Workplace Violence In Hospitals Research Articles

Exploring the protective capabilities developed by hospital nurses to deflect workplace violence: a qualitative study in Taiwan.

Workplace violence is a serious safety hazard in the healthcare sector and has attracted much attention worldwide, especially for nursing staff. Equipping nursing personnel with protective capabilities for workplace violence can reduce the risk they face in work settings. This study explored scenarios of common violent patient-nurse conflicts in the workplace of hospital nursing staff and their capabilities for de-escalating such conflicts. We used a qualitative content analysis for this study. Qualitative interviews were conducted with 21 nurses in two teaching hospitals in New Taipei City, Taiwan, until data saturation was reached. The data were transcribed, encoded, and analyzed and similar concepts were grouped under the same category. Four categories of workplace violence scenarios common to hospital nursing staff were identified: unreasonable requests, caring for high-risk patients, long waiting times for medical consultation, and close contact when caring for patients. Two protective capabilities were recognized: communication and interpersonal capabilities and problem-solving skills. Each scenario may require a different combination of abilities. Our findings suggest that a violence-prevention training program could be designed for various workplace violence scenarios to enhance nurses' abilities to de-escalate workplace violence in hospitals.

The association between the adverse event reporting system and burnout and job satisfaction of nurses: Workplace violence as a mediator.

This study aims to explore the association between the implementation of the adverse event reporting system (AERS), burnout, and job satisfaction among psychiatric nurses, with a focus on examining the mediating effect of workplace violence from patients. Many organizational and personal factors contribute to burnout and job satisfaction experienced by nurses. AERS, serving as a key component of organizational-level quality improvement system, impacts the overall workplace wellness of nurses. A national sample of 9,744 psychiatric nurses from 41 psychiatric hospitals across 29 provinces in China participated. Burnout was measured by the Maslach Burnout Inventory. Job satisfaction was measured using the Minnesota Satisfaction Questionnaire. Workplace violence was assessed by nurses' experience of verbal and physical violence. Multilevel linear regression analyses were carried out to examine if AERS impacts burnout and job satisfaction and to identify the mediating role of workplace violence. AERS was positively associated with job satisfaction, but negatively with burnout and workplace violence. Workplace violence exhibited a positive association with burnout and a negative association with job satisfaction. Mediation analyses indicated that the associations between AERS, burnout, and job satisfaction were mediated by workplace violence. The application of AERS is associated with a reduction in workplace violence in hospitals, which contributes to the diminished burnout and heightened job satisfaction among psychiatric nurses. The study highlights the importance of organizational efforts and mechanisms in promoting nurses' well-being. It is necessary for hospital management to create a safe workplace through the implementation of AERS.

Workplace Violence against Nurses Working at Private Teaching Hospitals of Kathmandu: A Descriptive Cross-sectional Study

Workplace Violence against Nurses Working at Private Teaching Hospitals of Kathmandu: A Descriptive Cross-sectional Study

The Mediating Effect of Nurses’ Emotional Intelligence in the Relationship between Moral Sensitivity and Communication Ability with Angry Patients

Aims. To test whether emotional intelligence plays a mediating role in the process by which moral sensitivity affects nurses’ ability to communicate with angry patients. Background. Hospital workplace violence is a global problem that disrupts the normal work order of healthcare, undermines trust between nurses and patients, and threatens the physical and mental health of nurses. Improving nurses’ ability to communicate with angry patients to identify and diffuse patients’ anger is critical to reducing the nurse‐patient conflict and avoiding violence in the hospital workplace. Methods. The data were collected in China. A sample of 212 nurses completed measures of moral sensitivity, emotional intelligence, and the ability to communicate with angry patients. Structural equation modeling was used to test the study’ hypothesis. Results. Our results suggest that nurses’ emotional intelligence mediates the relationship between nurses’ moral sensitivity and nurses’ ability to communicate with angry patients, with a positive correlation between nurses’ moral sensitivity, emotional intelligence, and ability to communicate with angry patients. Conclusions. The findings showed that nurses’ moral sensitivity indirectly influenced nurses’ ability to communicate with angry patients by directly influencing emotional intelligence. This study provides a theoretical and methodological approach to mitigate nurse‐patient conflict and reduce violence in the hospital workplace through a moral perspective. Implications for Nursing Management. Nursing managers should pay attention to the moral sensitivity and emotional intelligence of nurses and promote their moral development and emotional intelligence by strengthening moral education in hospitals, utilizing emotional intelligence training courses and narrative nursing, ultimately promoting nurses’ ability to communicate with angry patients, further contributing to the reduction of nurse‐patient conflict, avoiding violence in the hospital workplace, building a safer hospital environment, promoting the overall development of nurses, and contributing to the development of global health and wellness.

