Violence In Hospitals Research Articles

Pattern of Violence Among Healthcare Workers in a Tertiary Care Government Hospital and a Multi-Specialty Private Hospital in Sagar, India: A Cross-Sectional Study.

Background Workplace violence in hospitals is an occupational hazard that affects healthcare workers (HCWs) negatively in many aspects and causes deterioration of the doctor-patient relationship, resulting in providence of substandard healthcare. This study was conducted to compare the pattern of violence in a tertiary care government teaching hospital and a multi-specialty private trust hospital in Sagar district, Madhya Pradesh, India. Methodology After ethical clearance of this cross-sectional, observational study, participants (frontline healthcare workers, including doctors and nurses) were asked about the type, frequency, department, and place of violence, etc., along with its perceived causes, solutions, and arrangements made by hospitals for dealing with it using a pretested, semi-structured questionnaire. Data analysis was performed using IBM SPSS Version 26.0 (IBM Corp., Armonk, NY). Categorical variables were described using frequency and percentages, and inferential analysis was conducted using the chi-square/Fisher's exact test. A P-value of <0.05 was considered statistically significant. Results Among the 113 participants, 67 (59.3%) were female, 53 (46.9%) were doctors, and 60 (53.1%) were nurses. The mean age of participants was 30.9±7.3 years. Predominantly verbal, emotional, and physical violence were present in 96.5%, 43.4%, and 6.2% of participants, respectively. Violent incidents against healthcare workers were more frequent in government hospitals as compared to private hospitals. Most healthcare workers (87.6%) tried to resolve violent incidents peacefully, and 1.8% tried to fight back. The most perceived cause of violence in both setups was a lack of morality and literacy among patients and their relatives (i.e., 83.2%), followed by a lack of proper facilities and a lack of trust in healthcare workers. Conclusion Both setups faced a substantial amount of violence. The loopholes in both setups, considering resources, security, and other facilities, are clearly visible, and specific steps must be adopted to protect both systems from violence.

(162) Management of Hospital Violence in High-Risk Patient Populations: Utilizing Brøset Violence Checklist with Proactive C-L Psychiatry Consultation

(162) Management of Hospital Violence in High-Risk Patient Populations: Utilizing Brøset Violence Checklist with Proactive C-L Psychiatry Consultation

Thematic Analysis of Mental Health Nurses' Views of Contributing Factors Fueling Workplace Violence in Psychiatric Hospitals: Insights From Unsung Soldiers.

Workplace violence against mental health nurses is an international phenomenon that sparks concerns for nurses' safety and mental health. This phenomenon has recently arisen as a crucial concern in the Middle East as it has become pervasive and has negative implications, causing nurses to accumulate psychological and emotional distress. However, no research has yet investigated the contributing factors of this phenomenon in Jordanian psychiatric hospitals from the nurses' perspectives. This study aimed to explore the factors contributing to workplace violence in Jordanian psychiatric hospitals from the perspective of mental health nurses. An exploratory, qualitative design was utilized. Using audio-recorded, semi-structured, face-to-face interviews, a purposive sample of 24 mental health nurses were interviewed to collect data. Thematic analysis was used to analyze the data. Four overarching themes were identified: Peak Time of Violence, Unavoidable Part of the Job, Poor Organization and Lack of Policy, and Bite the Bullet. From nurses' perspectives, an in-depth understanding of factors contributing to workplace violence provides a foundation for developing preventive interventions, improving work environment safety, and promoting nurses' mental health. Prevention strategies and further studies are warranted to limit this phenomenon.

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.

A narrative review of emergency department design strategies to prevent violence against healthcare personnel: an Indian perspective

Workplace violence in hospitals, specifically in emergency departments (ED), has become a growing concern in recent years. This violence can come from patients, their families, or visitors and can take the form of verbal or physical attacks. Preventing violence in EDs can be achieved through design modifications with minimal personnel and infrastructure requirements. Infrastructure design plays a crucial role in reducing the risk of violence. Private lockers should be available at the ED entrance to limit dangerous objects being brought into the department. Furnishings should be fixed to prevent them from being used as weapons, and evacuation should be facilitated through open rows of seating. Positive distractions, such as gardens or natural areas visible through windows, can reduce stress in patients and lower aggression. Ligature points should be eliminated and tamper-resistant items should be provided to reduce dangers in the built environment. The triage desk should be positioned in a secure area with access control and panic buttons available for staff. Hidden exits should be provided in case of violence and emergency exits should open outward and be lockable only from the outside. It seems that preventing violence in EDs requires a combination of management, technology, planning, and physical design. Proper infrastructure design can play a crucial role in reducing the risk of violence, and healthcare professionals, administrators, and architects should be aware of best practices in ED design.

