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Ayaz B, Dozois G, Baumann AL, Fuseini A, Nelson S. Perpetrators of gender-based workplace violence amongst nurses and physicians-A scoping review of the literature. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003646. [PMID: 39240832 PMCID: PMC11379169 DOI: 10.1371/journal.pgph.0003646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 08/02/2024] [Indexed: 09/08/2024]
Abstract
In healthcare settings worldwide, workplace violence (WPV) has been extensively studied. However, significantly less is known about gender-based WPV and the characteristics of perpetrators. We conducted a comprehensive scoping review on Type II (directed by consumers) and Type III (perpetuated by healthcare workers) gender based-WPV among nurses and physicians globally. For the review, we followed the Preferred Reporting Items for Systematic and Meta Analyses extension for Scoping Review (PRISMA-ScR). The protocol for the comprehensive review was registered on the Open Science Framework on January 14, 2022, at https://osf.io/t4pfb/. A systematic search in five health and social science databases yielded 178 relevant studies that indicated types of perpetrators, with only 34 providing descriptive data for perpetrators' gender. Across both types of WPV, men (65.1%) were more frequently responsible for perpetuating WPV compared to women (28.2%) and both genders (6.7%). Type II WPV, demonstrated a higher incidence of violence against women; linked to the gendered roles, stereotypes, and societal expectations that allocate specific responsibilities based on gender. Type III WPV was further categorized into Type III-A (horizontal) and Type III-B (vertical). With Type III WPV, gendered power structures and stereotypes contributed to a permissive environment for violence by men and women that victimized more women. These revelations emphasize the pressing need for gender-sensitive strategies for addressing WPV within the healthcare sector. Policymakers must prioritize the security of healthcare workers, especially women, through reforms and zero-tolerance policies. Promoting gender equality and empowerment within the workforce and leadership is pivotal. Additionally, creating a culture of inclusivity, support, and respect, led by senior leadership, acknowledging WPV as a structural issue and enabling an open dialogue across all levels are essential for combating this pervasive problem.
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Affiliation(s)
- Basnama Ayaz
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | | | - Andrea L Baumann
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Adam Fuseini
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Sioban Nelson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Kim SC, Kaiser J, Hosford T, Sadate‐Akhavi C, Nurski A, Bos T, Ciampa C. A workplace violence prevention program targeting high-risk patients in emergency departments. J Am Coll Emerg Physicians Open 2024; 5:e13206. [PMID: 39056086 PMCID: PMC11269763 DOI: 10.1002/emp2.13206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/22/2024] [Accepted: 05/15/2024] [Indexed: 07/28/2024] Open
Abstract
Objective Patient violence in emergency departments (EDs) may be prevented with proactive mitigation measures targeting potentially violent patients. We aimed to evaluate the effects of two interventions guided by a validated risk-assessment tool. Methods A prospective interventional study was conducted among patients ≥10 years who visited two EDs in Michigan, USA, from October 2022 to August 2023. During triage, the ED nurses completed the Aggressive Behavior Risk Assessment Tool for EDs (ABRAT-ED) to identify high-risk patients. Following the baseline observational period, interventions were implemented stepwise for the high-risk patients: phase 1 period with signage posting and phase 2 period with a proactive Behavioral Emergency Response Team (BERT) huddle added to the signage posting. Before ED disposition, any violent events and their severities were documented. The data were retrieved retrospectively after the study was completed. Results Of 77,424 evaluable patients, 546 had ≥1 violent event. The violent event rates were 0.93%, 0.68%, and 0.62% for baseline, phase 1, and phase 2, respectively. The relative risk of violent events for phase 1 compared to the baseline was 0.73 (95% confidence interval [CI]: 0.59‒0.90; p = 0.003). The relative risk for phase 2 compared to phase 1 was 0.92 (95% CI: 0.76‒1.12; p = 0.418). Conclusion The use of signage posting as a persistent visual cue for high-risk patients identified by ABRAT-ED appears to be effective in reducing the overall violent event rates. However, adding proactive BERT huddle to signage posting showed no significant reduction in the violent event rates compared to signage posting alone.
