Workplace violence in the emergency department: a systematic review and meta-analysis

Aljohani, Bandar; Burkholder, Justin D.; Tran, Quincy; Chen, C.; Beisenova, Kamilla; Pourmand, Ali

doi:10.1016/j.puhe.2021.02.009

Cited by 119 publications

(122 citation statements)

References 30 publications

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“…Different perpetrators were treated with different interventions through a range of strategies. Among various types of WPV, PVV is the most frequent form of violence [ 7 , 11 , 22 , 56 ]. In this study, intervention trial was focused on PVV.…”

Section: Methodsmentioning

confidence: 99%

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Effects of Integrated Workplace Violence Management Intervention on Occupational Coping Self-Efficacy, Goal Commitment, Attitudes, and Confidence in Emergency Department Nurses: A Cluster-Randomized Controlled Trial

Chang

Hsu

Ouyang

2022

IJERPH

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Patient and visitor violence (PVV), the most prevalent source of workplace violence, is largely ignored, underreported, and a persistent problem in emergency departments. It is associated with physical injuries, psychological distress, and occupational stress in nurses. A randomized controlled trial was conducted in Taiwan from January to December 2020. This study aimed to test the efficacy of an integrated Workplace Violence Prevention and Management Training Program on PVV in 75 emergency department (ED) nurses from a hospital. Cluster sampling was used because the policy of subdivision strategy was enforced during the COVID-19 pandemic. ED nurses received either the intervention or 1-hour in-service class. Data were collected from questionnaires. Data were analyzed mainly by the repeated measure analysis of variance and generalized estimating equations. The intervention had positive effects on developing stronger goal commitment, improving occupational coping self-efficacy, increasing confidence in ability to deal with violent situations, and modifying attitudes toward the causes and management of PVV in ED nurses (p < 0.05). The marginal R2 of the generalized estimating equation model for goal commitment, occupational coping self-efficacy, confidence, attitudes toward aggression in ED and aggressive behavior variables was high as 0.54 (p < 0.001), 0.45 (p < 0.001), 0.58 (p < 0.001), 0.29 (p < 0.05), and 0.72 (p < 0.001), respectively. These study models could effectively predict changes in the mean values. The benefit was driven by the effect of the intervention in ED nurses. Thus, the intervention, when applied in conjunction with routine in-service class, could exert synergistic improvements on outcomes measured in nurses.

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Section: Methodsmentioning

confidence: 99%

“…There is a large body of evidence indicating that nurses are particularly at risk from violence exposure [ 1 , 3 , 7 , 9 , 10 ]. In EDs, 77% of staff reported experience of WPV [ 11 ]. Currently, COVID-19 which exacerbates WPV brought unique challenges for ED health professionals.…”

Section: Introductionmentioning

confidence: 99%

Effects of Integrated Workplace Violence Management Intervention on Occupational Coping Self-Efficacy, Goal Commitment, Attitudes, and Confidence in Emergency Department Nurses: A Cluster-Randomized Controlled Trial

Chang

Hsu

Ouyang

2022

IJERPH

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“…The incidents of WPV in emergency departments (EDs) are increasing and have become one of the most significant and problematic issues [ 3 ]. The intrinsic work feature of EDs is different from other health care settings [ 4 ]. For example, WPV in EDs is most likely to occur as a result of unmanageable conflict that escalates and turns into an impulsive and unplanned physical or non-physical aggression.…”

Section: Introductionmentioning

confidence: 99%

“…The high prevalence of WPV among nurses is not a new phenomenon. Nurses are particularly at high risk from WPV including physical aggression, verbal abuse, threats, and harassment because of the nature of their work, frequent and longer contacts with patients or families, provision of direct care or insufficient staffing within their work environments [ 4 ]. A review of 136 articles has reported that prevalence of violence against nurses ranged from 24.7% to 88.9% [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Dilemmas and Repercussions of Workplace Violence against Emergency Nurses: A Qualitative Study

