Management Of Workplace Violence Research Articles

Interventions to prevent or manage workplace violence against student nurses during clinical placement: a systematic review protocol.

The objective of this review is to investigate the effectiveness of workplace violence management or prevention interventions, including strategies, protocols, and policies, to address violence against, and provide support to, registered nursing students (RNS) following incidents of violence during clinical placement. Workplace violence is a global issue that affects victims' physical and mental health. RNS are especially vulnerable to workplace violence because of their limited work experience and confidence. These students often feel shocked and unprepared when experiencing workplace violence due to limited education and support provided by educational institutions or clinical sites. Workplace violence can lead to anxiety, decreased confidence, and professional attrition. There is a need to systematically synthesize the evidence on workplace violence management and prevention to support nursing students during clinical placement. The review will consider studies assessing the effectiveness of interventions to address workplace violence or improve support for RNS. Studies that report on educational interventions or pre-clinical placement strategies and measure the preparedness of students will also be considered. Study designs will be limited to quantitative methods that evaluate intervention effectiveness. Databases to be searched include MEDLINE (Ovid), CINAHL (EBSCOhost), Web of Science Core Collection, Scopus, Embase (Ovid), Cochrane Central, ERIC (ProQuest), ProQuest Central, ProQuest Social Science Premium Collection, and ProQuest Dissertations and Theses Global. Two independent reviewers will screen, review, appraise, and extract data from eligible articles. For data synthesis, studies will be pooled using JBI SUMARI. The GRADE approach for grading the certainty of evidence will be followed and a Summary of Findings will be created. PROSPERO CRD42022377318.

Managing workplace violence against health care workers: education alone is not enough.

Managing workplace violence against health care workers: education alone is not enough.

Evaluating a Workplace Violence Management Program and Nurses' Confidence in Coping With Patient Aggression.

The purpose of this study was to evaluate nurse confidence in coping with patient aggression after implementing a workplace violence prevention program that includes management and postevent support. Patient aggression toward nurses is increasing, leading many healthcare organizations to develop workplace violence prevention programs. This cross-sectional study was conducted at a large healthcare system in the Midwestern United States. Clinical nurses caring for adult patients across the care continuum ≥51% of the time were invited to participate. In situ simulation plus standard training did not have a significant impact on confidence after controlling for the year education occurred; however, nurses completing training in 2022 had significantly higher confidence than nurses completing training in 2019. Use of the Violence Assessment Tool and participating in a post-control alert debriefing were also associated with significantly higher confidence. Factors other than education may influence nurses' confidence in coping with patient aggression.

The Life Cycle of a Code White: A Framework for Managing Workplace Violence

A global challenge affecting health care organizations in the Covid-19 pandemic recovery era has been an increase in the incident frequency as well as qualitative severity and complexity of workplace violence (WPV) incidents. In Ontario, Canada, WPV in health care settings is often managed using an emergency response procedure known as a Code White (CW). The Toronto-based University Health Network (UHN) — a research and teaching hospital network with four centers of care and about 18,000 employees (including about 1,200 physicians and 3,900 registered nurses), a learning institute serving about 17,500 learners, and a research team with about 1,150 principal investigators — has engaged in a comprehensive quality improvement (QI) framework with the view to fully understand the complexity of CWs and effectively implement and evaluate complex interventions required to address the multidimensional problem of WPV. As part of this effort, UHN has developed the Life Cycle of a Code White (LCCW) by leveraging principles of System Engineering Initiative for Patient Safety 101, including the application of a journey map to outline the steps and involvement of specific functional units in CW incidents. This task necessitated extensive engagement with diverse stakeholders across the organization. The authors provide an example of how the LCCW initiative can be applied to enable the organization to operationalize the complexity of CW QI, catalyzing the formation of a formal CW governance structure, 12 distinct QI initiatives, and 17 quality indicators to inform data-driven change management.

Improvement of violence management among nurses in Iran: The best practice implementation project in a health promoting hospital.