Racial harassment and workplace violence in hospitals towards physicians and nurses from Indigenous minority and non-Indigenous groups

Racial harassment and workplace violence in hospitals towards physicians and nurses from Indigenous minority and non-Indigenous groups

Prevalence and determinants of physical violence against doctors in Bangladeshi tertiary care hospitals

BackgroundThe increasing physical violence against doctors in the health sector has become an alarming global problem and a key concern for the health system in Bangladesh. This study aimed to determine the prevalence and associated factors of physical violence against doctors in Bangladeshi tertiary care hospitals.MethodsA cross-sectional survey was performed among 406 doctors working in tertiary care hospitals. Data were collected using a self-administered questionnaire and the binary logistic regression model was employed for predicting physical violence against doctors.ResultsOf the participants, 50 (12.3%) doctors reported being exposed to physical violence in 12 months prior to the survey. According to logistic regression analysis, aged less than 30 years or younger, male and never-married doctors were prone to physical violence. Similarly, doctors from public hospitals and those worked in emergency departments were at higher risk of physical violence. More than 70% of victims reported that patients’ relatives were the main perpetrators. Two-thirds of the victims referred to violence in the hospitals as a grave concern.ConclusionsPhysical violence against doctors is relatively common in the emergency departments and public hospitals in Bangladesh. This study found that male and younger doctors were at high risk of exposing physical violence. To prevent hospital violence, authorities must develop human resources, bolster patient protocol and offer physician training.

Effects of verbal violence on job satisfaction, work engagement and the mediating role of emotional exhaustion among healthcare workers: a cross-sectional survey conducted in Chinese tertiary public hospitals

ObjectiveRecently, Chinese ministries and commissions have issued a series of policies and systems in response to violent injuries to doctors, physical violence have been managed to a certain extent. However,...

The effect of COVID-19 on workplace violence in California's hospitals: An interrupted time series analysis.

This study used California's unique Workplace Violent Incident Reporting System (WVIRS) to describe changes in workplace violence (WV) exposure for hospital-based healthcare workers during the pandemic. Interrupted time series analysis. We compared the linear trends in weekly WV incidents reported during the period before the COVID-19 pandemic (7/1/2017-3/20/2020) to the period following California's shutdown (3/21/2020-6/30/2021). We created mixed effects models for incidents reported in emergency departments (EDs) and in other hospital units. We used hospital volume data from the California Department of Health Care Access and Information. A total of 418 hospitals reported 37,561 incidents during the study period. For EDs, the number of reported incidents remained essentially constant, despite a 26% drop in outpatient visits between the first and second quarters of 2020. For other hospital units, weekly incidents initially dropped-parallel to a 13% decrease in inpatient days between the first and second quarters of 2020-but then continued parallel to the trend seen in the pre-COVID period. WV persists steadily in California's hospitals. Despite major reductions in patient volume due to COVID-19, weekly reported ED incidents remained essentially unchanged. Surveys and media reported that WV increased during the pandemic, but it has been difficult to measure these changes using a large-scale database. The absolute number of WV incidents did not increase during the pandemic; however, the trend in reported incidents remained constant in the context of dramatic decreases in patient volume. New federal WV prevention legislation is being considered in the U.S. California's experience of implementation should be considered to improve WV reporting and prevention. There was no public contribution to this study. The goal of this analysis was to summarize findings from administrative data. The findings presented can inform future discussion of public policy and action.

Criminal Litigation of Workplace Violence in Chinese Hospitals and Legal Effort to Deescalate Crimes.

