Interventions for Workplace Violence Prevention in Emergency Departments: A Systematic Review

Abstract

Emergency departments (EDs) are high-risk settings for workplace violence, but interventions to prevent violent incidents and to prepare staff are not yet consistently implemented, and their effectiveness is often unclear. This study aims to summarise evidence on workplace violence prevention interventions that were implemented in EDs to reduce violent incidents caused by patients/relatives or to increase the knowledge, skills or feelings of safety of ED staff. A systematic review was conducted. The databases MEDLINE, Web of Science, Cochrane Library, CINAHL and PsycINFO were searched for studies dated between January 2010 and May 2021. Interventional and observational studies reporting on behavioural, organisational or environmental interventions among healthcare workers in hospital EDs were included. Studies were assessed for methodological quality using the Johanna Briggs Institute Tools. Key findings of studies were summarised narratively. Fifteen studies were included, of which eleven examined behavioural interventions (classroom, online or hybrid training programmes) on de-escalation skills, violent person management or self-defence techniques. Four studies included in addition, organisational and environmental interventions. Most studies showed that interventions had a positive effect in the form of a reduction of violent incidents or an improvement in how prepared staff were to deal with violent situations; however, evidence is still sparse. Further studies should consider in particular, environmental and organisational interventions and ensure a high methodological quality.

Prevalence and Risk Factors of Workplace Violence Against Emergency Department Nurses in China

“…Furthermore, Chinese ED nurses still fail to take actions to protect themselves even after WPV, and the most important one is to submit a violence report. According to previous studies, submitting violence reports is of great importance in improving organizational management and obtaining psychological support, which will benefit all staff in the emergency departments [ 19 , 46 ]. In addition, the top three reasons for WPV were unmet patients’ need, long waiting times, and alcohol/drug abuse.…”

“…Large-scale studies about HCWs have already been established [ 13 , 14 ], and prospective studies [ 15 , 16 ] and longitudinal studies [ 17 , 18 ] as well. However, only small-scale cross-sectional studies, sample size was less than 500, about ED nurses were done in China and abroad [ 5 , 19 ]. Therefore, a large-scale and thorough research on WPV and its predictors among Chinese ED nurses is a necessity.…”

Effectiveness of the interventions against workplace violence suffered by health and support professionals: A meta-analysis

“…A systematic review without meta-analysis carried out with 15 studies revealed that most of them exerted a positive effect on preparing the team to deal with violent situations or on reducing the number of violent incidents, although the evidence is still scarce (59) .…”

Prevalence of Violence Perpetrated by Healthcare Workers in Long-Term Care: A Systematic Review and Meta-Analysis

“…Nevertheless, the use of multiple approaches such as education and support services seemed to be effective, as a mixed approach showed significant effects [43]. Thus, interventions using mixed approaches may be more effective, especially if combined with the use of technology (e.g., wearables, monitoring systems) that could track episodes of violence while maintaining the privacy of patients and HCWs [44]. Globally, individuals are increasingly vulnerable and at risk of violence [29], with significant economic and social consequences.…”