Workplace Violence Training Research Articles

Prevalence and factors associated with workplace violence in a tertiary healthcare facility in Nigeria.

Healthcare workers globally are at an increased risk of workplace violence. Adverse effects such as physical injury, reduced quality of care to patients and lower productivity with associated costs to employers occur. Non-reporting hinders the implementation of effective prevention. This study aimed to assess the prevalence, reasons for non-reporting of workplace violence, and knowledge of prevention prior to designing intervention strategies in the study location where there is a paucity of research on this issue. This cross-sectional study was conducted at a Teaching Hospital in Abakaliki, Ebonyi State, for 4 weeks in 2020 among 205 employees. The hospital was stratified into Clinical, Nursing Services, Pharmacy, Laboratory, and administrative divisions; proportionate allocation and random sampling were used to select the allocated samples. A structured questionnaire was used to collect data. Descriptive statistics determined the measures of central tendencies and dispersion, while bivariate analysis of the variables was done using Pearson's Chi-Square test. Statistical significance was set at p ≤ 0.05 with a confidence level of 95%. The mean age of the participants was 39.1 ± 7.8 years. The prevalence of workplace violence was 70%. The most common reason for non-reporting was complexities and time-consuming reporting procedures (26.5%) followed by fear of reprisal on career (22.4%). The proportion of respondents with good knowledge of workplace violence prevention strategies was high (69.8%). Gender (p = 0.03), work setting (p = 0.006), previous workplace violence training (p = 0.005) and knowledge of workplace violence preventive strategies (p = 0.04) had statistically significant associations with experience of workplace violence. The high prevalence of workplace violence suggests a need for a workplace violence prevention program which should include a simple process of reporting and training. The improved awareness from previous training may account for the significant association with workplace violence.

Challenges and Opportunities for Workplace Violence Training for Healthcare Workers: A Qualitative Study of Staff Experiences

Challenges and Opportunities for Workplace Violence Training for Healthcare Workers: A Qualitative Study of Staff Experiences

Violence, Harassment, and Turnover Intention in Home and Community Care: The Role of Training.

Violence and harassment affect healthcare workers' well-being and career decisions in the home and community care sector. The objective of this study is to assess the role of training in alleviating the relationship between violence and harassment at work and turnover intention among personal support workers (PSWs). Cross-sectional survey data from 1401 PSWs in Ontario, Canada are analyzed with structural equation modeling. Utilizing a resource perspective, the associations between job demands (i.e., violence and harassment at work), personal resources (i.e., self-esteem), job resources (i.e., workplace violence training and challenging task training), stress, and intention to stay among personal support workers (PSWs) are examined. Challenging task training is positively associated with self-esteem and negatively associated with stress, whereas workplace violence training does not have a significant association with either variable. Stress has a negative relationship with intention to stay. Self-esteem is the mediator of both associations between violence and harassment at work and stress and between challenging task training and stress. The results point to varied degrees of training effectiveness that may be shaping turnover decisions of PSWs who experience violence and harassment in home and community care organizations. There seems to be a need to assess and redesign workplace violence training. Home and community care managers might be able to lower the impact of violence and harassment on PSWs' turnover by providing training that is not directly related to workplace violence and harassment.

Improving Policy and Legislation Related to Healthcare Workplace Violence

Abstract Our group conducted the first known New Hampshire survey on healthcare staff experience of workplace violence. Study questions focused on experiences of workplace violence, incident reporting mechanisms, and the availability and benefit of workplace violence training programs. Results were consistent with recently published literature: violence against healthcare workers remains a serious public health problem that is under-reported, understudied, “tolerated and largely ignored.” We will discuss the aspects of policy and legislative responses to workplace violence that have been insufficient to address this problem. We also will present some strategies that, if implemented, could lead to improved policy and legislation that may be more proactive in reducing such violence.

Reframing Older Adults’ Violence Toward Staff as Self-Protection

One of the first studies on workplace violence in nursing homes was published in 1985. Forty-five (45) years later, resident violence against staff continues to increase in incidence and severity. At the request of a state senator, a New Hampshire psychiatrist formed a research group to conduct the first New Hampshire survey on staff experience of workplace violence. Study questions focused on experiences of workplace violence and incident reporting, and the availability and benefit of workplace violence training programs. Results were consistent with recently published literature: violence is an expected, normalized element when providing care; potential repercussions and perceived resident lack of intent were major reasons for incident non-reporting. Analysis of study results and review of the literature led to the question: Are older residents’ violent behaviors towards staff an act of self-protection?

A Systematic Review: Effectiveness of Interventions to De-escalate Workplace Violence against Nurses in Healthcare Settings.

