Organisational interventions for preventing and minimising aggression directed towards healthcare workers by patients and patient advocates

Spelten, Evelien; Thomas, Brodie; O’Meara, Peter; Maguire, Brian J.; Fitzgerald, Deirdre; Begg, Stephen

doi:10.1002/14651858.cd012662.pub2

Cited by 66 publications

(93 citation statements)

References 106 publications

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“…This view is similar to staff in hospital settings, who believe accountability and consequences for perpetrators of violence are a necessary component of violence prevention and social education (36). Some healthcare organisations have trialled non-punitive educational accountability interventions such as accountability letters and restorative justice processes (5,37). It appears there is an opportunity to develop interventions that may fill the gap in consequences for perpetrators and in turn potentially improve organisational follow-up, reporting and staff wellbeing.…”

Section: Accountabilitymentioning

confidence: 81%

“…Characteristically, they have no designated workplace and operate either alone or in pairs (3,8,9). These characteristics place paramedics at high risk of violence from patients and bystanders (5,9). In Australia, studies have reported between 65% and 88% of paramedics had experienced violence at work within a 12-month period (4,9,10) and serious violence related injuries requiring at least 1 week off of work have tripled in recent years from 10 to 30 per year (3).…”

Section: Introductionmentioning

confidence: 99%

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Barriers and Opportunities for Workplace Violence Interventions in Australian Paramedicine: A Qualitative Study

Thomas

O’Meara

Edvardsson

et al. 2020

Australasian Journal of Paramedicine

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Introduction Workplace violence directed at paramedics by patients and bystanders is a persistent and pervasive issue. There is little available evidence supporting the effectiveness of current interventions in the paramedicine context. No studies have reported on potential barriers and there is little evidence supporting opportunities for more effective interventions. The objective of this study was to make an inventory of current workplace interventions and explore the barriers and opportunities for these interventions as perceived by paramedics. Methods Ten paramedics were interviewed about their experiences and insights into workplace violence. The interview data underwent thematic and narrative analysis. Results Seven interventions were highlighted, 10 barriers and 12 opportunities for current and future workplace violence interventions were discussed. The majority of the barriers related to culture in society, attitudes of staff, and lack of capacity for the ambulance service to take action following violent events. The opportunities raised included co-design of interventions, culture change for paramedics and communities, accountability for paramedics and perpetrators of violence, increased ambulance service options following violent events, and improving feedback to staff. Conclusion The findings of this study suggest that interventions are likely to be more effective and sustainable if they are evidence-based, co-designed, address all levels of healthcare, and evaluated. Important areas for future research include a focus on consequences and accountability for perpetrators and strategies for ambulance services and paramedics to participate in public health approaches to reducing violence in communities.

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Section: Accountabilitymentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Barriers and Opportunities for Workplace Violence Interventions in Australian Paramedicine: A Qualitative Study

Thomas

O’Meara

Edvardsson

et al. 2020

Australasian Journal of Paramedicine

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“…Certainly, in agreement with Spelten and colleagues, as recently highlighted in their excellent systematic review on the effectiveness of interventions to prevent and minimise the aggression directed towards healthcare workers by patients and patient advocates, it is necessary to improve the evidence base. 11 We need further research, which include workers as participants and which collect information on the impact of violence. We are confident that emergency and security personnel will take up this challenge.…”

Section: …To Achieve Effective Resultsmentioning

confidence: 99%

“…However, we are absolutely convinced that sharing education and training is fundamental for increasing mutual knowledge and developing synergistic strategies to manage violence in the ED, because to date there is no evidence of the effectiveness of organisational interventions that aim to prevent and minimise attacks on the workplace against healthcare professionals. 11 From the results presented by Wand and colleagues, this need also seems to be felt by Australian security personnel. Certainly, it could be objected that combining the results and perspectives of two contexts 'literally' at the antipodes (Italy and Australia) is not scientifically correct given the cultural, regulatory, organisational and health differences of the two countries.…”

Section: Working Together…mentioning

confidence: 98%

Workplace violence in emergency departments: The health professionals and security personnel alliance

Ramacciati

Giusti

2020

Emerg Medicine Australasia

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Violence in the health sector is a widespread worldwide phenomenon. Emergency nurses and emergency physicians are among the most exposed. In violent incidents, security personnel also play an important role. Wand and colleagues on Emergency Medicine Australasia have tried to give voice to the opinions and experiences of security personnel in responding to aggression and behavioural problems. Sharing some data from our 2016 Italian National Survey on Violence towards Emergency Nurses, further elements are provided on this issue. The different perspectives of healthcare professionals and security personnel can converge in an alliance to counteract violence in the ED.

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“…Despite the increased awareness and efforts to reduce violence in clinical care among healthcare workers (McDermott and Holoyda, 2014;Spelten et al 2020) and policy-makers (Ministerie van Volksgezondheid, Welzijn en Sport, Minsterie van Binnenlandse Zaken en Koninkrijksrelaties, & Ministerie van Veiligheid en Justitie, 2012), aggression incidents remain prevalent in psychiatric inpatient facilities (Bowers et al 2011). Aggression is expressed either verbally or physically or both, and can be directed at objects, patients themselves, other patients, and staff members.…”

Section: Introductionmentioning

confidence: 99%

The incidence and economic impact of aggression in closed long-stay psychiatric wards

Bles

Hazewinkel

Bogers

et al. 2020

International Journal of Psychiatry in Clinical Practice

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Objective: Aggressive behaviour is highly prevalent in long-term psychiatric inpatient care. We aimed to estimate the overall incidence of aggression, the time staff took to handle aggression incidents, and the weighted average financial costs thereof. Methods: A random sampling procedure was conducted at long-term psychiatric inpatient care facilities. Nurses were asked to recall all incidents (i.e., verbal, physical towards objects, self, or others) of their shift. For the time spent on each type of incident, staff were monitored in real-time. Estimated costs were calculated by the time spent multiplied by hourly wages in addition to material-related costs. Results: Incidence rates were 90 incidents per patient year. The average time spent per incident was 125 min but differed for each type of incident. Almost 80% of this time was consumed by nursing staff. The average cost per aggression incident was e78; extrapolated per patient year, the total costs were approximately e7000. Conclusions: The current study found a high rate of aggression incidents in closed long-stay psychiatric wards. Reports of aggression on these types of wards are scarce. Nevertheless, aggression seems to have a severe impact on invested time and related costs, which suggests a need for aggression-prevention and de-escalating programs. KEY POINTS Aggression incidents are highly prevalent and are accompanied by high costs. The effect of aggression incidents on the workload for staff members is high, especially for nursing staff. Studies across countries on the incidence and the costs of aggression among psychiatric inpatients are needed to help model the effects of (new) strategies for aggression reduction.

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Organisational interventions for preventing and minimising aggression directed towards healthcare workers by patients and patient advocates

Cited by 66 publications

References 106 publications

Barriers and Opportunities for Workplace Violence Interventions in Australian Paramedicine: A Qualitative Study

Barriers and Opportunities for Workplace Violence Interventions in Australian Paramedicine: A Qualitative Study

Workplace violence in emergency departments: The health professionals and security personnel alliance

The incidence and economic impact of aggression in closed long-stay psychiatric wards

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