This project aimed to assess compliance with evidence-based criteria' for the prevention and management of workplace violence against nursing staff in Shahid-Beheshti hospital, Maragheh, Iran. Workplace violence is a managerial and workplace occupational health and safety issue that can affect the performance of an institution. Further, it might turn the work environment into an insecure and hostile one which can influence the performance of employees and their professional relationships negatively. Nevertheless, staff have their own legal rights, and their organizations are legally and ethically in charge of providing them with safe work environments. Following the JBI Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tool with three phases of activities, this project utilized an implementation framework incorporating quality improvement. Furthermore, the audit tool was used to establish the project and set up the measurement and evaluation of three evidence-based criteria. The post-implementation audit results indicated a significant improvement in violence management and prevention. The compliance rate on the first criterion, i.e. aggression management training, increased from 49% at baseline to 81% at the end. The second criterion, i.e. timely support and assistance following an incident, exhibited greater increase from eight to 73%. Finally, an increased compliance was noted on the third criterion, i.e. policy for risk management and safe environment, from 22 to 77%. The current project successfully implements evidence-based violence management in Shahid-Beheshti hospital. It reveals significant results on compliance and the increasing knowledge of nurses on evidence-based stress management, communication skills and self-companion.

Competence in managing workplace violence among nursing interns: Application of latent class analysis

AimTo identify subtypes of competence in managing workplace violence (WPV) among nursing interns and to assess between–group differences. BackgroundNursing interns are reported to be a vulnerable population for experiencing workplace violence during their clinical placement. Although WPV could have a negative impact on nursing interns' health and attitudes towards the nursing profession, little is known about nursing interns' competence in workplace violence management or its influencing factors. DesignA cross–sectional study. MethodsBetween March to April 2023, nursing interns at three tertiary general hospitals in Anhui Province, China, completed questionnaires including a general information questionnaire, the Management of Workplace Violence Competence Scale (MWVCS), the Utrecht Work Engagement Scale (UWES–9), the Emotional Labour Scale for Nurses (ELSN) and were classified into subtypes by latent class analysis. Subsequently, univariate analysis and multivariate logistic regression were performed to identify the influencing factors by subtypes. ResultsA total of 264 questionnaires were valid and the overall mean age of the participants was 21.06 ±1.41 years. Four classes were identified: low competency group (15.5%), low cognition–low coping competency group (18.2%), low cognition–medium to high competency group (21.6%) and high competency group (44.7%). The results of multinomial logistic regression analysis showed that placement hospitals with a WPV management department, emotional control effort in profession dimension and emotional pretense by norms dimension in the Emotional Labour Scale for Nurses, pursuing further education and vigour dimension in the Utrecht Work Engagement Scale were influencing factors of the potential categories of WPV management competence. ConclusionsFour classes were identified and there was competence variability among nursing interns. More attention should be given to nursing interns who did not receive WPV–related training in their school or placement hospital.

Prevalence of workplace violence against registered nurses and their perceptions of relevant management systems in acute care hospitals

Purpose: This study investigated the prevalence and perceptions of workplace violence against registered nurses (RNs) in hospitals.Methods: One thousand RNs replied to a nationwide survey from November 14 to December 22, 2022. They reported their general characteristics, prevalence of and their responses to different types of workplace violence from patients, family caregivers, physicians, and nurse peers, as well as their perceptions of workplace violence management systems.Results: A total of 71.1% of the RNs reported that they had experienced workplace violence in the last six months. The violence and sexual harassment experienced from patients and family caregivers were 57.3% and 19.1%, respectively. Furthermore, violence, sexual harassment, and workplace harassment from physicians were experienced by 24.6%, 4.0%, and 7.4%, respectively, of the RNs, and those from nurse peers by 21.4%, 3.1%, and 11.3%, respectively. The RNs stated that they often responded to workplace violence with passive and inactive behaviors, which were more serious toward physicians’ workplace violence or sexual harassment from different perpetrators. Only 69.5% were aware of their hospital’s workplace violence management systems, while only 14.7%~27.4%, according to the type of hospital (<i>p</i>=.471), perceived the systems as effective. Multiple important strategies were identified to prevent workplace violence.Conclusion: Critical suggestions are discussed for the prevention of workplace violence, including protecting the human rights of healthcare professionals, inter-organizational collaboration, and a culture of person-centered healthcare, and training nurse managers’ competency in managing workplace violence.