Workplace violence in Chinese hospitals has increasingly attracted world attention. This study aimed to describe the characteristics of criminal litigation cases on workplace violence in Chinese hospitals at a national level and explore the influencing factors associated with the severity of workplace violence. A retrospective study was designed to analyse 507 criminal litigation cases on workplace violence in Chinese hospitals, with data extracted from the Chinese court website. The multiple ordered logistic regression model was used to analyse the impact of the potential influencing factors on the severity of workplace violence. The crimes as workplace violence in the hospitals were concentrated in East and Central China (53.9%). The most common clinical specialty involved in workplace violence was Gynecology and Obstetrics (27.8%). The first 4 types of crimes as workplace violence in the hospitals were the crime as picking quarrels and provoking trouble (26.0%), the crime as disrupting public service (20.7%), the crime as intentional injury (19.1%), and the crime as gathering people to disturb public order (15.2%). The severity of crimes as workplace violence in the hospitals was significantly associated with location (OR = 2.569, P = .013), victim type (policemen or security guards) (OR = 0.495, P = .005), more than 3 victims (OR = 2.252, P = .035), perpetrators (patients' family member) (OR = 0.491, P = .045), previous arrest (OR = 2.113, P = .024), premeditation (OR = 2.234, P = .004), and psychiatric disorders (OR = 1.911, P = .019). The number of the crimes as workplace violence in Chinese hospitals was slightly declining from 2014 to 2020. The severity of crimes as workplace violence in the hospitals was significantly associated with secondary hospitals, more than 3 victims, victim type (policemen or security guards), perpetrators (patients' family member), previous arrest, premeditation, and psychiatric disorders.

Keeping Healthcare Workers Safe Through Policy Initiatives

Keeping Healthcare Workers Safe Through Policy Initiatives

Firearm-Related Injuries and Deaths in Children and Youth: Injury Prevention and Harm Reduction.

Firearms are the leading cause of death in children and youth 0 to 24 years of age in the United States. They are also an important cause of injury with long-term physical and mental health consequences. A multipronged approach with layers of protection focused on harm reduction, which has been successful in decreasing motor vehicle-related injuries, is essential to decrease firearm injuries and deaths in children and youth. Interventions should be focused on the individual, household, community, and policy level. Strategies for harm reduction for pediatric firearm injuries include providing anticipatory guidance regarding the increased risk of firearm injuries and deaths with firearms in the home as well as the principles of safer firearm storage. In addition, lethal means counseling for patients and families with individuals at risk for self-harm and suicide is important. Community-level interventions include hospital and community-based violence intervention programs. The implementation of safety regulations for firearms as well as enacting legislation are also essential for firearm injury prevention. Increased funding for data infrastructure and research is also crucial to better understand risks and protective factors for firearm violence, which can then inform effective prevention interventions. To reverse this trend of increasing firearm violence, it is imperative for the wider community of clinicians, public health advocates, community stakeholders, researchers, funders, and policy makers to collaboratively address the growing public health crisis of firearm injuries in US youth.

Spatio-Temporal Information for Action Recognition in Thermal Video Using Deep Learning Model

Researchers can evaluate numerous information to ensure automated monitoring due to the widespread use of surveillance cameras in smart cities. For the monitoring of violence or abnormal behaviors in smart cities, schools, hospitals, residences, and other observational domains, an enhanced safety and security system is required to prevent any injuries that might result in ecological, economic and social losses. Automatic detection for prompt actions is vital and may help the respective departments effectively. Based on thermal imaging, several researchers have concentrated on object detection, tracking, and action identification. Few studies have simultaneously extracted spatial-temporal information from a thermal image and utilized it to recognize human actions. This research provides a novelty based on frame-level and spatial and temporal features which combines richer context temporal information to address the issue of poor efficiency and less accuracy in detecting abnormal/violent behavior in thermal monitoring devices. The model can locate (bounded box) video frame areas involving different human activities and recognize (classify) the actions. The dataset on human behavior includes videos captured with infrared cameras in both indoor and outdoor environments. The experimental results using the publicly available benchmark datasets reveal the proposed model's efficiency. Our model achieves 98.5% and 94.85% accuracy on IITR Infrared Action Recognition (IITR-IAR) and Thermal Simulated Fall (TSF) datasets, respectively. In addition, the proposed method may be evaluated in more realistic conditions, such as zooming in and out etc.

