Workplace Violence Research Articles

A workplace violence prevention program targeting high-risk patients in emergency departments.

Patient violence in emergency departments (EDs) may be prevented with proactive mitigation measures targeting potentially violent patients. We aimed to evaluate the effects of two interventions guided by a validated risk-assessment tool. A prospective interventional study was conducted among patients ≥10 years who visited two EDs in Michigan, USA, from October 2022 to August 2023. During triage, the ED nurses completed the Aggressive Behavior Risk Assessment Tool for EDs (ABRAT-ED) to identify high-risk patients. Following the baseline observational period, interventions were implemented stepwise for the high-risk patients: phase 1 period with signage posting and phase 2 period with a proactive Behavioral Emergency Response Team (BERT) huddle added to the signage posting. Before ED disposition, any violent events and their severities were documented. The data were retrieved retrospectively after the study was completed. Of 77,424 evaluable patients, 546 had ≥1 violent event. The violent event rates were 0.93%, 0.68%, and 0.62% for baseline, phase 1, and phase 2, respectively. The relative risk of violent events for phase 1 compared to the baseline was 0.73 (95% confidence interval [CI]: 0.59‒0.90; p=0.003). The relative risk for phase 2 compared to phase 1 was 0.92 (95% CI: 0.76‒1.12; p=0.418). The use of signage posting as a persistent visual cue for high-risk patients identified by ABRAT-ED appears to be effective in reducing the overall violent event rates. However, adding proactive BERT huddle to signage posting showed no significant reduction in the violent event rates compared to signage posting alone.

Guardians of Care: Decoding Workplace Violence Through Qualitative Insights

Guardians of Care: Decoding Workplace Violence Through Qualitative Insights

Workplace Violence Pervasiveness in the Perioperative Environment: A Multiprofessional Survey

Workplace Violence Pervasiveness in the Perioperative Environment: A Multiprofessional Survey

EDITORIAL COMMENT ON “CHARACTERISTICS AND RISK ACTORS OF WORKPLACE VIOLENCE: EXPERIENCES OF UROLOGISTS WORKING IN TURKEY”

EDITORIAL COMMENT ON “CHARACTERISTICS AND RISK ACTORS OF WORKPLACE VIOLENCE: EXPERIENCES OF UROLOGISTS WORKING IN TURKEY”

Reply to Editorial Comment on "Characteristics and risk factors of workplace violence: Experiences of urologists working in Turkey"

Reply to Editorial Comment on "Characteristics and risk factors of workplace violence: Experiences of urologists working in Turkey"

Effectiveness of interventions for the prevention or management of workplace violence in student nurses during clinical placement: A systematic review.

To systematically investigate the effectiveness of interventions for managing workplace violence experienced by registered nursing students during clinical placement. A systematic review of experimental studies. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The key search concepts such as "Nursing students", "Education", "workplace violence", "clinical placement" and "clinical study" were inspected to identify relevant articles (Appendix A). Two independent reviewers completed screening, critical appraisal and data extraction. Due to heterogeneity among the included studies, results were synthesized narratively. MEDLINE (Ovid), CINAHL (EBSCOhost), Web of Science Core Collection (Clarivate Analytics), Scopus (Elsevier), Embase (Ovid), Cochrane CENTRAL, ERIC (ProQuest), ProQuest Central and ProQuest Social Science Premium Collection were searched from inception to 27th February 2023. A total of 13 studies were included in this review. The predominant intervention for managing workplace violence experienced by registered nursing students during clinical placements was education. Approaches varied among studies and included didactic teaching, e-learning, role-playing and simulation practice. The included studies showed uncertain improvements in registered nursing students' confidence, coping skills, knowledge, competence and self-efficacy in dealing with workplace violence during clinical placements. Only one study assessed the incidence rate of workplace violence and found that a multi-faceted intervention involving both staff and students decreased the incidence. Given the heterogeneity of educational interventions, the effect of interventions for managing workplace violence during students' clinical placement is uncertain. To address this gap, high-quality, proactive and combined interventions at both institutional and organizational levels are needed.