Management staff's perspectives on intervention strategies for workplace violence prevention in a tertiary health facility in Nigeria: a qualitative study.

Health workers have increasingly become victims of workplace violence. However, negligible action has been given to developing workplace violence (WPV) prevention programs in hospital settings in low-middle-income countries. An effective workplace violence prevention program is crucial for preventing violence and managing the consequences of incidents. This study assessed management staff perspectives on intervention strategies for workplace violence prevention in a tertiary health facility in Nigeria. A qualitative study design was employed to explore the intervention strategies for preventing and managing workplace violence at a tertiary health facility in southeast Nigeria. Six focus group discussions were conducted with thirty-eight management-level staff. The interview transcripts were manually coded according to six predefined constructs of workplace violence: creating interdisciplinary harmony and WPV experiences, causes, prevention, program/policy contents, and implementation strategies. A manual thematic analysis approach was adopted, and the results were presented as narratives. The findings revealed recognition, welfare, administrative control, and security as vital strategies for the WPV prevention program. The participants agreed that unanimity among staff could be promoted through respect for all cadres of staff and for people's perspectives (creating interdisciplinary harmony). Assaults and staff intimidation/victimization (experiences), attributed to unethical/poor health workers' behaviour and ethnic discrimination (causes), were viewed as preventable by ensuring patients'/caregivers' welfare through respectful and timely care and staff's welfare through incentives/remunerations and discouraging intimidation (prevention strategies). Furthermore, the staff expressed that the WPV program should employ administrative controls, including instituting WPV policy/unit, codes of ethics, and standard operating procedures across all workplace facets (program/policy contents), which should be implemented through awareness creation, enforcement of sanctions, and provision of appropriate and adequate security presence in the hospital (policy implementation strategies). Respect, patient/staff welfare, administrative control, and security are strong mechanisms to prevent workplace violence in tertiary hospitals. Hospital management should institutionalize workplace violence prevention programs/policies and ensure compliance.

Workplace Violence among Nurses in Public Hospitals in Vietnam: A Cross-sectional Study

Workplace violence causes negative impacts on the health of nurses, and the prevalence of workplace violence against nurses is rising globally. Studies to date in Vietnam have only concentrated on describing the frequency of types of violence within a specific healthcare facility with small sample sizes. This study aimed to determine the prevalence, impact and responses to workplace violence among registered nurses in public hospitals in Vietnam. This was the first nationwide study that has been carried out. A cross-sectional study design using an online questionnaire was conducted to achieve the study objectives with 2543 nurses working in 163 public hospitals. The frequency distribution and percentages were employed to describe the prevalence of workplace violence and nurses’ responses. The researchers also used the average value of the total score of each question to rank the impacts of workplace violence on nurses. The rate of workplace violence was 30.8%, of which physical and psychological violence were 5.3% and 29.7%, respectively. Among the types of psychological workplace violence, verbal abuse was the most common. The primary violent offenders were patients and caregivers. The biggest impact of workplace violence on nurses included always feeling stressed at work, decreased job satisfaction, and signs of stress or depression. The most common methods of responding to workplace violence were telling the perpetrator to stop or trying to defend themselves. These findings provide information for hospital leaders, health administrators and the Ministry of Health to reduce workplace violence against nurses. This can be done by increasing training on workplace violence management for nurses, creating a safe working environment to decrease the potential risks, and developing an appropriate system for reporting and responding to workplace violence incidents.

