Stop The Bleed

Background: Workplace violence refers to acts that occur inside or outside the workplace, ranging from verbal harassment, bullying, threats and physical assaults against workers to homicide. Workplace violence in health care settings is an incident involving verbal, physical or sexual assault against healthcare workers by patients, their relatives or others that poses a threat to healthcare workers. Violence in healthcare settings is a significant public health problem, not only for the victims of violence, but also for society because of its direct and indirect, short and long-term effects. Objectives: The aim of this study is to adapt the Workplace Violence Scale in Healthcare to Turkish, to conduct validity and reliability studies, and to determine its psychometric properties in order to overcome the problems faced by health policy makers in assessing workplace violence and to ensure that they implement appropriate interventions. Methods: In the research in which 191 healthcare workers were included in the pilot study and 627 healthcare workers in the main sample, data were collected using the Sociodemographic Data Form and the Workplace Violence Scale in Healthcare. SPSS 25.0 and AMOS 25.0 programs were used to analyse the data. In the scale validity and reliability study stage, Explanatory Factor Analysis and Confirmatory Factor Analysis methods were used after the language and content validity analyses. Results: The Cronbach alpha coefficient of the scale was found to be 0.946, and it was observed that the CR values of the scale consisting of five subdimensions and 37 items were over 0.70 and the AVE values were over 0.50. At the same time, in order to reveal the stability of the scale over time, the test-retest method was applied, and it was seen that the correlation coefficients obtained were 0.97 for the whole scale and between 0.80 and 0.94 for its subdimensions, indicating an excellent level of reliability. Conclusions: As a result of this study, it was accepted that the Workplace Violence Scale in Healthcare, developed with five subdimensions (frequency of workplace violence, impact of workplace violence on the individual, reasons for not reporting workplace violence legally, risk factors increasing workplace violence and workplace violence prevention strategies) and 37 items, can be used as a comprehensive and standard measurement tool that evaluates to measure workplace violence in healthcare settings. With this scale, future studies will be able to determine the type of violence (physical/verbal) that patients and their relatives use against healthcare professionals, how often healthcare professionals are exposed to violence, and how they, their families and social circles are affected physically and psychologically by the violence they experience (psychologically and socially). In addition, the results from the sections of the scale that ask about the risk factors for violence, the reasons why violence is not legally reported, and the practices used to prevent violence can guide health and legal policy makers.

Healthcare workers are exposed to workplace violence such as physical assaults, psychological violence and threats of violence. It is crucial to understand factors associated with workplace violence to prevent and mitigate its consequences. This study aims to identify work-related factors that might influence workplace violence in healthcare settings. A cross-sectional study was developed between March and April of 2022 with healthcare workers. The Aggression and Violence at Work Scale was used to assess workplace violence, and psychosocial risks were assessed through the Health and Work Survey—INSAT. Statistical analysis using bivariate analysis was performed to identify the psychosocial risk factors related to physical violence, psychological violence and vicarious violence. Subsequently, a multiple linear regression was performed to identify the models that better explained the relationship between psychosocial risk factors and the three dimensions of violence. Psychological violence was frequently experienced by the healthcare workers. Significant associations were found between psychosocial risk factors and physical, psychological and vicarious violence, namely working hours, work relationships, employment relations, high demands and work intensity. These findings highlight the importance of taking into consideration work-related factors when designing interventions to prevent and address workplace violence in healthcare settings.

Background: Workplace violence in healthcare settings is a global problem, with negative effects on safety and well-being of health care workers as well as workplace activities. However, there is a lack of studies on workplace violence generally and in Saudi Arabia particularly. Objectives: To estimate the prevalence and determine the demographic and occupational characteristics associated with workplace violence in primary health care centres (PHCCs) in Buraidah, Saudi Arabia. Subjects and Methods: A cross-sectional study including 288 physicians and nurses working at PHCCs in Buraidah city in Qassim region was carried out during June and July, 2021. A semi-structured self-administered questionnaire was used to estimate the frequency, timing, causes, reactions, and consequences of workplace violence in addition to participants` demographic and occupational data. Results: Among 288 study participants, 64.2 % were nurses and 63.7% were females. The mean (±SD) age of study participants was 36.7±8.2 years. History of exposure to workplace violence was mentioned by 41.2% of the participants. The majority (98.2%) of insults were verbal. The offender was a patient in most of the incidents (79.7%). Females represented 63.2% of offenders and those aged between 21 and 45 years represented 72.1% of them. The reasons for the violent event included misunderstanding, unmet service demand, overcrowding, and long waiting time. No action was taken as a reaction to violent event by 56.3% of the victims while reporting to supervisors was mentioned by 34.8% of the respondents. Conclusions: A considerable proportion of physicians and nurses in PHCCs were exposed to violence in the workplace; mainly verbal type. More than half of the violent incidents were not reported. Implementation of an appointment system in PHC settings and increasing awareness of patients regarding their rights and responsibilities is recommended. Key words: physical violence, verbal violence, physicians, nurses, PHC, Qassim province, Saudi Arabia