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.

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

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.

Characteristics of workplace violence, responses and their relationship with the professional identity among nursing students in China: a multicenter cross-sectional study

BackgroundNursing students are one of the most vulnerable groups suffering from workplace violence. This study aimed to investigate the workplace violence incidence of Chinese nursing students during clinical practice, to describe the characteristics of violence and students’ responses and to analyse the relationship between the experience of workplace violence and professional identity.MethodsA cross-sectional study was conducted among 954 nursing students in ten universities in China through convenience sampling. Workplace violence was surveyed through Hospital Workplace Violence Questionnaire for Nursing Students. Students’ professional identity was measured by Professional Identity Questionnaire for Nursing Students. Statistical methods included descriptive statistics, chi-square test, independent-samples t-test, analysis of variance and linear regression analysis.ResultsIt was found that the incidence of workplace violence among nursing students was 42.98%. The violent incidents ranking from high to low were: verbal abuse, threat, physical attack, sexual harassment, and gathering disturbance. The majority of the nursing students chose to avoid the conflict during the incident. 86.34% of the students didn’t report the incidents. More than half of the victims developed post-traumatic stress disorder after the incidents. Regression analysis results showed that workplace violence experience (β = − 0.076, P < 0.05) was a significantly negative predictor of professional identity.ConclusionsChinese nursing students were exposed to physical and psychological violence during clinical practice with insufficient coping solutions and psychological adjustment. The professional identity of the nursing students was significantly associated with the experience of workplace violence.

Intensive care units nurses' burnout, organizational commitment, turnover intention and hospital workplace violence: A cross-sectional study.

This study aimed to (1) assess the relationship between intensive care unit (ICU) nurses' burnout, organizational commitment and turnover intention, (2) examine the moderating effect of the organizational commitment on the relationship between ICU nurses' burnout and turnover intention, and (3) explore the prevalence and influencing factors of hospital workplace violence among ICU nurses. Cross-sectional study design. Data were collected from August to October 2020 and a convenience sample of registered nurses was recruited. To control common method biases, one-month temporal separation, Harman's single-factor analysis and method of latent variables were adopted. The moderating effect was tested by SPSS Hayes PROCESS Macro. Chi-square and logistic regression were used to examine workplace violence data. Organizational commitment (β=-.23, 95% confidence interval -.45 to -.03) and continuance commitment (β=-.15, 95% confidence interval -.24 to -.16) have negative moderation effects on the relationship between emotional exhaustion and turnover intention. 77.7% of ICU nurses experienced workplace violence, male and staff nurses, and nurses with lower professional titles and shorter working years have greater odds of experiencing this violence.

Mental Health Status of Medical Staff Exposed to Hospital Workplace Violence: A Prospective Cohort Study.