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Affiliation(s)
- Son Chae Kim
- School of NursingPoint Loma Nazarene UniversitySan DiegoCaliforniaUSA
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Nelson S, Ayaz B, Baumann AL, Dozois G. A gender-based review of workplace violence amongst the global health workforce-A scoping review of the literature. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003336. [PMID: 38954697 PMCID: PMC11218983 DOI: 10.1371/journal.pgph.0003336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 05/20/2024] [Indexed: 07/04/2024]
Abstract
Workplace violence (WPV) impacts all levels of the health workforce, including the individual provider, organization, and society. While there is a substantial body of literature on various aspects of WPV against the health workforce, gender-based WPV (GB-WPV) has received less attention. Violence in both the workplace and broader society is rooted in gendered socio-economic, cultural, and institutional factors. Developing a robust understanding of GB-WPV is crucial to explore the differing experiences, responses, and outcomes of GB-WPV with respect to gender. We conducted a scoping review and report on the prevalence and risk factors of GB-WPV in healthcare settings globally. The review followed the Preferred Reporting Items for Systematic and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We registered the scoping review protocol on the Open Science Framework on January 14, 2022, at https://osf.io/t4pfb/. A systematic search was conducted of empirical literature in five health and social science databases. Of 13667, 226 studies were included in the analysis. Across the studies, more women than men experienced non-physical violence, including verbal abuse, sexual harassment, and bullying. Men experienced more physical violence compared to women. Younger age, less experience, shifting duties, specific clinical settings, lower professional status, organizational hierarchy, and minority status were found to be sensitive to gender, reflecting women's structural disadvantages in the workplace. Given the high prevalence and impact of GB-WPV on women, we provided recommendations to address systemic issues in clinical practice, academia, policy, and research.
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Affiliation(s)
- Sioban Nelson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Basnama Ayaz
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Andrea L. Baumann
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Graham Dozois
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
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Khlaisuk A, Seeherunwong A, Utriyaprasit K, Poungkaew A, Tongsai S. Incident of violence escalation of patients with psychiatric emergencies boarding in the emergency department in the central region of Thailand and its association: a prospective observational study. BMC Health Serv Res 2024; 24:768. [PMID: 38937780 PMCID: PMC11210055 DOI: 10.1186/s12913-024-11228-0] [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: 02/27/2024] [Accepted: 06/20/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND This study investigates the incidence of violence escalation among psychiatric emergency patients admitted to general emergency departments in hospitals in central Thailand. In addition, patient and service delivery system factors associated with the survival time of violence escalation in 16 emergency departments in the central region of Thailand are determined. This is a prospective observational study, and the study sample includes 507 psychiatric emergency patients who are ≥ 18 years old. The patients are selected through stratified random and purposive sampling. METHODS Patient data-including demographic data, emergency services used, and clinical characteristics-are analyzed using descriptive statistics. The Kaplan-Meier method estimates the violence escalation curve, and the log-rank test compares the violence escalation-free time between the levels of the violent behavior group. In addition, univariable and multivariable Cox proportional hazard analyses are performed to investigate the factors affecting violence escalation. RESULTS The incidence of violence escalation in psychiatric emergency patients in the emergency department is 7.3%, whereas the incidence rate of violence escalation is 3 per 100 psychiatric emergency patient visit hours. Factors affecting violence escalation include the violent behavior score at triage (aHR = 2.004; 95% CI: 1.051-3.823) and the nurse competency score (aHR = 0.147; 95% CI: 0.032-0.680). CONCLUSIONS Assessing the violent behavior of psychiatric emergency patients at triage may assist emergency providers in monitoring patient behavior and providing early intervention to prevent the escalation of violent behavior. Furthermore, training emergency nurses in psychiatric emergency care is necessary.
