A Literature Review: Violence and Aggression in Neuroscience Nursing

Abstract

BACKGROUND: Violence and aggression is commonly encountered in nursing worldwide and is an increasing concern, although it is largely underreported by staff. Violence and aggression can take many forms, from verbal and physical abuse to sexual assault. This study aims to define agitation, violence, and aggression and to explore the prevalence of violence and aggression among neuroscience patients. This review also examines why violence and aggression occurs for neuroscience patients and to determine the effects on the patients, the environment, and the nursing staff. METHODS: A review of articles was conducted using CINAHL, PubMed, the Cochrane Database, and Google Scholar between 2012 and 2022. DISCUSSION: Agitation can escalate to violence and aggression. The reasons a neuroscience patient may become agitated are multifactorial. An injury to the brain may not cause agitation; however, the effect on the frontal lobe, hypothalamus, and hippocampus may cause a lack of self-control, impulsivity, an inability to control emotions, and an uncontrolled release of hormones, leading to a heightened sympathetic response. The effects of violence and aggression can be detrimental to the patient and include isolation, increased sedation, reduced observations, and even death. The effects on the nurse are profound including a decline in productivity at work, an increased risk of drug errors, and posttraumatic stress disorder or burnout as longer-term consequences. CONCLUSION: Violence and aggression is commonly experienced within neuroscience nursing, and the contributing factors are multifactorial. The effects for the patients and staff can be profound, and this is why prevention of agitation is fundamental to ensure the safety and retention of nursing staff.

Awareness of standard precautions, circumstances of occurrence and management of occupational exposures to body fluids among healthcare workers in a regional level referral hospital (Bertoua, Cameroon)

“…Both HCW and patient related factors were associated with AEB. Our study retrieved some patient factors like agitation during care, jerky movement during blood sampling, administration of injections… All interventions focusing on the use of non-threatening body language, positive tone of voice, gestures and facial expressions reduce patient’s agitation and jerky movements and could decrease AEB occurrence [ 23 ].…”

Circumstances of Occurrence and Post-Exposure Management of Body Fluids related Injuries Among Healthcare Workers in a Regional Level Referral Hospital (Bertoua, Cameroon)

“…Both health workers and patient related factors were associated with AEB. Patient factors were related to agitation during care, jerky movement during blood sampling, administration of injections, … To prevent patient agitation and jerky movement in health care milieu, it is suggested to care giver to focus on nonthreatening body language, tone of voice, gestures and facial expressions demonstrating control of own emotions [21].…”

“…Knowledge and Practices Related to Infection ControlHCW were and consider HIV transmission as a priority intervention in the healthcare environment. Such focus is valid for other HIV high risk foci including Sub-Saharan Africa[20][21][22].The fact that more than half of HCWs had not attended any training on occupational exposure to body uids is a major preoccupation and indicates the need for ongoing sensitization of HCW and their clientson the need to implement Infection Prevention and Control activities in healthcare settings. While focusing on HCW, such interventions should target visitors, patients and their caregivers.…”