Workplace violence (WPV) is an increasing cause of concern around the globe, and healthcare organizations are no exception. Nurses may be subject to all kinds of workplace violence due to their frontline position in healthcare settings. The purpose of this systematic review is to identify and consider different interventions that aim to decrease the magnitude/prevalence of workplace violence against nurses. The standard method by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA, 2009) has been used to collect data and assess methodological quality. Altogether, twenty-six studies are included in the review. The intervention procedures they report on can be grouped into three categories: stand-alone trainings designed to educate nurses; more structured education programs, which are broader in scope and often include opportunities to practice skills learned during the program; multicomponent interventions, which often include organizational changes, such as the introduction of workplace violence reporting systems, in addition to workplace violence training for nurses. By comparing the findings, a clear picture emerges; while standalone training and structured education programs can have a positive impact, the impact is unfortunately limited. In order to effectively combat workplace violence against nurses, healthcare organizations must implement multicomponent interventions, ideally involving all stakeholders.

Workplace Violence Training Programs for Nursing Students: A Literature Review.

Workplace violence (WPV) is a serious phenomenon affecting nurses in clinical settings around the globe. Like nurses, nursing students are at risk of encountering incidents of WPV, which may lead to negative consequences. WPV training programs are useful in helping nurses and nursing students prevent and manage incidents of WPV. Despite this evidence, the development and implementation of WPV training programs for nursing students pursuing their nursing training in university settings are scarce. The purpose of this literature review was to identify and synthesize the evidence about new training programs on prevention and management of WPV implemented exclusively for undergraduate and graduate nursing students published during the years 2012 to 2018. The literature review utilized five major databases to identify relevant articles containing WPV training programs implemented in university settings to train undergraduate and graduate nursing students. Appraisal of the evidence was conducted using the Mixed Methods Appraisal Tool. Nine articles included WPV training programs imparted to nursing students in university settings. Overall, nursing students increased their knowledge about WPV and learned practical skills that could be helpful in preventing and managing WPV incidents. WPV training programs were positively accepted by nursing students. WPV training programs for nursing students should be mandated in all nursing schools. These trainings are vital in equipping them with proper knowledge and practical skills that could be used to prevent and manage incidents of WPV.

Using Simulation Training to Promote Nurses' Effective Handling of Workplace Violence: A Quasi-Experimental Study.

Background: Workplace violence in the health care sector has become a growing global problem. Research has shown that although caregivers comprise a high-risk group exposed to workplace violence, most of them lacked the skills and countermeasures against workplace violence. Therefore, through a quasi-experimental design, this study aimed to investigate the effectiveness of situational simulation training on the nursing staffs’ concept and self-confidence in coping with workplace violence. Methods: Workplace violence simulation trainings were applied based on the systematic literature review and the conclusions from focus group interviews with nursing staff. Data were obtained from structured questionnaires including: (1) baseline characteristics; (2) perception of aggression scale (POAS); and (3) confidence in coping with patient aggression. Results: The results revealed that training course intervention significantly improved the nursing staffs’ self-perception and confidence against workplace violence (p < 0.001). Conclusions: The “simulation education on workplace violence training” as the intervention significantly improved the workplace violence perception and confidence among nursing staffs in coping with aggression events.

Workplace Violence Training Using Simulation.

: Workplace violence in health care settings is increasing dramatically nationwide. In response, an interdisciplinary team at an Ohio health system developed and piloted a model of training to address workplace violence. The model included classroom learning, a code silver (person with a weapon or a hostage situation) simulation training, and hands-on self-defense techniques. Based on data collected in the pilot, the team revised the model to offer a more comprehensive approach; the new, revised training program is known as Violence: enABLE Yourself to Respond. The team designed four distinct five-minute simulation scenarios depicting a range of threats from "escalating behavior" to "active shooter" and enacted them with standardized participants (health care personnel trained to perform specific behaviors in educational scenarios). Immediately after each simulation, the instructors facilitated a debriefing of the participants. Participants' pre- and post-training program self-evaluations of how prepared they felt to react to violent situations, as well as experts' evaluations of the participants' performance in simulations, provided evidence of the effectiveness of the model. Analysis of the data demonstrated a statistically significant positive difference in both participants' perception of their preparedness and experts' evaluation of their performance. The combination of classroom learning and simulation training is an effective, evidence-based method to prepare employees to respond when a situation escalates to violence, including the use of a weapon. This approach was designed for acute care but can be adapted to other settings. Skills learned can be used in both personal and professional life.