Healthcare Professionals’ Emotional Labor and Management of Workplace Violence with Underserved Patients in the Safety Net Context

ABSTRACT Healthcare providers (HP) work in high-stress situations, interacting with patients and families who are often in crisis. HPs who work in safety net clinics, which provide care to uninsured, Medicaid recipients and other vulnerable populations, interact with patients who are frequently frustrated by long wait times, extensive paperwork, short appointments, and have generally lower health literacy. Many patients have chronic conditions and substance use disorders which has been associated with higher likelihood to be perceived as verbally aggressive and/or perpetrate workplace violence (WPV). Using interviews with 26 HPs at safety net clinics, we investigated how HPs manage interactions with aggressive patients and avoid burnout. Findings are based on emotional labor constructs describing why and how workers use emotion management strategies to smooth communication and relationships with clients/patients. According to our participants, HPs perform emotional labor to de-escalate interactions, prevent WPV, and to develop relationships with patients who might become regular clinic patients. We found that HPs perceive an influence of the clinic context on patient aggression management, hold initial perceptions that shape engagement with aggressive patients, and report emotional labor and burnout that came from interacting with aggressive patients to prevent WPV. We offer implications that extend research on emotional labor and burnout, provide guidance to healthcare organizations, and offer directions for future theory and research.

Design, implementation and evaluation of workplace violence management educational program for nursing students

In this study, the effects of a workplace violence (WPV) management educational program on nursing students' attitudes toward WPV management and confidence in coping with patient aggression were examined. A 2-group, pretest and posttest, quasi-experimental study was conducted with 65 undergraduate nursing students. The results indicated that the education program had a significant effect on nursing students' attitudes toward the workplace violence management and confidence in coping with patient aggression.

The true (financial) costs of workplace violence in Australia

There is a need to determine the contemporary financial costs of workplace violence to the Australian economy. Since 2001, this intractable and typically gendered workplace problem has been viewed through a mythical lens which suggests it costs Australia between $6–36 billion every year. For over two decades, this estimate has been touted as an immutable source of truth. Accurate and realistic costings could support better policy and regulatory approaches to the prevention and effective management of workplace violence while also protecting those vulnerable members of our community who are most at risk of ongoing harm on account of workplace violence.

The Management of Workplace Violence against Healthcare Workers: A Multidisciplinary Team for Total Worker Health® Approach in a Hospital.

The risk of aggression against healthcare workers (HCWs) is a globally well-known topic. However, workplace violence (WV) is often considered as part of HCW’s job, leading to a general underreporting. This cross-sectional study aims at providing a descriptive analysis of aggressive acts against HCWs registered in a 34-month period in a pediatric hospital. According to a specific protocol, each aggressive act was analyzed by a multidisciplinary team using the “Modified Overt Aggression Scale” (MOAS), the “General Health Questionnaire-12” (GHQ-12), and the “Short Form-36 Health Survey” (SF-36) to build a report addressing improvement measures. A three-domain model of WV was also developed considering: (1) assaulted HCWs, (2) attacker-related issues, and (3) environmental context. Contributing factors to overt aggression were outlined and tested using univariate analyses. Statistically significant factors were then included in a multiple linear regression model. A total of 82 aggressive acts were registered in the period. MOAS scores registered a mean value of 3.71 (SD: 4.09). Verbal abuse was the most common form of WV. HCWs professional category, minor psychiatric disorder, emotional role limitation, type of containment used, and emotion intensity were significantly associated with overt aggression (p < 0.05), as well as the attacker’s role in the hospital (p < 0.05). The multiple regression analysis confirmed these findings (p < 0.001). Raising awareness on the aggression risk and contributing factors may lead to a relevant improvement of workplace environment, individual workers’ health, and organizational well-being.

Violence Against Physicians in the Workplace: Trends, Causes, Consequences, and Strategies for Intervention.

Violence against healthcare professionals has become an emergency in many countries. Literature in this area has mainly focused on nurses while there are less studies on physicians, whose alterations in mental health and burnout have been linked to higher rates of medical errors and poorer quality of care. We summarized peer-reviewed literature and examined the epidemiology, main causes, consequences, and areas of intervention associated with workplace violence perpetrated against physicians. We performed a review utilizing several databases, by including the most relevant studies in full journal articles investigating the problem. Workplace violence against doctors is a widespread phenomenon, present all over the world and related to a number of variables, including individual, socio-cultural, and contextual variables. During the COVID-19 pandemic, incidence of violence has increased. Data also show the possible consequences in physicians' deterioration of quality of life, burnout, and traumatic stress which are linked to physical and mental health problems, which, in a domino effect, fall on patients' quality of care. Violence against doctors is an urgent global problem with consequences on an individual and societal level. This review highlights the need to undertake initiatives aimed at enhancing understanding, prevention, and management of workplace violence in healthcare settings.