Violence in hospitals and burnout among nursing staff

BackgroundNursing staff, especially in violence-prone emergency departments (ED), are at high risk of burnout. Frequently experienced violence is expected to have a strong impact on the nursing staff's burnout. This study aimed to examine the differences in the level of burnout between nursing staff who work in the ED and nursing staff who work in other inpatient departments, and its relationship with violence in various hospitals in Israel. MethodA cross-sectional study that utilized a three-part questionnaire: demographic data, degree of burnout, and frequency occurrence of violence events against nurses. Results150 nurses in EDs (N = 75) and inpatient departments (N = 75) were sampled. Significant differences were found between the two groups: Nurses in EDs experienced a higher degree of burnout than nurses in other hospital departments, and the degree of burnout was found to have a positive relationship with exposure to both verbal and physical workplace violence. ConclusionsNursing staff in EDs could develop a high degree of burnout, and exposure to workplace violence could exacerbate it. The physical and emotional safety of the staff is an important aspect in preventing burnout, and creating a secure work environment.

Improving Medication Adherence among Patients with Schizophrenia in the Sunyani Municipality, Ghana: The Role of Therapeutic Alliance

Schizophrenia is a chronic condition associated with poor psycho-social and medical outcomes. Non-adherence to antipsychotic medications accounts for most of the relapses in schizophrenia, resulting in frequent hospital readmissions, self-harm, violence, and poor cognitive, clinical, and functional outcome. This multi-center study examined the role of therapeutic alliance in medication adherence. One hundred and eight (108) schizophrenia patients aged 18-60 years were recruited for the study through a purposive sampling technique. The study was conducted at the Bono Regional Hospital and the Sunyani Municipal Hospital in Ghana. The Medication Adherence Rating Scale (MARS) and the Scale to Assess the Therapeutic Relationship-Patients version (STAR-P) were adapted for the study. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 25. Most of the respondents were between 18 and 35 years (85.2%) of age. Males constituted 61.1% of the sample. A larger proportion of the respondents were residents of urban communities (66.7%). More than half of the sample did not have any formal education (51.9%) and 51.9% were unemployed. The mean (standard deviation) for the overall medication adherence and the therapeutic alliance was 4.56 (± 1.715) and 42.16 (± 7.710) respectively. There was no association between overall therapeutic alliance and medication adherence, rs = .14, n = 108, p = .146. However, affective bond showed a weak negative correlation with medication adherence, rs = .19, n = 108, p = .044. This finding indicates the need for clinicians to consistently seek patients’ views and concerns at each level of their treatment to achieve optimum outcomes.

Violence and unsafety in Italian hospitals: Experience and perceptions of nursing students.

Assessment of workplace violence towards healthcare workers represents a challenge for healthcare organizations worldwide. Workers' experience and perceived risk of violence may have a serious impact on job satisfaction and retention of workers. To date, no studies have been conducted on nursing students. To assess the prevalence of physical and non-physical violence among nursing students during their clinical experiences and to analyze the perceived risk of violence. Multicentre, cross-sectional survey. We enrolled a convenience sample of nursing students of the bachelor's degree in Nursing of the University of Milan (Italy). The students completed a structured questionnaire prepared in accordance with the available literature on violence in healthcare settings. Out of 1185 questionnaires sent, 603 were collected (50.89%). 35.1% had experience of verbal violence during the clinical internship training period, while 8.1% were victims of physical violence. 202 students (33.5%) reported unsafety, which was related to experience of physical or psychological violence, witnessed episodes of violence, gender, hospital structure and efficacy of the safety policies. Our findings highlight that nursing students are exposed to the risk of violence which influences their perception of risk.

Workplace violence against doctors in China: A case analysis of the Civil Aviation General Hospital incident.

BackgroundViolence against health professionals is a global public health problem. In 2019, a doctor was killed in Civil Aviation General Hospital (CAGH), which triggered national discussion about hospital violence. Sina Weibo, the Chinese version of Twitter, played an important role in this public discussion. The CAGH incident provides us with an opportunity to explore how social media was used in the discussion on violence against doctors.MethodsUsing the built-in search engine of Sina Weibo, a data set containing 542 Chinese micro-blogs was established. Three keywords: Civil Aviation General Hospital, doctor, and knife were used to search for related posts between December 24th, 2019 and January 19th, 2020. We made a content analysis of the posts to investigate: Weibo users' demographics, views about the incident of CAGH, and measures to prevent hospital violence.ResultsOverall, 89.3% of the posts were sent by individual Weibo users, and 10.7% by organizations. Among the individual users, doctors accounted for 27.4%, but only 1.0% came from the legal profession. In addition, 86.7% of the micro-blogs expressed sympathy for the attacked doctor, and 23.1% of the micro-blogs thought that the imperfect medical system was the main cause of the accident. Nearly half of the posts described their disappointment with the government and the society, and 58.6% of medical staff users expressed regret for engaging in medical work. Only 14.2% of micro-blogs put forward some constructive strategies to prevent hospital violence.ConclusionWeibo users played an important role in spreading and discussing the CAGH incident. However, constructive measures to protect doctors were rarely mentioned, and legal opinions were not reflected in time. Hospital violence has caused public dissatisfaction with the government and weakened the professional confidence of medical staff. Occupational health and public health stakeholders must take effective measures to solve workplace violence against doctors.