The effect of a workplace violence training program for generalist nurses in the acute hospital setting: A quasi-experimental study

BackgroundWorkplace violence prevalence has attracted significant attention within the international nursing literature. Little attention to non-mental health settings and a lack of evaluation rigor have been identified within review literature. ObjectivesTo examine the effects of a workplace violence training program in relation to risk assessment and management practices, de-escalation skills, breakaway techniques, and confidence levels, within an acute hospital setting. DesignA quasi-experimental study of nurses using pretest-posttest measurements of educational objectives and confidence levels, with two week follow-up. SettingA 440 bed metropolitan tertiary referral hospital in Sydney, Australia. ParticipantsNurses working in specialties identified as a ‘high risk’ for violence. MethodA pre-post-test design was used with participants attending a one day workshop. The workshop evaluation comprised the use of two validated questionnaires: the Continuing Professional Development Reaction questionnaire, and the Confidence in Coping with Patient Aggression Instrument. Descriptive and inferential statistics were calculated. The paired t-test was used to assess the statistical significance of changes in the clinical behaviour intention and confidence scores from pre- to post-intervention. Cohen's d effect sizes were calculated to determine the extent of the significant results. ResultsSeventy-eight participants completed both pre- and post-workshop evaluation questionnaires. Statistically significant increases in behaviour intention scores were found in fourteen of the fifteen constructs relating to the three broad workshop objectives, and confidence ratings, with medium to large effect sizes observed in some constructs. A significant increase in overall confidence in coping with patient aggression was also found post-test with large effect size. ConclusionsPositive results were observed from the workplace violence training. Training needs to be complimented by a multi-faceted organisational approach which includes governance, quality and review processes.

Workplace violence against nurses in Indonesian emergency departments

The objective of this study was to examine the experiences of violent incidents by nurses in Indonesian emergency departments. The World Health Organization's structured questionnaire on workplace violence in the health sector was modified and translated into Bahasa. The study participants were 169 nurses working in emergency departments in six hospitals in Jakarta and Bekasi, Indonesia. The gathered data were analyzed using descriptive and multivariate logistic regression. Ten percent of emergency nurses reported experiencing physical violence, perpetrated mostly by patients, whereas more than half of emergency nurses (54.6%) reported experiencing non-physical violence, with patients' relative as the main perpetrators. A majority of nurses (55.6%) did not have encouragement to report workplace violence, and very few nurses (10.1%) had received any information or training about workplace violence. The findings of this study highlighted the seriousness of violence in Indonesian emergency departments. Support from management, encouragement to report violence, and access to workplace violence training were expected to mitigate and manage violence against nurses in emergency departments.

Corrigendum.

Arbury, S., Zankowski, D., Lipscomb, J., & Hodgson, M. (2017). Workplace violence training programs for health care workers: an analysis of program elements. Workplace Health & Safety, 65(6), 266-272. (Original DOI: 10.1177/2165079916671534) In this article, the author list was incorrectly ordered in the OnlineFirst and print versions. It should have appeared as follows: Sheila Arbury, MPH, RN, Donna Zankowski, MPH, RN, COHN, Jane Lipscomb, PhD, RN, FAAN, and Michael Hodgson, MPH, MD. This error has been corrected in the online article.

Workplace Violence Training Programs for Health Care Workers: An Analysis of Program Elements

Workplace Violence Training Programs for Health Care Workers: An Analysis of Program Elements

Workplace Violence and Training Required by New Legislation Among NJ Nurses.

The aim of this study was to examine nurses' knowledge of the state of New Jersey (NJ) Violence Prevention in Health Care Facilities Act, workplace violence training, and experience with workplace violence. In 2013, 309 (22.5% response rate) nurses returned a mailed survey. Univariate and multivariate analyses were conducted. Ninety percent of respondents were female. When the perpetrator was a patient or a family member, the respondents experienced verbal abuse the most (57.8%), followed by threats (52.3%), and physical assault (38.3%). Respondents who had heard of the regulation (89.6%) received a higher proportion of training than those who had not heard of the regulation (57.9%) (P < 0.0001). Nurses who received at least 80% of the required training components were more likely to feel more secure at work, suggesting that training is an important tool to address workplace violence.

A survey of workplace violence and its related cognition and demands of nurses in emergency de-partment

Objective To describe the prevalence of workplace violence against nurses in emergency departments, and investigate its related cognition and demands of nurses. Methods A total of 385 emergency department nurses from 13 general hospitals in Beijing were recruited by convenient sampling method and were investigated with the Version of Hospital Workplace Violence Questionnaire in February to October 2014. Results The prevalence of workplace violence against nurses was 89.9% during the past 12 months. The incidence of verbal abuse, threat, physical assault and sexual assault were 89.9%, 70.6%, 20.5% and 3.9% respectively. The responses of nurses were mainly tolerance and avoidance, explain patiently and ask for help; 81.6% of the nurses considered that workplace violence was inevitable in the workplace, and 78.7% of the nurses thought the hospital was not capable of dealing with workplace violence in the past. The nurses demanded that the hospital to increase the prevention of workplace violence training, to set up a sector to deal with violence events, or to take on workplace violence policy of zero tolerance. Conclusions Workplace violence against nurses is prevalent in emergency departments. Nurses hope the hospital to have more positive attitude against workplace violence and take more measures to prevent and deal with it. Further intervention should be conducted to reduce workplace violence against nurses by individuals, hospitals, the government and the whole society. Key words: Emergency room, hospital; Nurses; Cognition; Demand; Workplace violence

Workplace Violence Training Programs for Health Care Workers: An Analysis of Program Elements.