Unmasking the silent epidemic: Prevalence of workplace violence against healthcare workers in wad Madani hospital, Gezira, Sudan (2023)

Unmasking the silent epidemic: Prevalence of workplace violence against healthcare workers in wad Madani hospital, Gezira, Sudan (2023)

The prevalence of physical and verbal violence among emergency medicine physicians in military hospitals vs non-military hospitals, Jeddah, Saudi Arabia: multi-center cross-sectional study

IntroductionIn healthcare settings, physical and verbal attacks are commonly encountered in the workplace among healthcare providers. Patients and patients’ relatives and friends have been reported to be the perpetrators of workplace violence. Among all healthcare settings, emergency department (ED) have been designated as high-risk settings for violence, where more than one-quarter of emergency physicians reported that they were victims of physical assault. This study aimed to report the prevalence of workplace violence against emergency medicine physicians in military and non-military hospitals in Jeddah city.MethodologyA cross-sectional design has been used in this study. An electronic questionnaire was developed through the Google Form Platform and it included demographic data, the occurrence of verbal or physical violence in the workplace to participants, how many times they experienced this violence, the time of incidents, the location either inside or outside the hospital, whether the perpetrators were mostly patients, patient families, or friends, and whether they reported any violence or not. Categorical variables were used to describe frequencies and percentages, while descriptive statistics such as mean and 95% Confidence Interval (95% CI) were used to summarize the scale variables. P < 0.05 was considered for statistically significant differences.ResultsAmong the 100 participants, 76 experienced either physical or verbal violence, or both. The remaining 24 did not experience any sort of violence. 83% of the physicians who have been physically violated were working in non-military hospitals. Of the 72 participants who had experienced verbal violence, 51 (70.8%) were working in a non-military hospital, while 21 (29.2%) were in a military hospital. The most common reason for not reporting was that the participants felt that reporting the violence incidence was useless. Moreover, 92% of participants chose “Train healthcare workers to deal with violent attacks” as a suggested helpful factor in decreasing the number of work-related violence. In addition, “Education of the public” and “Raising awareness of healthcare workers” were chosen as helpful factors as well by 91% and 90% of participants, respectively.ConclusionThis revealed that physicians in non-military hospitals experience higher levels of violence compared to their military counterparts. However, it is concerning that instances of violence are substantially under-reported across both military and non-military healthcare facilities.

Impact of Workplace Violence Against Emergency Medical Services (EMS)

Objectives The objectives of this study were to: (1) understand the personal impact of workplace violence (WPV) on staff within a large multistate emergency medical services (EMS) agency, (2) describe the impact of WPV on subsequent patient interactions, examining how experiences of violence affect the quality of care provided by EMS clinicians, (3) examine the influence of WPV on perceived workplace safety among prehospital personnel and its correlation with retention in the EMS field, and (4) solicit recommendations from staff for the prevention and mitigation of WPV in the future. Methods We conducted virtual focus groups and individual interviews with 22 prehospital personnel using a descriptive qualitative design within a large multistate Midwest EMS agency between 4/5/2023-6/20/2023. Data were analyzed using Thematic Analysis to identify common perceptions among and across participants. Results Major themes of personal impact; impact on patient interactions; influence of WPV on career longevity/sustainability; and relationship between EMS culture and WPV were identified. Overall, participants shared the perception that WPV is “part of the job”, and that verbal abuse was so common that they hadn’t previously considered it as violence. Participants provided several examples of WPV and described how these experiences impacted them personally (e.g., hypervigilance) and impacted their subsequent interaction with patients (e.g., quicker to use restraints, loss of empathy). Participants shared the perception that EMS is no longer valued or respected by patients or communities. Several voiced concerns for the next generation of colleagues and nearly all participants reported the need for education and training in situational awareness, de-escalation, and self-defense tactics. Participants referenced desire for more coordination and communication with law enforcement, change in culture of abuse from patients without repercussions, and improved agency mental health support and peer support/mentoring following a violent event. Despite experiences with WPV, the majority reported plans to remain in EMS. Conclusions Emergency Medical Services personnel are commonly traumatized by violence in their work and nonphysical violence is underappreciated. Despite its impact on staff and subsequent patient interactions, most participants reported plans to remain within EMS. Multi-faceted system-focused efforts are needed to shift toward and support a zero-tolerance culture for WPV.