A systems analysis of work-related violence in hospitals: Stakeholders, contributory factors, and leverage points

Work-related violence in hospitals is a growing problem that has significant personal, societal, and economic costs and adversely impacts the quality of patient care. The complex and multi-factorial nature of the issue is such that it is extremely difficult to understand and manage, and interventions have had varying levels of success. Systems thinking and associated analysis methods are useful when attempting to understand and respond to complex issues; however, they have not previously been applied to work-related violence in hospital settings. This study involved the application of three systems thinking methods in conjunction with healthcare stakeholders to analyse the problem of work-related violence in hospital settings in New South Wales, Australia. The ActorMap method was used to identify the stakeholders who share the responsibility for the issue and the AcciMap method was used to identify the contributory factors which interact to create work-related violence incidents. PreventiMaps were then developed to show where interventions could be used to better prevent or mitigate work-related violence. The findings show a complex and diverse set of contributory factors beyond patients and healthcare workers and suggest that fundamental system reform is required. Nine key areas of hospital practice are proposed as the most suitable targets for intervention moving forward.

Violence Against Frontline Emergency Nurses During COVID-19 Pandemic in Guilan: A Cross-sectional Study

Background: Violence in the workplace is one of the most critical risk factors worldwide. Nurses are continuously exposed to violence in their workplace, primarily because of having contact with patients and their families. Objectives: The present study aimed to investigate the violence against nurses in Razi educational and remedial center in Rasht. Methods: In a cross-sectional study, we recruited 112 nurses working in Rasht's educational and remedial center by convenience sampling. The instrument included a questionnaire to assess workplace violence in medical settings, which had been used in several Iranian studies and was psychometrically assessed by Najafi in Iran. After collecting and entering the data into SPSS version 22 software, they were analyzed by independent t test, chi-square test, and Fisher's exact test. The significance level was set at a P value &lt; 0.05. Results: The findings showed that 11.1% of nurses experienced physical violence, and 55.7% experienced verbal violence. We found a significant relationship between education level and verbal violence (P = 0.02) and between job (P = 0.02) and marital (P = 0.02) status and physical violence. Linear regression analysis showed that nurses with low experience were 1.01 times more likely to undergo violence (OR = 1.01; CI: 0.66 - 1.44). Conclusions: Verbal and physical violence frequently occurred against nurses during the COVID-19 pandemic. Thus, the authorities are required to take adequate measures to reduce the incidence of violence in hospitals.

Do nurses receive any support following incidents of workplace violence? A qualitative study.

We aim to investigate nurses' perceptions of support after incidences of Workplace Violence. Nurses experience workplace violence daily. Adequate support following incidents of violence can reduce adverse impacts. Current support systems for coping with workplace violence are lacking. Focus group interviews were conducted with 23 nurses working in a regional Queensland Hospital. Qualitative data was transcribed and thematically analyzed to determine themes. The consolidated criteria for reporting qualitative research checklist was followed. The primary source of support after a violent incident was from other nurses. Support was needed immediately to empower nurses to be able to continue their caring role. Often the support was not provided nor were nurses aware of the support services available. Although personal family and friends were a valuable support, most nurses were reluctant to disclose their experiences to protect them. This paper discusses nurses' experience of support following violence incidents at work as part of findings from a more extensive study that explored the perceptions of nurses regarding violence, strategies and support in a regional Queensland Hospital. Hospital support following a violent incident was perceived as inadequate and nurses felt unsupported immediately following an incident. After an incidence of workplace violence, appropriate effective support may mitigate the enduring impacts of experiencing violence. There is the need for hospital management to provide effective support services and improve staff awareness of available support services.