Violence In Hospitals Research Articles

Embracement to women victims of sexual violence in a reference hospital, Porto Alegre, Brasil

This work aimed to study the care of women victims of sexual violence in a public reference hospital of Porto Alegre. We characterized the profile of women attended and the embracement process afforded to them. This is qualitative and quantitative research; data were collected from records of users from the year 2006, when the service was deployed. We carried out participant observation and semi-structured interviews with five users attended in the second semester of 2008. The study found weaknesses in attendance, loss to the integrality in the attention of women and low compliance of users to the service.

Violence in the nursing workplace – a descriptive correlational study in a public hospital

To explore the prevalence, types and sources of violence in the nursing workplace and to assess the factors related to violence. Workplace violence in nursing is not a new phenomenon; in recent years, much more attention has been paid to the issue in Taiwan. Few studies, however, have investigated the overall distribution of violence and the reasons for not reporting these incidents in nursing workplaces. This descriptive, correlational study used structured questionnaires to collecting information about workplace violence experienced by nurses over the last year. Nurses (n = 880) working in a public hospital in southern Taiwan were invited to complete the questionnaires, with a response rate of 89·9%. Nurses working in outpatient units and emergency rooms experienced more frequent violence than those on surgical wards and intensive care units. These findings provide evidence of workplace violence in hospitals and may aid hospital and nursing administration to reduce and control violence. RELEVANCE TO NURSING PRACTICE: These results provide evidence in relation to the importance of effective communication training to nurses and will assist hospital administrations in establishing higher-quality, healthy workplace environments.

Risk factors associated with patient and visitor violence in general hospitals: Results of a multiple regression analysis

BackgroundPatient and visitor violence (PVV) is the most dangerous occupational hazard that health professionals must contend with. Staff training is recommended to prevent and manage PVV. There is minimal research focusing on risk factors associated with PVV in general hospital settings. Therefore, staff training is mostly based upon expert knowledge and knowledge from psychiatric and emergency settings. ObjectivesThis study investigates health professionals’ experiences with PVV in order to describe risk factors related to PVV that occur in general hospital settings. DesignA retrospective cross-sectional survey was conducted in 2007. SettingA university general hospital in Switzerland. Participants2495 out of 4845 health professionals participated (58.0% nurses & midwives, 19.2% medical doctors, 3.6% physical therapists, occupational therapists & nutritionists, 6.1% ward secretaries, medical & radiology assistants, 6.3% nursing assistants or less qualified nursing staff and 5.1% other staff). All had direct patient contact and 82% were female. MethodsData were collected via questionnaires using the Survey of Violence Experienced by Staff German-Version-Revised, the German version of the shortened Perception of Aggression Scale and the Perception of Importance of Intervention Skills Scale. Descriptive statistics and multiple logistic regression analyses were used. ResultsRisk factors associated with PVV depend upon the form of violence. Those trained in aggression management and/or those who work predominantly with patients over 65years of age experience twice as much PVV as others. Health professionals working in emergency rooms, outpatient units, intensive care units, recovery rooms, anesthesia, intermediate care and step-down units also experience PVV more often. When health professionals are older in age, are from the medical profession, are students, or when they have an attitude rating preventive measures as being less important and aggression as emotionally letting off steam, they experience less PVV. ConclusionTraining could change the perception and the recognition of PVV, and could therefore increase the risk of experiencing PVV. The health professionals’ specific occupation along with attitude and age, the patients’ age, the communication and the workplace are all relevant risk factors. Further studies should investigate the impact of aggression management training and other measures that would reduce PVV.

Workplace violence against nurses in hospitals in Guangdong, China

BackgroundViolent incidents can appear everywhere including hospitals. Nurses are the main working population in health facilities with female gender mostly. How is workplace violence against this special group in Guangdong...

Analysis on Epidemiological Characteristics and Reasons of Hospital Violence based on Logistic Regression Model

Analysis on Epidemiological Characteristics and Reasons of Hospital Violence based on Logistic Regression Model

Guideline for Preventing Violence at Hospitals in China (2011-2012)

Tensions have been rising between physicians and patients in China recently. More and more Chinese medical professionals are being hurt or even killed by patients. There are many complicated reasons for the frequent violence in Chinese hospitals; this guideline is not intended to solve the problem but attempts to provide a practical way to prevent and handle violence in the workplace. This guideline consists of 3 parts: violence prevention, violence handling, and postviolence management.

