci H, Tarquinio P, Fayard A, Alla F. Early Psychological Preventive Intervention For Workplace Violence: A Randomized Controlled Explorative and Comparative Study Between EMDR-Recent Event and Critical Incident Stress Debriefing. Issues Ment Health Nurs 2016; 37:787-799. [PMID: 27696918 DOI: 10.1080/01612840.2016.1224282] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This randomized controlled trial study aims to investigate the efficacy of an early psychological intervention called EMDR-RE compared to Critical Incident Stress Debriefing on 60 victims of workplace violence, which were divided into three groups: 'EMDR-RE' (n = 19), 'CISD' (n = 23), and 'delayed EMDR-RE' (n = 18). EMDR-RE and CISD took place 48 hours after the event, whilst third intervention was delayed by an additional 48 hours. Results showed that after 3 months PCLS and SUDS scores were significantly lower with EMDR-RE and delayed EMDR-RE compared to CISD. After 48 hours and 3 months, none of the EMDR-RE-treated victims showed PTSD symptoms.
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Ramacciati N, Ceccagnoli A, Addey B, Giusti GD. Commentary on Tan MFet al. “Nursing management of aggression in a Singapore emergency department: A qualitative study”.Nursing and Health Sciences. 2015; 17: 307-312. Nurs Health Sci 2016; 18:270-1. [DOI: 10.1111/nhs.12248] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 08/20/2015] [Accepted: 08/21/2015] [Indexed: 12/01/2022]
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Abiri S, Oakley LD, Hitchcock ME, Hall A. Stigma Related Avoidance in People Living with Severe Mental Illness (SMI): Findings of an Integrative Review. Community Ment Health J 2016; 52:251-61. [PMID: 26668008 DOI: 10.1007/s10597-015-9957-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 10/06/2015] [Indexed: 11/28/2022]
Abstract
The purpose of this integrative review is to synthesize primary evidence of the impact of internalized stigma on avoidance in adult community treatment patients living with SMI. A keyword database search of articles published through 2015 yielded 21 papers and a total of 4256 patients. Our analyses found that stigmatizing beliefs associated with avoidance are related to significant loss of self-esteem. Factors generally thought to reduce stigma internalized as self-stigmatizing beliefs, such as improved insight, increased self-awareness, and psycho-education to improve stigma coping skills, do not appear to improve self-esteem.
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Affiliation(s)
- Sadat Abiri
- MPH Program, University of Wisconsin Madison School of Medicine and Public Health, Madison, WI, USA.,Psychiatric Mental Health Nurse Practitioner Program, University of Wisconsin Madison School of Nursing, 4171 Signe Skott Cooper Hall, 701 Highland Avenue, Madison, WI, 53705, USA.,Fordem Connections Community Support Programs, Journey Mental Health Center, West Washington Avenue, Madison, WI, USA
| | - Linda Denise Oakley
- Psychiatric Mental Health Nurse Practitioner Program, University of Wisconsin Madison School of Nursing, 4171 Signe Skott Cooper Hall, 701 Highland Avenue, Madison, WI, 53705, USA.
| | - Mary E Hitchcock
- Department of Health Sciences Library, University of Wisconsin Madison School of Medicine and Public Health, 750 Highland Avenue, Madison, WI, 53705, USA
| | - Amanda Hall
- Fordem Connections Community Support Programs, Journey Mental Health Center, West Washington Avenue, Madison, WI, USA
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d'Aubarede C, Sarnin P, Cornut P, Touzet S, Duclos A, Burillon C, Fassier J. Impacts of users’ antisocial behaviors in an ophthalmologic emergency department—a qualitative study. J Occup Health 2016; 58:96-106. [DOI: 10.1539/joh.15-0184-fs] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Constance d'Aubarede
- UMR T 9405 (Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail. Environnement: UMRESTTE)Université Claude Bernard Lyon 1France
- Hospices Civils de Lyon, Service de Médecine et Santé au TravailGroupement Hospitalier EstFrance
| | - Philippe Sarnin
- GREPS ‐EA 4163 (Groupe de Recherche en Psychologie Sociale)Université Lyon 2 ‐ Institut de PsychologieFrance
| | - Pierre‐Loïc Cornut
- Service d'OphtalmologieHôpital Edouard Herriot, Hospices Civils de LyonFrance
| | - Sandrine Touzet
- Pôle Information Médicale Evaluation et Recherche, Hospices Civils de LyonFrance
| | - Antoine Duclos
- Pôle Information Médicale Evaluation et Recherche, Hospices Civils de LyonFrance
| | - Carole Burillon
- Service d'OphtalmologieHôpital Edouard Herriot, Hospices Civils de LyonFrance
| | - Jean‐Baptiste Fassier
- UMR T 9405 (Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail. Environnement: UMRESTTE)Université Claude Bernard Lyon 1France
- Hospices Civils de Lyon, Service de Médecine et Santé au TravailGroupement Hospitalier EstFrance
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Heckemann B, Breimaier HE, Halfens RJ, Schols JM, Hahn S. The participant's perspective: learning from an aggression management training course for nurses. Insights from a qualitative interview study. Scand J Caring Sci 2016; 30:574-85. [DOI: 10.1111/scs.12281] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 07/27/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Birgit Heckemann
- CAPHRI; School for Public Health and Primary Care; Maastricht University; Maastricht the Netherlands