Workplace Violence in Healthcare Settings: A Scoping Review of Guidelines and Systematic Reviews.

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.

Experiences of exposure to workplace violence among ambulance personnel

BackgroundDespite an increased occurrence of workplace violence within the ambulance services, little is known about being exposed for such incidents.The aim of this study was to explore ambulance personnel’s experiences of workplace violence. MethodInterviews with 15 Swedish ambulance personnel was conducted and analyzed using content analysis. ResultsWhen exposed to workplace violence, the ambulance personnel felt offended, vulnerable, and experienced ethical dilemmas. Several strategies were used to deescalate the situation, but sometimes the ambulance personnel had to escape or fight the perpetrator. After the violent situation, the ambulance personnel described mental health issues and a frustration over long-lasting legal processes. To recover, reflections and social support was used. Having been exposed to workplace violence led to an increased awareness of onés vulnerability and a changed behavior both individually and professionally. ConclusionHaving been exposed to workplace violence affected both the professional and personal dimensions of serving as ambulance personnel and in caring in a hostile environment. Both individual and organizational strategies to manage workplace violence are needed to identify the risk of a violent situation and mitigate its effect.

Spot It, Prevent It: Evaluation of a Rapid Response Algorithm for Managing Workplace Violence Among Home Care Workers.

Workplace violence incidents remain pervasive in health care. Home care workers like personal support workers (PSWs) provide services for clients with dementia, which has been identified as a risk factor for workplace violence. The objective of this study was to evaluate whether the implementation of a rapid response algorithm resolved unsafe working conditions associated with responsive behaviors and decreased perception of risk. A nonexperimental pre- and post-evaluation design was utilized to collect data from PSWs and supervisors. PSWs completed an online survey about their experience with workplace violence and perception of risk. Bi-weekly check-ins were conducted with supervisors to track incidents and their level of resolution in the algorithm. Semi-structured interviews were also conducted to gather in-depth feedback about the algorithm in practice. We found no difference in risk perception among PSWs pre- and post-implementation. However, PSWs who had been employed for less than 1 year had a significantly higher risk perception. Overall, the algorithm was found to be helpful in resolving workplace violence incidents. Opportunity exists to further refine the algorithm and ongoing dissemination, and implementation of the algorithm is recommended to continually address incidents of workplace violence. Newly hired PSWs may require additional supports. Ongoing education and training were identified as key mitigation strategies.

Prevention and Management of Workplace Violence.

Prevention and Management of Workplace Violence.

Formally reporting incidents of workplace violence among nurses: A scoping review.

We aim to describe and synthesize the scientific literature on nurses' formal reporting of workplace violence. Research on reporting workplace violence among nurses is increasing annually, but the evidence from such reports has not been summarized or analysed. A scoping review was conducted using electronic databases including PubMed, Web of Science, Scopus, CINAHL and Ovid-Embase. Forty-nine studies were included in this review, and four significant issues pertinent to reporting of workplace violence was identified: (1) the reporting rate is generally low, and oral report is the most popular medium; (2) nurses are often not satisfied with how the organisation handles their report; (3) the reasons affecting reporting are complex and diverse; and (4) few studies have proposed countermeasures to promote reporting formally. Scholars are paying increasing attention to workplace violence; however, the reporting of workplace violence in real world situations is not being facilitated to inform improvements in managing violence in the workplace. Therefore, more countermeasures conducive to reporting urgently need to be put forward. Nurse managers are in a pivotal position to encourage reporting by their staff, respond pro-actively and advocate for more streamlined and accessible processes. The findings of this review can provide a basis for nursing managers to better manage workplace violence and improve the reporting rate among nurses.

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.

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.