Implementation of Coaching to Address Burnout in Emergency Clinicians

BackgroundFactors including sleep disturbances, shift work, secondary traumatization, and workplace violence make emergency nurses uniquely susceptible to burnout. A recent study cited nearly half of emergency registered nurses (49.3%) experienced moderate to severe burnout. There is an urgent need for evidence-based solutions to address burnout and turnover in emergency nurses. The objective of this quality improvement project was to determine the effectiveness of a wellness coaching program for reducing burnout and turnover in emergency nurses and advanced practice providers. MethodsBaseline assessments of burnout and turnover intention were measured at the beginning of the coaching program and measured again upon completion of the coaching program. InterventionEight registered nurses and 2 advanced practice providers from an emergency department in a west coast community hospital completed 6 to 8 weeks of wellness coaching led by a board-certified nurse coach. The wellness coaching program was an evidence-based, modular curriculum in which participants chose the number and length of sessions. ResultsAn average of 6 hours of individualized, 1-on-1 wellness coaching was completed over 7.5 weeks. The project resulted in a large reduction in emotional exhaustion and turnover intention, no effect on depersonalization, and a small reduction in lack of personal achievement (Cohen’s d = 0.79, 1.53, −0.18, and −0.35). Ninety percent of clinicians agreed or strongly agreed that coaching helped improve their burnout and said they would consider it again in the future. ConclusionThis quality improvement project demonstrates wellness coaching was an evidence-based solution for improving burnout and turnover in emergency nurses. More investigation is needed to determine duration of reduction of these outcomes.

The prevalence and consequences of workplace violence among psychiatrists in Saudi Arabia: a cross-sectional study

Background and objectiveThere has been increasing concern globally about the rise in workplace violence (WPV), which is considered a persistent problem generally overlooked by the public and professional organizations. WPV is a significant challenge faced by psychiatrists internationally, yet little is known about WPV among psychiatrists in Saudi Arabia. This study aims to estimate the prevalence of WPV against psychiatrists in Saudi Arabia and identify the types and sources of violence experienced as well as the associated risk factors that contribute to WPV.ResultsAmong 239 psychiatrists, the prevalence of WPV in Saudi Arabia was 56.3%. The prevalence was particularly high among those working in the central region (55.4%) and in Ministry of Health hospitals, Violent behavior was exhibited mostly by patients 133 (99.3%), and the most common type of violence was verbal abuse 75 (56.0%). Respondents reported that patients’ health conditions, denial of admission to the hospital, and staff shortages were the most common triggers for violence. More than two-thirds of the psychiatrists (74.6%) did not require medical intervention after incidents of violence. The majority of psychiatrists felt either stressed (39%) or angry (22.0%) after such incidents. Reasons for not reporting violent events included feeling that violence is part of the job (76.9%) and being unaware of the violence reporting system (50.8%).ConclusionThis study underscores the significant prevalence of WPV among Saudi Arabian psychiatrists, especially in the central region and in Ministry of Health hospitals, notably in emergency rooms. Perpetrators are primarily psychiatric patients and their relatives. The issue is compounded by staffing shortages. WPV poses physical risks and causes psychological stress, negatively impacting productivity. Underreporting persists due to a lack of awareness or violence being perceived as part of the job. Addressing these challenges through raising awareness, providing support mechanisms, and enforcing regulations is essential to bolster workplace safety and patient care for psychiatrists.