Workplace violence includes acts of incivility, bullying, verbal and physical aggression, threatening words or actions, sexual harassment, and physical assaults; and is a profound problem for healthcare workers. Although the number of published articles addressing workplace violence has increased in recent years, there was a lack of opportunities for researchers studying workplace violence in the United States’ healthcare sector to meet and share theories, models, findings, and prevention programs and their evaluations. As a result, there became a critical need for a domestic conference to be held where innovators, educators, and researchers could come together to network, build interprofessional teams, and share strategies, potential solutions, educational materials, best practices, programs, policies, and findings related to the prevention, management, and recovery associated with workplace violence. In May 2012, the National Conference for Workplace Violence in Healthcare Settings was held in Cincinnati, Ohio. At the 21/2 day conference, four keynote, 20 paper, and 23 poster presenters delivered relevant and timely content with direct implications for healthcare policy. From this cadre of presentations, we invited presenters to submit papers for this special issue. We are now excited and honored to present this special issue of Workplace Violence in Healthcare Set-

The outbreak of the COVID-19 pandemic has affected the safety and well-being of healthcare workers. A scoping review was conducted to highlight the impact of COVID-19 on the safety, health, and well-being of healthcare workers and to shed light on the concerns about their perceived safety and support systems. A literature search was conducted in three different databases from December 1, 2019, through July 20, 2022, to find publications that meet the aim of this review. Using search engines, 3087 articles were identified, and after a rigorous assessment by two reviewers, 30 articles were chosen for further analysis. Two themes emerged during the analysis: safety and health and well-being. The primary safety concern of the staff was mostly about contracting COVID-19, infecting family members, and caring for patients with COVID-19. During the pandemic, the health care workers appeared to have anxiety, stress, uncertainty, burnout, and a lack of sleep. Additionally, the review focused on the suggestions of health care providers to improve the safety and well-being of workers through fair organizational policies and practices and timely, individualized mental health care.

This commentary provides a partial review of the consequences of violence bullying and incivility for nursing staff. These factors are widespread and increasing. Each of these factors has been shown to have negative effects on nurse job satisfaction, job performance, quit intentions and psychological and physical health. Most victims are uncertain of the best ways to respond to these experiences. Sources of each include patients, families of patients, physicians, supervisors and co-workers. Interventions that have proven to be successful in reducing workplace violence, bullying and incivility in nursing settings are described. Common factors include developing policies and procedures to recognize and indicate when one is experiencing these, informing those at senior levels, investigating the incidents and providing follow-up care and support. Staff training to recognize potential threats and ways to best respond to them is vital but not always offered to staff. I have undertaken research on the work experiences of nursing staff over the past 25 years. My first project, with the Ontario Nurse’s Association, studied the effects of hospital restructuring and budget constraints on the quality of work life, satisfaction and performance of nursing staff. Other research projects in the US and Turkey examined workplace factors such as hospital culture associated with work engagement, satisfaction and psychological well-being of nursing staff. This commentary takes a different tack. I am now editing a book for Gower titled “Violence and abuse in and around organizations.” In identifying potential chapters I came across studies of workplace incivility and violence in health care settings suggesting these are increasing documents increasing levels of violence towards nurses from patients and visitors in all countries. As I am writing this, nursing staff worldwide are experiencing violence, abuse and incivility. Warplanes from Russia, the US and Syria are dropping bombs on hospitals in Aleppo, accidentally or deliberately, killing nurses, patients and families of patients. A sample of this material forms the basis of this commentary. It will consider violence, bullying and incivility in health care settings focusing on the experiences of nursing staff.

