Patient and visitor aggression in healthcare: A survey exploring organisational safety culture and team efficacy

Heckemann, Birgit; Hahn, Sabine; Halfens, Ruud J.G.; Richter, Dirk; Schols, Jos M. G. A.

doi:10.1111/jonm.12772

Cited by 15 publications

(17 citation statements)

References 27 publications

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“…A possible explanation may be the lack of commonly agreed industry standards regarding the training of security staff, which means that some staff may lack adequate training in PVA prevention and management. Nurse managers’ reporting of lack of support is congruent with research that highlights inconsistencies in how measures against PVA are employed in the general hospital setting (Heckemann et al, ; Hegney et al, ). Overall, the lack of security measures reveals a lack of commitment at the organisational management level to create a culture of safety.…”

Section: Discussionsupporting

confidence: 54%

“…Nurse managers' reporting of lack of support is congruent with research that highlights inconsistencies in how measures against PVA are employed in the general hospital setting (Heckemann et al, 2019;Hegney et al, 2010). Overall, the lack of security measures reveals a lack of commitment at the organisational management level to create a culture of safety.…”

Section: Contextual Factorsmentioning

confidence: 66%

“…Despite this evidence, training in the general hospital setting appears to be unspecific, as some evidence shows that training is offered to individual members of staff, but not routinely to entire teams (Heckemann et al, 2019). Individual staff training has been shown to increase individual staff members' confidence and their ability to manage PVA, although this knowledge has not in general been transferred successfully into the professional and inter-professional team (Heckemann, Breimaier, Halfens, Schols, & Hahn, 2016;Heckemann et al, 2015).…”

Section: Management Of Clinical Aggression-rapid Emergency Departmentmentioning

confidence: 99%

“…Such cultures foster the underreporting of PVA (Hegney, Tuckett, Parker, & Eley, 2010;Lindy & Schaefer, 2010). Organisational policies and procedures may be available, but they lack implementation into clinical practice on the micro level, particularly in the general hospital setting (Heckemann, Hahn, Halfens, Richter, & Schols, 2019;Hegney et al, 2010). Yet, as Bowers (2014) emphasises, staff have considerable power to prevent and reduce PVA.…”

Section: Introductionmentioning

confidence: 99%

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Team efficacy and leadership in managing aggressive situations in the general hospital setting: A qualitative descriptive analysis of focus groups with ward managers

Heckemann

Siegrist-Dreier

Thilo

et al. 2020

Journal of Clinical Nursing

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Aims and objectives To explore the perception and issues regarding the ability of nursing teams to manage patient and visitor aggression in clinical practice, from ward managers’ perspectives. Background Patient and visitor aggression causes substantial human suffering and financial damage in healthcare organisations. Nurse managers are key persons for developing their teams’ efficacy in dealing with patient and visitor aggression. However, their perception of patient and visitor aggression in clinical practice has rarely been explored, and issues relating to team management in this context are underinvestigated. Design A secondary, qualitative thematic analysis of focus group interviews. Methods Five focus groups consisting of a total of 30 ward and deputy ward managers from five Swiss hospitals were interviewed with audio recording between December 2015–January 2016. Since the recordings were rich in additional content exceeding the primary research question, a secondary analysis was conducted to answer the questions: (1) Which factors influence team efficacy in regard to patient and visitor aggression? (2) What are the implications for nurse leadership? The Consolidated Criteria for Reporting Qualitative Research was followed in the conduct and reporting of this study. Results Three themes emerged from our analysis: (a) contextual factors (organisational safety culture and collaboration), (b) influences from within the team (team culture, nursing aggression and general management principles) and (c) implications for nurse leadership. Conclusions Managing patient and visitor aggression is a challenge for nurse managers. A team's ability to prevent, de‐escalate and debrief after PVA incidents is an important leadership task in which ward managers are neither supported in nor trained for within their organisations. Relevance to clinical practice Nurse managers in general hospitals require more support to enable their teams to cope effectively with patient and visitor aggression. Policy and guideline implementation need to be prioritised.

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Section: Discussionsupporting

confidence: 54%

Section: Contextual Factorsmentioning

confidence: 66%

Section: Management Of Clinical Aggression-rapid Emergency Departmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Team efficacy and leadership in managing aggressive situations in the general hospital setting: A qualitative descriptive analysis of focus groups with ward managers

Heckemann

Siegrist-Dreier

Thilo

et al. 2020

Journal of Clinical Nursing

Self Cite

View full text Add to dashboard Cite

show abstract

“…Managing patient and visitor aggression is also a challenge for nurse managers. In one study, perceived high team e cacy in dealing with patient and visitor aggression was shown to be predicted by physical environment, a shared positive organizational attitude and psychiatric setting [44]. The authors conclude that general hospitals could bene t from approaches in psychiatry focusing on staff e cacy in the management of patient and visitor aggression.…”

Section: Discussionmentioning

confidence: 98%

Health Care Workers’ Experiences of Workplace Incidents that Posed a Risk of Patient and Worker Injury: A Critical Incident Technique Analysis

Strid

Wåhlin

Ros

et al. 2020

Preprint

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Background Health care workers (HCWs) are at high risk of occupational injuries and approximately 10-15% of patients are affected by an adverse event during their hospital stay. There is scarce scientific literature about how HCWs manage these risks in practice and what support they need. This knowledge is needed to improve safety for patients and HCWs. This study explores HCWs’ experiences of workplace incidents that led to injury or posed a risk of patient and worker injury, with focus on HCWs’ actions and emotions.Methods This study employed a qualitative design using the critical incident technique. Semi-structured individual interviews were held with 34 HCWs from three regions in Sweden. Data were analysed using inductive category development. Results Altogether 71 workplace incidents were reported. The analysis of two dimensions – actions HCWs take and emotions they feel when a workplace incident occurs – yielded two main areas each: HCWs’ actions, actions by the team and managers, anxiety during the incident, and persistent distress after the incident. Health care workers risked their own safety and health to provide patient safety. Teamwork and trustful relationships were critical for patient and worker safety. Support and validation from colleagues and managers were important for closure; unsatisfactory manager response and insufficient opportunities to debrief the incident could lead to persistent negative emotions. Participants described insecurity and fear, sadness over being injured at work, and shame and self-regret when the patient or themselves were injured. When the workplace had not taken the expected action, they felt anger and resignation, often turning into long-term distress. Conclusions Work situations leading to injury or risk of patient and worker injury are emotionally distressing for HCWs. Team interplay may facilitate safe and dynamic practices and help HCWs overcome negative emotions. Organizational support is imperative for individual closure. For safety in health care, employers need to develop strategies for active management of risks, avoiding injuries and providing support after an injury.

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Exploring staff experiences: A case for redesigning the response to aggression and violence in the emergency department

Davids

Murphy

Moore

et al. 2021

International Emergency Nursing

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Patient and visitor aggression in healthcare: A survey exploring organisational safety culture and team efficacy

Cited by 15 publications

References 27 publications

Team efficacy and leadership in managing aggressive situations in the general hospital setting: A qualitative descriptive analysis of focus groups with ward managers

Team efficacy and leadership in managing aggressive situations in the general hospital setting: A qualitative descriptive analysis of focus groups with ward managers

Health Care Workers’ Experiences of Workplace Incidents that Posed a Risk of Patient and Worker Injury: A Critical Incident Technique Analysis

Exploring staff experiences: A case for redesigning the response to aggression and violence in the emergency department

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