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Affiliation(s)
| | - Acharaporn Seeherunwong
- Department of Mental Health and Psychiatric Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand.
| | - Ketsarin Utriyaprasit
- Department of Surgical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Autchariya Poungkaew
- Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Sasima Tongsai
- Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Ikpae EB, Buowari DY. Characteristics of Workplace Violence on Doctors and Nurses at the Accident and Emergency Department in a Southern State of Nigeria. Niger Med J 2023; 64:398-407. [PMID: 38974071 PMCID: PMC11223013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Abstract
Background Violence against healthcare workers is a menace ravaging the health sector and staff of the accident and emergency department are the worst affected. As a consequence, this violence puts health-care provision at risk and compromises the quality of care. This study aimed to determine the prevalence, type, sources and risk factors of violence against doctors and nurses in the emergency department. Methodology This is a cross-sectional study conducted in March-April 2022 amongst doctors and nurses in the ED using a self- administered questionnaire on the staff. Result There were 51 respondents in this study comprising 35.3% doctors and 64.7% nurses. Most (72.5%) of the respondents have been victims of workplace violence and 86.2% experienced verbal abuse. Patient relatives make up a majority (83.8%) of the perpetrators of the violence, with lack of communication (41.2%) making up the majority of the perceived reason for the assault. Most of the victims did not make any report about the incident (86.5%). There was a significant relationship between the occurrence of workplace violence and the category of healthcare professionals. Conclusion Workplace violence is common in the accident and emergency department and nurses are the worst affected. Most victims do not report the incident. Hospital administrators and managers should put policies, deterrents and strategies, such as training on communication skills and an improved reporting system to prevent violence against healthcare workers.
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Affiliation(s)
- Edward Barile Ikpae
- Department of Accident and Emergency, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | - Dabota Yvonne Buowari
- Department of Accident and Emergency, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
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Baxter SL, Saseendrakumar BR, Cheung M, Savides TJ, Longhurst CA, Sinsky CA, Millen M, Tai-Seale M. Association of Electronic Health Record Inbasket Message Characteristics With Physician Burnout. JAMA Netw Open 2022; 5:e2244363. [PMID: 36449288 PMCID: PMC9713605 DOI: 10.1001/jamanetworkopen.2022.44363] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
IMPORTANCE Physician burnout is an ongoing epidemic; electronic health record (EHR) use has been associated with burnout, and the burden of EHR inbasket messages has grown in the context of the COVID-19 pandemic. Understanding how EHR inbasket messages are associated with physician burnout may uncover new insights for intervention strategies. OBJECTIVE To evaluate associations between EHR inbasket message characteristics and physician burnout. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study in a single academic medical center involving physicians from multiple specialties. Data collection took place April to September 2020, and data were analyzed September to December 2020. EXPOSURES Physicians responded to a survey including the validated Mini-Z 5-point burnout scale. MAIN OUTCOMES AND MEASURES Physician burnout according to the self-reported burnout scale. A sentiment analysis model was used to calculate sentiment scores for EHR inbasket messages extracted for participating physicians. Multivariable modeling was used to model risk of physician burnout using factors such as message characteristics, physician demographics, and clinical practice characteristics. RESULTS Of 609 physicians who responded to the survey, 297 (48.8%) were women, 343 (56.3%) were White, 391 (64.2%) practiced in outpatient settings, and 428 (70.28%) had been in medical practice for 15 years or less. Half (307 [50.4%]) reported burnout (score of 3 or higher). A total of 1 453 245 inbasket messages were extracted, of which 630 828 (43.4%) were patient messages. Among negative messages, common words included medical conditions, expletives and/or profanity, and words related to violence. There were no significant associations between message characteristics (including sentiment scores) and burnout. Odds of burnout were significantly higher among Hispanic/Latino physicians (odds ratio [OR], 3.44; 95% CI, 1.18-10.61; P = .03) and women (OR, 1.60; 95% CI, 1.13-2.27; P = .01), and significantly lower among physicians in clinical practice for more than 15 years (OR, 0.46; 95% CI, 0.30-0.68; P < .001). CONCLUSIONS AND RELEVANCE In this cross-sectional study, message characteristics were not associated with physician burnout, but the presence of expletives and violent words represents an opportunity for improving patient engagement, EHR portal design, or filters. Natural language processing represents a novel approach to understanding potential associations between EHR inbasket messages and physician burnout and may also help inform quality improvement initiatives aimed at improving patient experience.