ObjectiveHospital workplace violence is one of the most frequently reported types of workplace violence in the world, and it harms the mental and physical health of medical staff. Existing research on workplace violence focused more on cross-sectional studies, than longitudinal studies. Therefore, this study examined the dynamic impact of hospital workplace violence on the mental health of medical staff, with the aim of providing appropriate countermeasures and suggestions for hospitals to develop targeted psychological intervention measures in time for medical staff who experience workplace violence.DesignA prospective cohort study.ParticipantsA total of 112 medical staff who had experienced workplace violence in the hospital for the first time were chosen.SettingAn unconditional latent variable growth curve model was established based on the average value of the general health scale scores of medical staff, and gender and violence types (intimidation threats, physical violence) as control variables. Each medical staff was assessed for depression and anxiety at 4 different time points and the changes in the trajectories was observed.ResultsThere were significant differences in the incidence of mental health and anxiety among medical staff at different observation times. There were significant individual differences in the initial mental health status, growth rate of anxiety and depression of medical staff.ConclusionsHospitals should undertake various psychological intervention strategies based on the staff's mental health to safeguard those who have experienced workplace violence.

Prevalence, influencing factors and adverse consequences of workplace violence against nurses in China: A cross-sectional study.

The primary objective of this study was to determine the prevalence of workplace violence among nurses in China and its association with demographic characteristics, quality of work life and coping styles. The secondary objective was to explore how nurses deal with workplace violence and the emotional/psychological impact of workplace violence on nurses. Workplace violence is a common occupational hazard that causes physical and psychological harm to nurses. A cross-sectional study was conducted with 2769 nurses from China. A demographic information questionnaire, hospital workplace violence questionnaire, Chinese version of the work-related quality of life scale and coping style scale were used in this study. The Chi-squared test, Mann-Whitney U test and binary logistic regression analysis were used to investigate the effects of demographic characteristics, quality of work life and coping styles on nurses' workplace violence. A total of 49.12% of the nurses (n= 1360) had experienced at least one type of workplace violence in the past 6 months. Night shifts, work department, chronic diseases (odds ratio [OR] = 1.53, p < .001), sleep disorders (OR = 1.54, p< .001), frequent overtime (OR = 1.78, p < .001), adverse nursing events (OR = 2.01, p < .001) and passive coping (OR = 1.47, p < .001) were risk factors for workplace violence. Working conditions (OR = 0.61, p< .001), general well-being (OR = 0.65, p < .001) and positive coping (OR = 0.76, p< .001) were identified as protective factors for workplace violence. Nurses exposed to workplace violence experience various negative emotional and psychological consequences. Workplace violence is common among nurses in China. Good working conditions, general well-being and positive coping may help prevent workplace violence injuries. Efforts should be made to improve and optimize existing workplace violence prevention measures, create and maintain a good working environment for health care workers and develop various coping styles or strategies to manage stress to reduce workplace violence. The cross-sectional study has been approved by the Ethics Committee of the First Affiliated Hospital of China Medical University, with the registration number 2019-221-2. Written informed consent was obtained prior to the survey.

Workplace Violence against Hospital Workers during the COVID-19 Pandemic in Israel: Implications for Public Health.

Workplace violence (WPV) against healthcare workers, a serious public health problem with profound implications, has worsened during the COVID-19 pandemic. This study examined the incidence of different types of WPV in a public hospital in Israel during the pandemic and analyzes the factors associated with its occurrence. A cross-sectional study was performed via an online questionnaire with 486 workers at a government hospital in Israel. Data were collected about sociodemographic and occupational characteristics, exposure to different forms of WPV over the preceding six months, and the responsibility and reasons for WPV from the workers’ perspective. Approximately 71% of respondents were exposed to WPV and 64% perceived that WPV escalated during the pandemic. The prevalence of verbal/psychological and physical WPV were 69 and 11%, respectively. The main reason for WPV was frustration over long wait times (70%). The escalation during the pandemic can be attributed to patients’ or relatives’ anxiety and mental states following the onset of the COVID-19 pandemic (72%), an increase in waiting time since the pandemic began (54%), lack of hospital resources to care for everyone (45%), and the inability to visit critically ill relatives with COVID-19 (44%). Increased exposure to WPV was attributed to lower seniority, working in emergency or internal departments, and being a nurse or a doctor. The findings raise an urgent need to develop strategies to reduce WPV in hospitals at all levels: national, organizational, and individual. Further research could focus on the effectiveness of innovative strategies and interventions to prevent violence against healthcare workers.