Commentary: Professional Hospital Violence

Commentary: Professional Hospital Violence

Patient and visitor violence in the general hospital, occurrence, staff interventions and consequences: a cross‐sectional survey

AIM.: This study focuses on the experience of healthcare staff with regard to patient and visitor violence in a general hospital. The occurrence of patient and visitor violence, staffs' interventions and the consequences of violence for different professions are investigated. There is a lack of studies describing the factors influencing the occurrence of patient and visitor violence, intervention strategies and consequences. Existing studies often focus on nurses' experiences and single interactive factors between staff and patients/visitors involved. A cross-sectional survey. The survey was conducted in 2007 including 2495 staff working on different wards in a Swiss university general hospital. The questionnaire used was the Survey of Violence Experienced by Staff German Version-Revised. Half of the staff experienced patient and visitor violence in the past 12 months and 11% in the past week. The age of the staff and the length of experience in their present workplace influenced the exposure to patient and visitor violence. Violence occurred mainly when staff carried out tasks involving close personal contact. Only 16% of the staff was trained in aggression management. The feeling of confidence in managing patient and visitor violence depended significantly on the organizational attitude towards violence. The principal interventions used were calming and informative discussion. To prevent patient and visitor violence and improve management strategies, training which focuses on communication skills, which is specific to the professional context and which emphasizes patient centeredness, need to be designed and implemented. A strong organizational commitment is imperative to reduce violence.

Mania, homicide and severe violence

Mania has been reported to be a risk factor for aggression and violence in psychiatric hospitals, but the extent of any association between mania and severe interpersonal violence in community settings is not known. To examine the association between mania and severe violence in a series of patients found not guilty by reason of mental illness (NGMI). A review of the court documents of those found NGMI of offences involving severe violence, including homicide, attempted homicide and assault causing wounding or serious injury, in New South Wales between 1992 and 2008. Twelve of 272 people found NGMI were in a manic state when they committed a severe violence offence. Ten were diagnosed with schizo-affective disorder and two with bipolar disorder. Three patients were in the depressed phase of schizo-affective disorder and there were no patients in the depressed phase of bipolar disorder. Mania, in particular the manic phase of bipolar disorder, is not strongly associated with severe violence.

Violence in daily hospital nursing work

OBJECTIVE: To describe the frequency of referred verbal, physical and sexual violence and factors associated with verbal violence in nursing teams' work at public hospitals. METHODS: Cross-sectional study, involving 1509 workers at three public hospitals in Rio de Janeiro City - (RJ). Bivariate analysis and logistic regression were applied. Significance was set at 5%. RESULTS: The frequencies of verbal, physical and sexual violence amounted to 982 (65.1%), 46 (3%) and 87 (5.7%), respectively. After applying multivariate analysis, higher chances of referred verbal violence were observed among women, younger professionals, with higher education levels, nurses, who were contracted and receive low levels of social support at work. CONCLUSION: Verbal violence is frequent in the hospital work environment and associated with different characteristics. A less hostile environment needs to be built for nursing workers.

제주 지역 병원 간호사의 직장 폭력 경험 실태

Purpose: This study was to investigate the prevalence & types of workplace violence toward nurses in hospitals, and to understand nurse's coping response, cause of violence and prevention strategy. Methods: The data were collected from 254 nurses working in 9 hospitals in Jeju Province by the self-report from June to August 2010. Results: The respondents experienced unpleasant or insulting words (89.8%), verbal threat (38.2%), physical threat (67.7%), physical injury (32.7%), severe physical injury (2.8%), and sexual harassment (26.4%) during the last one year. The frequent offenders were patients, patients' family and physicians in order. The causes of violence which nurses perceived were personality of offenders (76.4%), lack of assessment of aggressive patients or care givers (42.1%), and lack of explanation to patients or caregivers (33.5%). They reported that coping strategies for workplace violence were 'established reporting system (63.4%)', 'building a cooperative circumstances within team members (58.3%)', and 'formulation of hospital policies for violence prevention and coping (54.3%)'. Conclusion: These findings showed nurses are at considerable risk for workplace violence, and they experience various types of violence from patients, caregivers, and physicians. We suggest that hospitals formulate appropriate policies, guidelines and programs to prevent and cope with workplace violence in hospitals.