Social Workers’ Experiences of Violence: A Critical Literature Review

Violence against social workers is an international issue, yet research worldwide is limited. Social work is a predominantly female profession making violence against social workers an issue of gender-based violence (GBV). Using a post-feminist lens, this paper examines the violence experienced by social workers in the workplace and its impacts on their personal and professional lives. More specifically, the objectives of this study were to 1) critically understand social workers’ experiences of violence in the workplace violence; 2) critically review peer-reviewed and grey literature to examine how intersectionality intersect to escalate the vulnerability of social workers to different forms of GBV; and 3) identify significant gaps and priorities for future policies, practices and research on GBV in the social worker profession. Twenty-four peer-reviewed and grey literature were selected for the study. Three themes emerged through this critical review 1) definition of violence; 2) rates of violence; 3) reporting violence; and 4) impacts of violence. The paucity of research in this area highlights the need for increased research in experiences of violence within the social work workplace, as well as how social work education prepares social work students for the potential of violence within the field of social work.

Timings, Reporting Procedures About Violence Incident and Encouragement to Report WPV Among Health Care Workers

Objective: To evaluate and gain insight about timings, reporting procedures and encouragement to report workplace violence events among HCW’s of Multan Methodology: Using a World Health Organization (WHO) tool, a cross-sectional study was carried out at emergency department of hospital in Multan from June to August 2019. Quantitative data on various aspects of the workplace violence (WPV) amongst 164-universally-sampled healthcare workers was collected. Results: There were 167 healthcare workers; 97 of them were men and 67 were women. 98 (60%) reported violence at some point in their employment. Almost half of the participants (44.5%) most frequently worked with children &lt; 10 years, whereas 13.4% treat elder patients. Talking about worriedness about violence in current workplace, 22.6% subjects were very worried in comparison to 56% little bit worried. One third subjects in this study reported that physical violence incident happened during the morning shift and 1st day of week. All HCW’s said that there are procedures for reporting of violence at their workplace, they know how to use them &amp; there is an encouragement to report WPV as well. 92.7% &amp; 2.4% partakers said that encouragement was from colleague &amp; management / employer respectively Conclusion: Mostly, violence was reported at 1st working day of the week and there were reporting procedures and an encouragement to report those events as well. Local, state, and federal initiatives are required to modify policies in future to address workplace violence in the healthcare sector.

Interaction, Management and Response of Healthcare Workers Towards Workplace Violence Events

Objective: To evaluate the interaction, management and response towards WPV events by HCW’s of emergency department Methodology: We conducted this cross-sectional study using World Health Organization’s tool to collect quantitative data on workplace violence (WPV) amongst universally sampled 164 health professionals working in an emergency department at Nishtar hospital Multan from June-August 2019 after taking an inform consent. All physically present health professionals who have been working there including paramedics, doctors, &amp; nurses, were part of research. Results: Out of 164 healthcare employees, males were ninety-seven while females were sixty-seven. All the subjects said that they work in shifts, anytime between 18h00 (6 PM) and 07h00 (7 AM), and interact with patients/clients during work as well. Only 11% reported that they have routinely direct physical contact (washing, turning, lifting) with patients/clients. When talking about response to the incident, approximately one-third of the participants sought help from association, almost half of the HCW’s reported to their senior staff, 13.5% subject sought help from union, merely 3.5% HCW told the person to stop whereas, 4.5% told family/friends Conclusion: Health professionals working in shifts, and also interacting with patients/clients faced violence and mostly reported to their senior staff, or sought help from their association.

Suicidal ideation among non-physician hospital system staff: Prevalence and workplace correlates