Is there a need to change strategies? - an exploratory study of the hospital workplace violence

Is there a need to change strategies? - an exploratory study of the hospital workplace violence

Dimensions of hospital workplace violence: Patient violence towards the healthcare team.

To investigate the cognitive dimensions nurses use when perceiving patient-to-healthcare provider workplace violence. The concept of workplace violence, especially with respect to healthcare settings, has been well documented. Healthcare workers are at particular risk for experiencing violence from their patients, though these incidents often go unreported. Experiencing violence in the workplace has been associated with numerous negative outcomes, including absenteeism, burnout and diminished quality of care. However, little emphasis has been placed on understanding the concept of violence itself, or why one type of violence might go unreported whilst another is readily communicated to officials. A card-sorting, multidimensional scaling design. Thirty two nurses completed the card-sorting task. Using multidimensional scaling (MDS), 75 reported incidents of violence were considered. SPIRIT research reporting checklist followed. Nurses categorise patient violence in three dimensions: physical versus verbal, active versus threatening and more versus less severe. Implications for further research and intervention are discussed. Violence in the hospital workplace is a complex perception by the healthcare worker that cannot be captured by a single dimension. This study provides a theoretical framework for understanding the complexity of patient-to-provider violence in a hospital setting. It sheds light on why only a minority of such events are reported. This model can serve as a foundation for future research exploring interventions for hospital violence.

Mental health status and its influencing factors of nurses in geriatric department after workplace violence

Objective: To investigate the mental health status and influencing factors of geriatric nurses after workplace violence. Methods: From February 2019 to January 2020, 102 geriatric nurses who suffered workplace violence in three hospitals in Shaoxing were collected as the observation group and 100 geriatric nurses who did not suffer workplace violence in the same period as the control group. The general data of nurses in the two groups were investigated, the workplace violence was investigated with the hospital workplace violence questionnaire, the mental disorders and mental diseases were investigated with the symptom checklist 90 (SCL-90) , the symptoms of post-traumatic stress disorder were investigated with the symptom checklist of post-traumatic stress disorder (pcl-c) , and the psychological elasticity was investigated with the psychological elasticity scale, Social support was investigated with social support scale (SSRs) . Results: The total average score of symptom checklist 90 (SCL-90) of nurses with workplace violence was (1.49 ± 0.48) . Compared with the control group, the total average score of SCL-90, somatization, obsessive-compulsive symptoms, depression, anxiety and fear factors in the observation group were significantly increased (P<0.05) . The total score of post-traumatic stress disorder symptom list (pcl-c) in the observation group was (34.51±9.87) . Compared with the control group, the total average score of pcl-c, re experience, avoidance and vigilance factors in the observation group were significantly increased (P<0.05) . The total average score of SCL-90 of nurses with workplace violence was positively correlated with psychological elasticity and social support (P<0.05) . Multivariate linear analysis showed that psychological elasticity, tenacity and control, optimism, social support and subjective support were the main factors affecting nurses＇mental health. Conclusion: Geriatric nurses suffering from workplace violence are prone to mental health problems and post-traumatic stress disorder, which should be improved by improving their psychological elasticity and social support.

Mediating role of coping styles on anxiety in healthcare workers victim of violence: a cross-sectional survey in China hospitals

ObjectiveThe purposes of this study were to evaluate the rate of workplace violence in county hospitals in China and its impact on healthcare workers and to explore the relationship between...

The Effects of Emergency Room Violence toward Nurse's Intention to Leave-Resilience as a Mediator.