| | | | - Ruud J.G. Halfens
- Department of Health Services Research; CAPHRI; School for Public Health and Primary Care; Maastricht University; Maastricht the Netherlands
| | - Jos M.G.A. Schols
- Department of Health Services Research; CAPHRI; School for Public Health and Primary Care; Maastricht University; Maastricht the Netherlands
- Department of Family Medicine; CAPHRI; School for Public Health and Primary Care; Maastricht University; Maastricht the Netherlands
| | - Sabine Hahn
- Bern University of Applied Sciences; Bern Switzerland
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42
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ALBashtawy M, Aljezawi M. Emergency nurses' perspective of workplace violence in Jordanian hospitals: A national survey. Int Emerg Nurs 2016. [DOI: 10.1016/j.ienj.2015.06.005#] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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43
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ALBashtawy M, Aljezawi M. Emergency nurses' perspective of workplace violence in Jordanian hospitals: A national survey. Int Emerg Nurs 2016; 24:61-5. [DOI: 10.1016/j.ienj.2015.06.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 06/13/2015] [Accepted: 06/21/2015] [Indexed: 10/23/2022]
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44
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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]
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45
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Hills DJ, Ross HM, Pich J, Hill AT, Dalsbø TK, Riahi S, Guay S, Martínez-Jarreta B. Education and training for preventing and minimising workplace aggression directed toward healthcare workers. Hippokratia 2015. [DOI: 10.1002/14651858.cd011860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Danny J Hills
- University of Canberra; Disciplines of Nursing and Midwifery, Faculty of Health; Canberra ACT Australia 2601
| | - Heather M Ross
- Arizona State University; College of Nursing and Health Innovation; 500 N. 3rd Street Phoenix AZ USA 85004
| | - Jacqueline Pich
- University of Newcastle; School of Nursing and Midwifery; University Drive Callaghan NSW Australia 2308
| | - April T Hill
- Arizona State University; College of Nursing and Health Innovation; 500 N. 3rd Street Phoenix AZ USA 85004
| | - Therese K Dalsbø
- Norwegian Knowledge Centre for the Health Services; Postboks 7004 St. Olavs plass Oslo Norway N-0130
| | - Sanaz Riahi
- Ontario Shores Centre for Mental Health Sciences; Professional Practice & Clinical Information; 700 Gordon St. Whitby ON Canada L1N 5S9
| | - Stéphane Guay
- University of Montreal; School of Criminology; 3150, rue Jean-Brillant Montreal QC Canada H3T 1N8
| | - Begoña Martínez-Jarreta
- University of Zaragoza; Department of Forensic Medicine and Toxicology. Faculty of Medicine; C/ Domingo Miral s/n Zaragoza Spain 50.009
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46
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La violence dans les services d’urgences : évaluation d’une politique de réduction de la violence dans un service d’accueil des urgences parisien. ANNALES FRANCAISES DE MEDECINE D URGENCE 2015. [DOI: 10.1007/s13341-015-0558-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Heckemann B, Zeller A, Hahn S, Dassen T, Schols JMGA, Halfens RJG. The effect of aggression management training programmes for nursing staff and students working in an acute hospital setting. A narrative review of current literature. NURSE EDUCATION TODAY 2015; 35:212-219. [PMID: 25200511 DOI: 10.1016/j.nedt.2014.08.003] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 07/14/2014] [Accepted: 08/08/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Patient aggression is a longstanding problem in general hospital nursing. Staff training is recommended to tackle workplace aggression originating from patients or visitors, yet evidence on training effects is scarce. AIMS To review and collate current research evidence on the effect of aggression management training for nurses and nursing students working in general hospitals, and to derive recommendations for further research. DESIGN Systematic, narrative review. DATA SOURCES Embase, MEDLINE, the Cochrane library, CINAHL, PsycINFO, pubmed, psycArticles, Psychology and Behavioural Sciences Collection were searched for articles evaluating training programs for staff and students in acute hospital adult nursing in a 'before/after' design. Studies published between January 2000 and September 2011 in English, French or German were eligible of inclusion. REVIEW METHODS The methodological quality of included studies was assessed with the 'Quality Assessment Tool for Quantitative Studies'. Main outcomes i.e. attitudes, confidence, skills and knowledge were collated. RESULTS Nine studies were included. Two had a weak, six a moderate, and one a strong study design. All studies reported increased confidence, improved attitude, skills, and knowledge about risk factors post training. There was no significant change in incidence of patient aggression. CONCLUSION Our findings corroborate findings of reviews on training in mental health care, which point to a lack of high quality research. Training does not reduce the incidence of aggressive acts. Aggression needs to be tackled at an organizational level.