Workplace violence in healthcare settings is alarmingly common and represents significant financial and human cost. The aim of this scoping review was to identify and summarize evidence on strategies to prevent and/or manage workplace violence in healthcare settings. Searches were limited to evidence-based clinical practice guidelines and systematic reviews published between 2015 and 2021. Multiple databases were searched and screened. Quality of the included guidelines and reviews was also assessed. Three guidelines and 33 systematic reviews were included. Both the Occupational Safety and Health Administration 2015 and Registered Nurses' Association of Ontario 2019 guidelines provided useful recommendations for building a comprehensive prevention program. Evidence-based risk assessment, prevention and management, and education and training are all central components. Regular reassessment and adjustment is required. Included reviews (n = 33) were grouped into five main categories: violence toward nurses (n = 10); violence toward healthcare workers in general (n = 8); violence in the emergency department (n = 5); violence related to mental health (n = 5); and measurement related to workplace violence (n = 5). Multicomponent interventions were often more effective than those applied in isolation. We found consistent support for certain strategies including education and training, post-incident debriefing, multidisciplinary rapid response teams, and environmental modifications; however, the strength of evidence and certainty of conclusions were limited across reviews. This scoping review found that strong leadership that cultivates and enforces a culture of inclusivity, support, and respect is a prerequisite for a successful workplace violence prevention program. Rigorous comparative effectiveness research testing interventions are needed.

Workplace violence against healthcare workers is a complex issue with significant implications for the safety and wellbeing of professionals in the healthcare sector. Drawing on data from 136 participants across Türkiye, this study explores the prevalence, forms, impacts, and management strategies of workplace violence in healthcare settings. The demographic characteristics of the participants reveal a diverse composition of healthcare workers affected by workplace violence, highlighting the universal nature of the issue. Verbal abuse emerges as a predominant form of violence, ranging from insults and threats to humiliation, while instances of physical violence pose grave risks to healthcare professionals. The study also underscores the inadequacy of support systems within healthcare institutions and the legal system, exacerbating the distress experienced by healthcare workers. Strategies for managing workplace violence include internal coping mechanisms, peer support, and institutional intervention, underscoring the need for comprehensive training programs and enhanced institutional protocols. Recommendations for prevention encompass a multifaceted approach involving enhanced security measures, support systems, and policy reforms at various levels. The study concludes with a call to action for concerted efforts to address workplace violence against healthcare workers, emphasizing the importance of targeted interventions to ensure the safety and well-being of professionals in their workplace. These findings provide valuable insights into the complexities of workplace violence in healthcare settings and highlight the urgent need for action to address this pressing issue.

Introduction: Workplace violence (WPV) against healthcare providers has severe consequences and is underreported worldwide. The aim of this study was to present the features, causes, and outcomes of serious WPV against healthcare providers in China.Method: We searched for serious WPV events reported online and analyzed information about time, location, people, methods, motivations, and outcomes related to the incident.Result: Serious WPV reported online in China (n = 379) were mainly physical (97%) and often involved the use of weapons (34.5%). Doctors were victims in most instances (81.1%). Serious WPV mostly happened in cities (90.2%), teaching hospitals (87.4%), and tertiary hospitals (67.9%) and frequently in Emergency Department (ED), Obstetrics and Gynecology Department (OB-GYN), and pediatric departments; it was most prevalent in the months of June, May, and February. Rates of serious WPV increased dramatically in 2014 and decreased after 2015, with death (12.8%), severe injury (6%), and hospitalization (24.2%) being the major outcomes. A law protecting healthcare providers implemented in 2015 may have helped curb the violence.Conclusion: Serious WPV in China may stem from poor patient–doctor relationships, overly stressed health providers in highly demanding hospitals, poorly educated/informed patients, insufficient legal protection, and poor communication. Furthering knowledge about WPV and working toward curtailing its presence in healthcare settings are crucial to increasing the safety and well-being of healthcare workers.

Workplace violence has attracted increasing public attention over the past few decades in China. This study was conducted to evaluate the frequency of workplace violence in healthcare settings by various job titles and hospital departments, and to explore the related risk factors among Chinese medical professionals. A total of 2,464 medical professionals in 12 hospitals of two provinces were surveyed by using a stratified cluster sampling method. The Chinese version of the Workplace Violence Scale was used to measure the frequencies of workplace violence, classified as physical assault, emotional abuse, threat of assault, verbal sexual harassment and sexual assault experienced by the subjects over the previous 12 months. A structured questionnaire was administered to collect information on potentially influencing factors for workplace violence. Multivariate analysis was applied to determine the risk factors for workplace violence. About 50% of study subjects reported at least one type of workplace violence. The rates of experiencing two episodes or more of physical assault, emotional abuse, threat of assault, verbal sexual harassment, and sexual assault were 11%, 26%, 12%, 3%, and 1%, respectively. Identified risk factors for workplace violence included working in the departments of psychiatry, emergency, pediatrics and surgery, male gender, divorce/widowed status, long working hours (≥10 hr/day), and night shift. The study suggested that workplace violence occurs commonly in Chinese healthcare settings. Effective intervention strategies targeting workplace violence should be formulated in terms of major risk factors.