(1) Background: Healthcare workplace violence has been a focused issue in the whole world. The rate of the occurrence is pretty high in every country. The emergency room is a high risk and high frequency place for violence to occur. Under the medical service demands from people, it is quite easy to bring about conflicts. This leads to serious physical and mental harm to nurses. When suffering from physical and mental injuries, resilience is a protective factor away from negative influence. It is rare to explore and study how the nurses’ resilience ability, workplace violence and turnover intention are related. Thus, the aim of this study is to understand resilience as a mediator effect in emergency nurses toward the workplace violence. (2) Methods: A cross-sectional survey study was used to collect information from emergency room nurses of a medical center in northern Taiwan. There were 132 samples in total. Three research instruments were included as follows: Hospital Workplace Violence Prevention Questionnaire, Connor-Davidson Resilience Scale, and Turnover Intention Scale. Statistical analysis using t-test, ANOVA, Correlation, as well as Sobel test were used in this study. (3) Results: The results revealed that the average age was 29.5 ± 5.6. Almost 58% of nurses experienced workplace violence. Twelve percent of nurse had experienced physical violence and 53.8% had experienced mental violence. There was significant relationship between shift personnel and religious believers. To the people who suffered physical violence, there was a significant relationship between emergency room working years and the total working years. There was significant difference between those who had suffered mental violence and religious believers. Female nurses suffered mental violence to a much higher extent than male nurses. There was a significant relationship between nurses’ working years, the total working years, resilience, and turnover intention. Resilience was not the mediator for workplace violence toward turnover intention in this study. (4) Conclusions: The outcome of this study suggested that on an individual level, nurses can enhance self-protection and communication skills to decrease workplace violence. For emergency environment settings, designing a good working environment, visitors’ restriction, avoiding working alone, and enhancing supervising alarm system are recommended. As for hospital administrators, fitness for work and to set up a project team is necessary. These can be references in planning prevention on workplace violence and promoting quality of workplace and patient safety in the future.

Relationships between nurses' experiences of workplace violence, emotional exhaustion and patient safety.

BackgroundThe rising rate of workplace violence in hospitals is a serious concern. While leading organisations recommend implementing interventions to address workplace violence, little is known about the workplace violence relationship between patients and visitors, and how it affects nurses’ emotional exhaustion and their perceptions of patient safety.AimsThe study’s purpose was to understand the status of workplace violence in hospitals and the relationships between nurses’ experiences of workplace violence, emotional exhaustion, and perceptions of patient safety.MethodsThis cross-sectional analysis used data from a survey conducted at a large academic medical centre using the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture plus additional measures of workplace violence and emotional exhaustion.ResultsNurses reported more occurrences of verbal violence than physical violence. Nurses’ experiences of workplace violence negatively affect nurses’ emotional exhaustion and patient-safety perceptions. Moreover, nurses’ emotional exhaustion mediated the relationship between verbal abuse and patient-safety perceptions.ConclusionsInterventions to reduce nurses’ emotional exhaustion and strengthen resilience can mitigate the negative effects of verbal abuse and to some extent the effects of physical violence.

Factors associated with physical injury or police involvement during incidents of workplace violence in hospitals: Findings from the first year of California's new standard.

Workplace violence in healthcare settings is known to be a costly and often underreported problem. In California, hospitals are required to report incidents of violence towards workers to the California Occupational Safety and Health Administration (CalOSHA) using an online reporting system that went into effect in 2017. Reports submitted to CalOSHA from July 2017 to September 2018 pursuant to this new requirement were analyzed using descriptive methods and logistic regression. Four hundred eight hospitals submitted reports using the new incident reporting system. Behavioral health units had 1.82 times the odds of the reported incident resulting in physical injury compared to inpatient medical units, and investor-owned facilities had 2.43 times the odds of the reported incident resulting in physical injury compared to city or county-owned facilities. Inpatient and behavioral health units had significantly reduced odds of a reported incident resulting in police involvement when compared to other locations within the hospital. These findings indicate that protections for healthcare workers deserve ongoing attention from stakeholders and legislators and provide insight into how healthcare facilities report incidents of violence towards workers.