Hsu

Chou

Ouyang

2022

IJERPH

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Nurses received the highest rate of workplace violence due to their close interaction with clients and the nature of their work. There have been relatively few qualitative studies focus on nurses’ perceptions of and experiences with the antecedents, dilemma and repercussions of the patient and visitor violence (PVV), leaving a considerable evidence gap. The aim of this study was to explore nurses’ experience of PVV in emergency department, the impact of PVV on quality of care, and supports needed after exposure to such incidents. We conducted semi-structured interviews with a purposive and snowball sample of nurses, and analyzed the content of the interview transcripts. A total of 10 nurses were approached and agreed to participate. Those participants ranged in age from 24 to 41 years old, eight female and two male nurses, and the majority of them (80%) held a university Bachelor degree in nursing. The average time in nursing practice was 7.2 years. We conceptualized five analytical themes, which comprised: (1) multifaceted triggers and causes of PVV; (2) experiences following PVV; (3) tangled up in thoughts and struggle with the professional role; (4) self-reflexivity and adjustment; and, (5) needs of organizational efforts and support following PVV. This paper provides compelling reasons to look beyond solely evaluating the existence of workplace, and considering the perceived professional inefficacy, impacts of being threatened or assaulted in nurses. There are also urgent needs in provision of prevention and management of workplace training programs to ensure the high-quality nursing care.

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“…[4] Although 32% of violent deaths of healthcare workers investigated in the USA from 2003-2016 (n=62) were due to homicide and perpetrated by a patient, relative or someone close to the patient -there was a larger proportion of deaths due to self-harm. [5] Emergency department staff, first responders, nursing or care home workers and psychiatric unit staff [6,7] are more at risk of physical violence.…”

mentioning

confidence: 99%

Reducing Violence against Health Professionals

Chakravorty

2021

Sus

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There is a rising trend of violence against healthcare professionals across the world, especially after the COVID-19 pandemic. Many countries report between 43-75% of professionals experiencing at least one incident in any annual survey. The most recent incident of doctors and healthcare staff in a Manchester City General Practice raised alarms. As the healthcare infrastructure and services are severely stretched following the disruption of 2020, there are more reasons for disquiet and frustration from the public. The media and political portrayal of primary care physicians as not caring enough to provide face-to-face appointments in the UK is believed to increase the public angst. There are protests from professional organisations but this is not heard by the public. In any violence prevention strategy, a multi-system approach is critical. While tackling misinformation is essential, so is the tackling the root causes, the waiting lists and a balanced information to the public. Political and organisational leaders need to be visible and vocal in explaining why the healthcare infrastructure is beyond breaking point. This will justify the additional resources needed and reduce the frustrations of the public, in need of care. There is also a vital need to help new doctors and nurses as well as all frontline staff in violence dissipation techniques, self-preservation. The Voluntary community organisations including those that support professional groups have a vital role to play. The NHS People Plan has recommended that VSCEs should join robust and reliable partnerships with Integrated Care Organisations in developing strategies and interventions. There is more work to be done. This article is a call for action and invites all VSCEs interested in the reduction of violence against staff to join with employing organisations to set up collaborative working groups with specific actions to implement. This is essential to reduce harm and reduce the demoralisation of an already burnt-out healthcare workforce.

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Workplace violence in the emergency department: a systematic review and meta-analysis

Cited by 119 publications

References 30 publications

Effects of Integrated Workplace Violence Management Intervention on Occupational Coping Self-Efficacy, Goal Commitment, Attitudes, and Confidence in Emergency Department Nurses: A Cluster-Randomized Controlled Trial

Effects of Integrated Workplace Violence Management Intervention on Occupational Coping Self-Efficacy, Goal Commitment, Attitudes, and Confidence in Emergency Department Nurses: A Cluster-Randomized Controlled Trial

Dilemmas and Repercussions of Workplace Violence against Emergency Nurses: A Qualitative Study

Reducing Violence against Health Professionals

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