BackgroundResearch suggests that healthcare workers are at greater risk for suicide than other occupations, but most published studies focus on physicians. This study examines the prevalence of suicidal ideation (SI) and associated occupational factors among a broad group of non-physician healthcare staff. MethodsAn anonymous online survey was sent to a random sample of 30 % of non-physician healthcare staff at a large urban healthcare system between September and November 2022. Weighted multivariable binary logistic regressions were conducted to determine the workplace and mental health factors associated with SI. ResultsThe 1084 respondents included nurses, administrative staff, research staff, medical assistants, nurse practitioners, physician assistants, and other roles. Of the sample, 8.8 % endorsed having SI over the prior two weeks. Results of the regression indicated that, after adjusting for demographic factors, greater odds of SI were associated with physical violence experienced from a patient or visitor (odds ratio [OR] = 2.15, 95 % confidence interval [CI] = 1.06–4.37), lower perceived leadership support (OR = 0.95, 95 % CI = 0.92–0.98), and positive screening for depression (OR = 4.66, 95 % CI = 2.45–8.86). Exploratory analysis suggests that depression may be a mediating factor between workplace stressors and SI. LimitationsLimitations include the response rate, the use of a single item to assess SI, and the cross-sectional design. ConclusionFindings suggest that workplace violence and leadership support are important occupational factors associated with SI among healthcare workers. Reducing and mitigating workplace violence, enhancing leadership support, and improving access to mental health care should be considered targets for interventions to decrease suicide risk in this population.

The role of interpersonal conflict as a cause of work-related stress in construction managers in Ireland

Purpose The purpose of this study is to provide evidence to support an emerging theory that interpersonal conflict is the primary cause of workplace stress among a self-selected sample of Irish construction managers. Design/methodology/approach Eighteen construction managers working in Ireland were recruited for this study. Using semi-structured interviews and interpretative phenomenological analysis as the research methodology, the causes of their workplace stress were investigated. Findings Participants reported that the principal cause of their workplace stress was high levels of interpersonal conflict between colleagues. The effects of this interpersonal conflict included avoidance behaviour, ill health, absences from the workplace and loss of productivity issues. Deadlines, penalty clauses, lack of appreciation, cliques, costs, communication, temporary contracts and delays were also reported stressors. Research limitations/implications A limitation of the study is the small sample of 18 construction managers and the limited geographical area. Social implications The social implications of this study could be to clearly identify that interpersonal conflict may be under reported in the construction industry, and there is a possibility that it is being misclassified as other workplace behaviours such as bullying, harassment and workplace violence. If this is so, this could aid future researchers in addressing this challenging workplace behaviour. Originality/value The current consensus in the literature is that the three main causes of workplace stress are bullying, harassment and violence. However, the role and importance of interpersonal conflict as reported in this study, with the exception of North America and China, is not reflected in the wider health and safety research literature. In addition, interpersonal conflict and its reluctance to be reported is largely absent from construction safety research. The findings of this study may be explained if the workplace stress research community is currently misclassifying interpersonal conflict as a manifestation of bullying, harassment or violence. If this is the case, interpersonal conflict needs further research. This is to establish if this cause of construction-related workplace stress needs to be reconsidered as a standalone phenomenon in the wider family of challenging workplace behaviours.

Practical Considerations of Workplace Wellbeing Management under Post-Pandemic Work-from-Home Conditions.

As a natural experiment or "stress test" on the rapidly shifting work environment from office to home during and after the COVID-19 pandemic, staff wellbeing has been considered as the most critical issue in organizational change management. Following an overview of the relevant literature and recent official statistics, this essay aims to (i) address the major considerations and challenges in light of the transformation and re-design of the mode of work in the new normal and (ii) inform practical decisions for overall staff wellbeing under post-pandemic work-from-home (WFH) conditions with recommendations. For the sake of both staff healthiness and safety, as well as organizational competitiveness, senior management should take reasonable steps to enhance occupational safety in their WFH policy in line with practical recommendations on five areas, namely, (i) ergonomics, (ii) stress and anxiety management, (iii) workplace boundaries, (iv) work-family conflicts, and (v) other factors regarding a negative work atmosphere (e.g., loneliness attack, burnout, and workplace violence) particularly on virtual platforms. With the suggested evidence-based practices on WFH initiatives, senior management could make a difference in optimizing the overall workplace wellbeing of staff after the pandemic.

Framework for managing inappropriate behavior in clinical dental learning environments.