Commercial workplace violence (WPV) prevention training programs differ in their approach to violence prevention and the content they present. This study reviews 12 such programs using criteria developed from training topics in the Occupational Safety and Health Administration's (OSHA) Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers and a review of the WPV literature. None of the training programs addressed all the review criteria. The most significant gap in content was the lack of attention to facility-specific risk assessment and policies. To fill this gap, health care facilities should supplement purchased training programs with specific training in organizational policies and procedures, emergency action plans, communication, facility risk assessment, and employee post-incident debriefing and monitoring. Critical to success is a dedicated program manager who understands risk assessment, facility clinical operations, and program management and evaluation.

Caregivers’ Concerns – Age-Group Issues on Workplace Violence

The issue of workplace violence (WPV) around the world can be characterized as workplace terrorism. The health care industry is the most important industry that manages, promotes and ensures wellness of its people. Therefore, issues concerning its caregivers should not be underemphasized. The whole world is fighting seriously to eliminate terrorism, so reduction and elimination of WPV in the healthcare industry should be a major concern to everyone. This study investigates the age group among long term care facilities’ nurses and Certified Nursing Assistant (CNA)’s that have experienced WPV most during the performance of their duties. Eighty caregivers from three facilities in Greensboro, North Carolina participated in the study. Caregivers were grouped into four age-group categories. Group one was nurses and CNA's from the age of 18 – 25 years old, group two from 26 - 35, group three from 36 – 45, and group four from 46 and above. Thirty-two of the participants fall into age group four, 19 falls into age group three, 20 into age group two and 9 into age group one. Every participant has a minimum of seven years and maximum of ten years’ work experience in long-term facility. Participants were predominantly Black or African-American and Caucasian. Results revealed that 78% of the nurses and CNAs in group one have experienced WVP, followed by group three 70%, and group four 63%. A statically significant difference was found in the number of nurses and CNAs that falls in age group three and group one (t= 2.014, df = 45; p = 0.019) and (t=2.12; df = 16; p = 0.017) respectively. The findings from this study could help identify the age groups that are predominantly exposed to WPV and how WPV training should be designed differently for the age groups.

Workplace Violence Prevention Policies in Home Health and Hospice Care Agencies

Workplace violence in the home health industry is a growing concern, but little is known about the content of existing workplace violence prevention programs. The authors present the methods for this study that examined workplace violence prevention programs in a sample of 40 California home health and hospice agencies. Data was collected through surveys that were completed by the branch managers of participating facilities. Programs were scored in six different areas, including general workplace violence prevention components; management commitment and employee involvement; worksite analysis; hazard prevention and control; safety and health training; and recordkeeping and program evaluation. The results and discussion sections consider these six areas and the important gaps that were found in existing programs. For example, although most agencies offered workplace violence training, not every worker performing patient care was required to receive the training. Similarly, not all programs were written or reviewed and updated regularly. Few program differences were observed between agency characteristics, but nonetheless several striking gaps were found.

Workplace violence in healthcare settings: risk factors and protective strategies.

This article describes the risk factors and protective strategies associated with workplace violence perpetrated by patients and visitors against healthcare workers. Perpetrator risk factors for patients and visitors in healthcare settings include mental health disorders, drug or alcohol use, inability to deal with situational crises, possession of weapons, and being a victim of violence. Worker risk factors are gender, age, years of experience, hours worked, marital status, and previous workplace violence training. Setting and environmental risk factors for experiencing workplace violence include time of day and presence of security cameras. Protective strategies for combating the negative consequences of workplace violence include carrying a telephone, practicing self-defense, instructing perpetrators to stop being violent, self- and social support, and limiting interactions with potential or known perpetrators of violence. Workplace violence is a serious and growing problem that affects all healthcare professionals. Strategies are needed to prevent workplace violence and manage the negative consequences experienced by healthcare workers following violent events.

When Domestic Violence Turns into Workplace Violence: Organizational Impact and Response

The purpose of this article is to briefly examine the literature on domestic violence entering the workplace. The crossing over of domestic violence into the workplace can make it difficult for law enforcement agencies to address and prevent violence in general. When everyone is impacted in some way, the responsibility to improve safety and well-being is shared among all. The success of that effort will depend on the actions managers and employees within the workplace take in establishing and enforcing workplace-violence training, policies, and programs in coordination with law enforcement agencies. Operational definitions will be reviewed. Workplace implications will also be discussed. In possible upcoming supplements to this article, vignettes and implications for future research may be presented.