Issues of workplace violence (WPV) in health care have garnered increasing attention due to the impact on the health care worker's well-being and retention. Yet, our understanding of whether and how WPV rates vary between health care facilities and occupations is limited, particularly information on growth over time. This information is needed to develop and target policies and interventions toward health care workers and settings most at risk. We examined trends in WPV among health care occupations and facilities over the past decade (2011-2021/2022), utilizing data from the Bureau of Labor Statistics' Survey of Occupational Injuries and Illness. Findings reveal a 30% increase in WPV across all health care facility types between 2011 and 2021/2022; however, there was no difference in the average rate of WPV for health care occupations over the same time period. The increase in WPV for health care facilities began long before the pandemic, suggesting larger systemic issues are likely driving WPV. Existing state and organizational efforts aim to mitigate WPV, yet targeted interventions are crucial. Understanding variations across occupations and facilities will inform tailored strategies to safeguard health care workers.

Why Won’t It Stop: Workplace Violence in Emergency Care

Introduction: In healthcare settings, needle stick injuries (NSIs) pose a serious risk to occupational health. They often go unreported, which exposes a crucial weakness in workplace safety procedures. Research on needle stick injuries is crucial for enhancing the safety and well-being of healthcare workers, improving healthcare delivery, and ensuring that healthcare environments are as safe and effective as possible. Objectives: To determine the prevalence and associated factors of needle stick injuries among Healthcare workers in a Tertiary Care Hospital in Lucknow. Method: A cross-sectional study was conducted from April 2024 to June 2024 in a tertiary care hospital, Lucknow, Uttar Pradesh among 213 Health Care Workers (HCWs) i.e., physicians (consultants, specialists, and residents), nurses, other healthcare workers, and class IV employee working for a period of more than one year. A pre designed and pre tested structured questionnaire was developed for the study. Data regarding injuries by needle stick was collected. All needle stick injuries occurring between the period April 2023 and March 2024 was recorded. Results: The prevalence of needle stick injuries among healthcare workers was found to be 11.7% (25 out of 213) in the period of April 2023 to March 2024. Fingers (88%) were the most common site of NSI, followed by palm (8%) and hands (4%). The most common place of occurrence of NSI was wards (40%) and majority of the injuries were superficial (84%). The most common sharp causing NSI was needle (72%), followed by glass items (20%) and scalpel (4%). There was a statistically significant association between NSI and gender, years of experience, dissembling of needles by hand and working shift of health care workers (p=0.000). Conclusion: Prevalence of NSI was found to be higher among medical and paramedical staff who were working during day shift, working more than 7 hours a day and had an experience of less than 3 years.

Workplace violence in healthcare settings: The risk factors, implications and collaborative preventive measures

Workplace violence (WPV) directed toward health care staff by patients and their relatives has become one of the major problems faced by health care systems around the world. Incidences of WPV have increased over the past decade, crossing borders and cultures and creating a worrisome global phenomenon. To date, most of the research has examined health care workers' perceptions of strategies that might prevent violence. Although the public, as prospective patients, has a central role in this state of affairs, little is known about public attitudes to prevention of violence in health care settings. In light of this, the current mixed-methods study aimed to explore public attitudes toward appropriate preventive and punitive measures that should be employed to diminish the occurrence of WPV incidents in health care settings. Five hundred sixty Jewish Israeli individuals participated in the study. Quantitative findings indicate the public's overall agreement and positive attitudes toward preventive and punitive measures aimed at reducing WPV against health care staff. Qualitative findings revealed two main themes: "focusing on the staff" by improving their work conditions, training them to deal with violence, and providing a sense of security, as well as "focusing on the public" by teaching tolerance, raising awareness of zero tolerance to violence, and punitive measures. The Israeli public believes that to deal with the problem of violence in the health care system, it is necessary to act simultaneously on two levels: health staff and the health care system, and the general public. In view of these findings, we recommend that policy makers address this issue by adopting preventive measures, such as increasing the number of health care personnel, workshops for the staff on dealing with violence, campaigns against violence in health care settings, and enforcing appropriate punitive measures against attackers.