Measuring patient and visitor violence in general hospitals: feasibility of the SOVES‐G‐R, internal consistency and construct validity of the POAS‐S and the POIS

To investigate the feasibility of a survey measuring patient and visitor violence after translation and modification, namely the Survey of Violence Experienced by Staff (German version revised) and to validate the shortened Perception of Aggression Scale (POAS-S) and the Perception of Importance of Intervention Skills Scale (POIS) after adaptation for use in a general hospital setting. The use of different approaches and research instruments for investigating patient and visitor violence negatively influences the comparability of studies. Typically, general hospitals use self-administered surveys. However, support for these instruments' validity is insufficient. Between November 2006-January 2007, 291 nurses working in general hospitals in the German-speaking region of Switzerland completed the SOVES-G-R, the POAS-S and the POIS (response rate=71%). Results. The participants' responses demonstrated a need for modifications to enhance the feasibility of the SOVES-G-R in two categories, namely experiences with patient and visitor violence in 'the past 12 months' and in 'the past working week'. The POAS-S revealed the same factor solution as in earlier studies, with two factors explaining 38·0% of variance. In the POIS, two factors were distinguished: (1) structured interventions and evaluation and (2) the importance of preventive measures. The SOVES-G-R, the POAS-S and the POIS are adequate for investigating factors influencing the occurrence of patient and visitor violence in general hospitals. Given the changes in the SOVES-G-R and the moderate size of our sample, further testing with a larger sample is recommended. The instruments help determine which clinical settings have a greater risk of patient and visitor violence and the specific factors that influence this risk. This can facilitate the implementation of situation-specific preventive measures against patient and visitor violence in general hospitals.

The Comparative Study of Workplace Violence in Both the State-Owned Hospitals and Private Hospitals

To understand the prevalence of workplace violence of the state-owned hospitals and private hospitals and to compare the characteristics of them in Tangshan city. Cluster sampling method were used to investigate the three state-owned hospitals and five private hospitals， medical staff who suffer violence in the workplace from April 2008 to April 2009 in Tangshan city. The incidence rate of workplace violence in state-owned hospitals(62.98%) was higher than private hospitals（13.55％）. The type of the violence is mainly psychological violence both in state-owned hospitals and private hospitals. And state-owned hospitals’ incidence of psychological violence (46.48％) was higher than private hospitals（13.55％）. Both state-owned hospitals and private hospitals， the violence mainly occurred during daytime hours. Violence of state-owned hospital most occurred in wards（47.92%）， while private hospitals most occurred in medical rooms（32.35%）. The most important reasons for workplace violence in State-owned hospitals and private hospitals were the perpetrators of alcohol (42.81%) and patients without improvement or self-opinion that there is no improvement（57.35％）, respectively. Private Hospitals’ incidence of workplace violence is lower than the state-owned hospitals’ in Tangshan city， According to the characteristics of various hospitals， we should implement interventions to reduce the incidence of violence in the hospital.

Comparison of BP Neural Network Model and Logistic Regression in the Analysis of Influencing Factors of Violence in Hospitals

Collecting violence cases for medical personnel from different levels of the hospital of Tangshan, we create a model for influential factors of hospital violence, and respectively with BP Nerve Network and logistic regression, by sensitivity, specificity and ROC curve, it is compared with two methods,in order to discovering effective analytical method . The training set and testing set sensitivity of BP Neural Network Model are 0.916 and 0.935,and the specificity is 0.447 and 0.526,the area of ROC curve is 0.769 and 0.785；for logistic regression Model ,for its the training set and testing set, sensitivity is 0.907 and 0.925, the specificity is 0.377 and 0.404, the area of ROC curve is 0.663and0.666. In hospital violence influencing factors, the forecast capability of BP Neural Network Model is better than logistic regression Model and it has farther extend value.

Pisada como trapo de piso: experiencia de violencia hospitalaria en el Nordeste Brasileño