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Affiliation(s)
- B Heckemann
- CAPHRI - School for Public Health and Primary Care, Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands; GPCC-Gothenburg Centre for Person-centred Care, Sahlgrenska Academy, Gothenburg University, Centre for Person-Centred Care Research (GPCC), Gothenburg, Sweden.
| | - A Zeller
- Department of Health Sciences, St. Gallen University of Applied Sciences, Rosenbergstrasse 59, Postfach, 9001 St. Gallen, Switzerland.
| | - S Hahn
- Berne University of Applied Sciences, Berner Fachhochschule, Fachbereich Gesundheit, Murtenstrasse 10, 3008 Bern, Switzerland.
| | - T Dassen
- Center for the Humanities and Health Sciences, Department of Nursing Science, Charité-Universitätsmedizin, Augustenburger Platz 1, 13353 Berlin, Germany.
| | - J M G A Schols
- Department of Family Medicine and Department of Health Services Research, Caphri-School for Public Health and Primary Care, Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands.
| | - R J G Halfens
- Faculty of Health, Medicine and Life Sciences, Caphri-School for Public Health and Primary Care, Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands.
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Vezyridis P, Samoutis A, Mavrikiou PM. Workplace violence against clinicians in Cypriot emergency departments: a national questionnaire survey. J Clin Nurs 2014; 24:1210-22. [DOI: 10.1111/jocn.12660] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2014] [Indexed: 11/28/2022]
Affiliation(s)
| | - Alexis Samoutis
- School of Health Sciences; Frederick University Cyprus; Nicosia Cyprus
| | - Petroula M Mavrikiou
- School of Economic Sciences and Administration; Frederick University Cyprus; Nicosia Cyprus
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Jerkič K, Babnik K, Karnjuš I. Verbalno in posredno nasilje v urgentni dejavnosti. OBZORNIK ZDRAVSTVENE NEGE 2014. [DOI: 10.14528/snr.2014.48.2.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Uvod: Namen raziskave je bil proučiti pojavnost verbalnega in drugih oblik posrednega nasilja na vzorcu zaposlenih v zdravstveni negi v urgentni dejavnosti, in sicer identificirati pogostost doživljanja, oblike nasilja, najpogostejše povzročitelje nasilja, zaznane vzroke ter demografske spremenljivke zaposlenih, ki nasilje na delovnem mestu zaznavajo pogosteje. Metode: Raziskava je bila opravljena na nenaključnem vzorcu zaposlenih v zdravstveni negi v urgentnih ambulantah primarne in sekundarne ravni zdravstvenega varstva (n = 62) v severnoprimorski regiji. Uporabljen je bil strukturirani vprašalnik, ki je vključeval 18 vprašanj. Podatki so bili obdelani s frekvencami, strukturnimi deleži in testom χ2. Rezultati: Dve tretjini udeležencev (46 izborov oz. 74,2 %) je že doživelo verbalno ali druge oblike posrednega nasilja na delovnem mestu, predvsem v obliki aktivnega neposrednega verbalnega nasilja s strani svojcev in pacientov. Najpogosteje zaznani razlogi nasilja so neustrezni, prenapolnjeni čakalni prostori (36 izborov). Tovrstno nasilje pogosteje zaznavajo zaposleni z daljšo delovno dobo (χ2 = 9,841, p = 0,003) ter starejši delavci (χ2 = 4,891, p = 0,041). Stopnja verbalnega in posrednega nasilja se je po oceni udeležencev z leti zmerno do opazno povečala. Diskusija in zaključek: Dobljeni rezultati so primerljivi z rezultati raziskav v tujini. Nadaljnje raziskave se morajo usmeriti v podrobnejšo fenomenološko izkušnjo doživljanja nasilja na delovnem mestu.
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Beydon L, Rineau E. [Violence against health professionals - let's woks promoting a group protective culture]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 2013; 32:136-137. [PMID: 23414927 DOI: 10.1016/j.annfar.2013.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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