Workplace violence (WPV), such as physical violence, harassment, intimidation, or other threatening behavior, commonly occurs within healthcare settings including dentistry. The objective of this study was to analyze the behavioral and environmental factors contributing to WPV, determine its prevalence within one dental institution, and develop a WPV prevention and management protocol that is dental specific. To identify factors that impact WPV occurrence, the PRECEDE-PROCEED planning model was employed. A pilot cross-sectional survey was then conducted among faculty, staff, and dental learners (students/residents) to evaluate the prevalence of WPV incidents experienced and witnessed over the past year. The survey also assessed the locations where incidents took place, their type, and the strategies employed to manage them. A comprehensive protocol aimed at preventing and managing WPV in dental settings was subsequently developed. Multiple factors influence the occurrence of WPV. The prevalence of experienced and witnessed WPV incidents was 22% and 24% among faculty/staff and 7% and 5% among learners, respectively. Verbal aggression was the most common type of WPV. Most respondents lacked awareness of the available reporting mechanisms for WPV. A WPV prevention and management protocol was developed, consisting of five steps: intervene, report, document, access support services, and resolve (IRDAR). Administrators must have a comprehensive understanding of the prevalence of violence in their workplace and the underlying factors that contribute to it in order to take appropriate action. IRDAR is a clearly defined and easily implemented protocol designed for preventing and managing WPV in dental learning environments.

The paradox of workplace violence in the intensive care unit: a focus group study

BackgroundConflicts with patients and relatives occur frequently in intensive care units (ICUs), driven by factors that are intensified by critical illness and its treatments. A majority of ICU healthcare professionals have experienced verbal and/or physical violence. There is a need to understand how healthcare professionals in ICUs experience and manage this workplace violence.MethodsA qualitative descriptive analysis of four hospitals in Sweden was conducted using semi-structured focus-group interviews with ICU healthcare professionals.ResultsA total of 34 participants (14 nurses, 6 physicians and 14 other staff) were interviewed across the four hospitals. The overarching theme: “The paradox of violence in healthcare” illustrated a normalisation of violence in ICU care and indicated a complex association between healthcare professionals regarding violence as an integral aspect of caregiving, while simultaneously identifying themselves as victims of this violence. The healthcare professionals described being poorly prepared and lacking appropriate tools to manage violent situations. The management of violence was therefore mostly based on self-taught skills.ConclusionsThis study contributes to understanding the normalisation of violence in ICU care and gives a possible explanation for its origins. The paradox involves a multifaceted approach that acknowledges and confronts the structural and cultural dimensions of violence in healthcare. Such an approach will lay the foundations for a more sustainable healthcare system.

Adverse childhood experiences of Korean mothers with young children: a latent class analysis

ABSTRACT Background: Adverse childhood experiences (ACEs) have negative impacts on women with children, including psychosocial and general health problems. However, there is limited research investigating ACEs identifying the characteristics of distinct subgroups according to the frequency of ACEs. Objective: Utilizing the national dataset of the Family with Children Life Experience 2017, this study aimed to classify patterns of ACEs based on the total number of types of ACEs and the types of predominant events, and to examine differences in general and psychological characteristics, as well as experiences of violence in adulthood among the classes identified. Method: A total of 460 Korean mothers raising infants or toddlers participated. Latent class analysis was performed to classify the patterns of ACEs, while t-tests and Chi-square tests were used to examine differences in general and psychological characteristics and experiences of violence between the ACEs subgroups. Results: The participants were classified into two subgroups: the ‘high-ACEs group’ and the ‘low-ACEs group’. The high-ACEs group exhibited higher rates of child abuse, workplace violence perpetration and victimization, as well as lower self-esteem, higher depression levels, and increased suicidal thoughts compared to those of the low-ACEs group. Conclusion: The findings highlight the significant role of ACEs on the formation of an individual’s psychological characteristics and their propensity to experience additional violence even into adulthood, as perpetrators and as victims. It is noteworthy how the influence of ACEs extends across generations through child abuse. These findings offer insights for developing interventions aimed at mitigating the negative effects of experiences of violence on mothers raising young children.