A pesar de los recientes esfuerzos para mejorar la calidad de los servicios publicos de salud en el Brasil, iniquidades y violencia institucional persisten en los hospitales. Este estudio antropologico-critico investiga la experiencia humana de hospitalizacion del punto de vista del paciente internado en un hospital publico, localizado en Fortaleza (Ceara), nordeste brasileno. Un metodo cualitativo original, “El camino del paciente” fue creado y utilizado, mezclando entrevista etnografica, narrativa del paciente realizada prospectivamente durante la internacion, desde la llegada al hospital hasta el alta, y observacion-participante de 13 informantesclaves. Los resultados rebelaran 225 experiencias distintas de hospitalizacion narrada por los pacientes. La mayoria (83,6%) de los hechos fue interpretada como “desprecio” y “humillacion”; solo 16,4% fueron percibidos como “cuidado” por el paciente, contribuyendo para la recuperacion de su salud. Mostraron la desmoralizacion progresiva del “paciente sospechoso” desde la recepcion por un guardia uniformado hasta la apropiacion de sus pertenencias personales. La hospitalizacion se caracteriza por abandono, soledad y prision, por la imposicion de normas, reglas y procedimientos que ignoran la autonomia, condiciones personales y subjetividad del paciente. A pesar de la estructura opresiva, los pacientes resisten a las agresiones, utilizando multiples estrategias: trazos personales, imaginacion creativa, solidaridad social y fe religiosa. Humanizar la hospitalizacion publica en el Nordeste brasileno requiere incluir la voz y la experiencia del paciente, desechando los estigmas que perjudican.

Evaluation of a violence risk assessment system (the Alert System) for reducing violence in an acute hospital: A before and after study

Objectives To investigate the effectiveness of a risk assessment system in reducing the risk of violence in an acute care hospital in the Canadian province of British Columbia. Methods Hospital violence incident rates (number of incidents/100,000 work hours) were calculated and compared pre, during and post implementation of the Alert System, a violence risk assessment system, at one acute care hospital. Poisson regression models were used to examine the effect of the Alert System on hospital-level violent incident rates. Multivariable, conditional logistic regression was used to examine the effect of the Alert System on the individual-level risk of violent incidence using a case–control study. Results The violent incident rate decreased during the Alert System implementation period only, but subsequently returned to pre-implementation levels. In the case–control analyses, the Alert flag was associated with an increased risk for a patient violent incident (odds ratio = 7.74, 95% CI = 4.81–12.47). Conclusions Although useful at identifying violent patients, the Alert System even though offered in conjunction with violence prevention training, does not appear to provide the resources or procedures needed by healthcare workers to prevent a patient from progressing to a violent incident once flagged. Violence in healthcare should be studied and prevented using a multifaceted approach.

Predictive Validity and Other Psychometric Properties of the Short-Term Assessment of Risk and Treatability (START) in a Norwegian High Secure Hospital

Short- to medium-term risk assessment in psychiatric hospitals is a topic of clinical relevance that deserves attention from the research community. In this paper, the Short Term Assessment of Risk and Treatability, or START (Webster, Martin, Brink, Nicholls, & Middleton, 2004), a new structured instrument for judgment of dynamic risk and treatment factors is briefly described. Internal reliability properties are analyzed and the predictive validity for severe violence in a Norwegian high secure psychiatric hospital is investigated. The results indicate that the START has promise as a valid tool for short-term violence risk assessment. The authors make an argument for the importance and relevance of dynamic risk and strength factors in the short to medium term.

Prevalence of and risk factors associated with workplace violence: a cross-sectional study in 7026 health staff in South China

ObjectiveTo probe prevalence of and risk factors associated with workplace violence in hospitals so as to establish a theory basis for maintaining regular working order in hospitals and lawmaking against...

A narrative review of the effectiveness of aggression management training programs for psychiatric hospital staff

Workplace violence, including patient-perpetrated violence in healthcare settings, is increasingly being recognized as preventable. Staff training has been identified as a necessary component of any initiative aimed at preventing or reducing incidents of aggression and violence in the workplace. This narrative review of the literature evaluates the effectiveness of staff training programs designed to prevent and manage violence and aggression in psychiatric hospitals. An exhaustive review of the literature was performed on all articles published in English between January 1, 1990 and April 1, 2007 that evaluate an aggression management training program. Twenty-nine studies met the inclusion criteria for a full review and were summarized using a qualitative narrative approach. Aggression management training has been proven effective in some areas, such as reducing the use of restraints and other coercive control devices, but more methodologically rigorous research is needed to firmly establish whether it is effective in reducing aggression and staff injuries. The findings of this study suggest that relying too heavily on aggression management staff training will have limited effect on addressing the range of issues related to patient-perpetrated violence in psychiatric hospitals. Mental healthcare organizations must look beyond staff training if they are to achieve meaningful reductions in aggressive incidents and staff injuries.

Workplace violence in hospitals in Japan and in-house management systems dealing with it

Workplace violence in hospitals in Japan and in-house management systems dealing with it