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Affiliation(s)
- Sally L Baxter
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California, San Diego, La Jolla
- Department of Medicine, University of California, San Diego, La Jolla
| | - Bharanidharan Radha Saseendrakumar
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California, San Diego, La Jolla
| | - Michael Cheung
- Department of Family Medicine, University of California, San Diego, La Jolla
| | - Thomas J Savides
- Department of Medicine, University of California, San Diego, La Jolla
| | - Christopher A Longhurst
- Department of Medicine, University of California, San Diego, La Jolla
- Department of Pediatrics, University of California, San Diego, La Jolla
| | | | - Marlene Millen
- Department of Medicine, University of California, San Diego, La Jolla
| | - Ming Tai-Seale
- Department of Medicine, University of California, San Diego, La Jolla
- Department of Family Medicine, University of California, San Diego, La Jolla
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Shiyab A, Ababneh RI, Shyyab Y. Causes of workplace violence against medical staff as perceived by physicians and nurses in Jordanian public hospitals. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2022. [DOI: 10.1108/ijwhm-01-2021-0002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PurposeWorkplace violence against medical staff has become an endemic problem in the healthcare sector in Jordan. This study investigates the perceived main causes of workplace violence (medical staff, administrative, patients, patient's escorts and legislative) against physicians and nurses in public hospitals.Design/methodology/approachA self-administered questionnaire was used to collect data from a convenient random sample of 334 physicians and nurses employed in Jordanian public hospitals. Descriptive statistics and analysis of variance were used to answer questions and test hypotheses.FindingsFindings indicated that the practice of the causes of workplace violence behaviors assessed by the participants is at a moderate level in Jordanian public hospitals with a mean value of 3.26. The causes of violence were reported as most causative to least causative: patient escort (M = 3.60), legislative (M = 3.56), patients (M = 3.40), administrative (M = 3.16) and medical staff related (M = 2.74), respectively. Analysis showed statistical differences in the participants' attitudes toward the causes of workplace violence behaviors due to their gender, job title, education level, experience and income.Practical implicationsThis study has a significant practical contribution in providing information about the causes of workplace violence that will help health policymakers and hospital administrators to deter violence against medical staff. To reduce or eliminate the potential causes of violence, several actions can be taken, such as criminalizing violent behaviors, managing work pressure, staff shortages, developing comfortable and secure medical treatment settings, training the medical staff on aggression and stress management, and enhancing their communication skills with patients and their escorts. Findings also highlight the need for hospital management to develop protocols for reporting and dealing with workplace violence.Originality/valueThis is one of the first studies in the Arab context that examines the causes of workplace violence against medical staff.
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Buowari D, Abaate T, Inimgba T, Ogbonna V, Onyeaghala C, Osi C, Somiari A, Utchay (JR) A. Workplace violence against health care workers in Nigeria. NIGERIAN JOURNAL OF MEDICINE 2022. [DOI: 10.4103/njm.njm_102_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
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Lee HS, Myung J, Choi MJ, Shin HJ, Park I, Chung SP, Kim JH. Risk factors for computed tomography interpretation discrepancy in emergently transferred patients. World J Emerg Med 2022; 13:54-58. [PMID: 35003416 PMCID: PMC8677922 DOI: 10.5847/wjem.j.1920-8642.2022.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 08/16/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Hyun Sim Lee
- Department of Emergency Nursing, Yonsei University Health system, Seoul 03722, the Republic of Korea
| | - Jinwoo Myung
- Department of Emergency Medicine, College of Medicine, Yonsei University, Seoul 03722, the Republic of Korea
| | - Min Ji Choi
- Department of Emergency Nursing, Yonsei University Health system, Seoul 03722, the Republic of Korea
| | - Hye Jung Shin
- Department of Biostatistics Collaboration Unit, College of Medicine, Yonsei University, Seoul 03722, the Republic of Korea
| | - Incheol Park
- Department of Emergency Medicine, College of Medicine, Yonsei University, Seoul 03722, the Republic of Korea
| | - Sung Phil Chung
- Department of Emergency Medicine, College of Medicine, Yonsei University, Seoul 03722, the Republic of Korea
| | - Ji Hoon Kim
- Department of Emergency Medicine, College of Medicine, Yonsei University, Seoul 03722, the Republic of Korea
- Department of Preventive Medicine and Public Health, College of Medicine, Yonsei University, Seoul 03722, the Republic of Korea
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