护士工作场所暴力的现状调查与分析

目的:调查护士工作场所暴力水平并分析原因,为今后干预护士工作场所暴力提供依据。方法:采用医院工作场所暴力调查量表对广州市5家三级甲等医院的护士进行调查。结果:60.8%的护士在过去一年中遭受过工作场所暴力,其中,辱骂、威胁、语言性骚扰、躯体攻击(无损伤)、躯体攻击(轻度损伤)、躯体攻击(明显损伤)、性袭击的发生率分别是57%、39%、13.1%、8.8%、3.7%、1%、2.5%。80.2%的急诊科护士在过去一年中遭受过工作场所暴力,45%在过去一年中遭受过工作场所暴力。结论:护士遭受高水平工作场所暴力,暴力的形式主要是非身体暴力,急诊科护士较非急诊科护士遭受更多工作场所暴力。     

Workplace Violence and Bullying Faced by Health Care Personnel at the Emergency Department of a Tertiary Care Hospital of Karachi,Pakistan: A Cross-Sectional Study

IntroductionThe emergency department is the most affected by physical and verbal abuse and bullying in health care. Violence against health care workers not only affects their safety, but also their performance and motivation. This study aimed to determine the prevalence and associated determinants of violence against health care personnel.MethodsA cross-sectional study design was used with 182 health care personnel at the emergency department tertiary care hospital of Karachi, Pakistan. Data were collected through a questionnaire comprised of 2 sections: (1) demographic questions and (2) statements to identify the prevalence of workplace violence and bullying among health care personnel. Nonprobability purposive sampling was used for recruitment. Binary logistic regression was used to identify the prevalence and determinants of violence and bullying.ResultsMost participants were younger than 40 years of age (n = 106, 58.2%). Participants were mainly nurses (n = 105, 57.7%) and physicians (n = 31, 17.0%). Participants reported experiencing sexual abuse (n = 5, 2.7%), physical violence (n = 30, 16.50%), verbal abuse (n = 107, 58.8%), and bullying (n = 49, 26.9%). The odds of experiencing physical violence were 3.7 times greater (confidence interval = 1.6-9.2) when there was not a procedure for reporting workplace violence compared to when there was a procedure.DiscussionAttention is required to identify the prevalence of workplace violence. Creating effective policies and procedures for a reporting system would potentially lead to lowering violence rates and positively impacting health care workers’ well-being.     

Report and Prevent: A Quality Improvement Project to Protect Nurses From Violence in the Emergency Department

IntroductionMost nurses experience some form of workplace violence resulting in a stressful work environment, employee injury, and turnover. The aims of this project were to develop and evaluate strategies to improve the reporting of workplace violence as well as to empower emergency nurses to prevent assaults and protect themselves.MethodsThis quality improvement project had 2 phases. The phase I educational intervention focused on the importance of reporting workplace violence. Pre- and postintervention surveys measured experiences with workplace violence and reporting. The phase II educational intervention focused on de-escalation and self-protection strategies, training, safety, confidence, and emergency nurses’ preparedness to defend themselves. Responses were analyzed using Wilcoxon signed-rank and McNemar tests.ResultsTwenty-five emergency nurses participated in phase I, with >90% reporting that they had been assaulted in the past month. Most did not report a workplace assault, which was unchanged after the intervention. Thirty-four emergency nurses participated in phase II, with a postintervention increase reported in the perceived helpfulness of learning self-protection techniques for the emergency nurses’ work life (Z = –2.179, P = 0.029).DiscussionThis study was consistent with the literature in that emergency nurses often do not report workplace assaults. Most of the emergency nurses surveyed had been assaulted. Although the educational interventions did not achieve the desired outcome, it is clear that additional interventions for individual nurses and institutions need to be developed and refined to increase reporting and prevent workplace assaults.     

Violence in hospitals and burnout among nursing staff

BackgroundNursing staff, especially in violence-prone emergency departments (ED), are at high risk of burnout. Frequently experienced violence is expected to have a strong impact on the nursing staff's burnout. This study aimed to examine the differences in the level of burnout between nursing staff who work in the ED and nursing staff who work in other inpatient departments, and its relationship with violence in various hospitals in Israel.MethodA cross-sectional study that utilized a three-part questionnaire: demographic data, degree of burnout, and frequency occurrence of violence events against nurses.Results150 nurses in EDs (N = 75) and inpatient departments (N = 75) were sampled. Significant differences were found between the two groups: Nurses in EDs experienced a higher degree of burnout than nurses in other hospital departments, and the degree of burnout was found to have a positive relationship with exposure to both verbal and physical workplace violence.ConclusionsNursing staff in EDs could develop a high degree of burnout, and exposure to workplace violence could exacerbate it. The physical and emotional safety of the staff is an important aspect in preventing burnout, and creating a secure work environment.     

Pediatric emergency nurses’ workplace violence experiences: A qualitative study

IntroductionWorkplace violence is a crucial problem experienced by health workers who serve at the emergency service. The identification of emergency nurses’ workplace experiences is of importance to the prevention of violence and the development of solutions.PurposeThis study was performed to identify the workplace violence experiences of the nurses working for the pediatric emergency units.MethodA total of 20 nurses who experienced violence at the emergency service participated in the study that was conducted as qualitative research. The data were collected with the semi-structured interview form and were evaluated by using thematic analysis.ResultsFive themes, namely, “the characteristics of violence”, “the causes of violence”, “the approach during/after the violence”, “the consequences of the violence for the person”, and the “consequences of the violence for the profession”, were identified. Nurses stated that they often experienced verbal violence due to patient relatives’ unmet expectations, the failure of patient relatives to understand treatments and practices, and the heavy workload, they endeavored to eliminate violence by trying to communicate with perpetrators of the violence, calling the security staff, and reporting the violence to their managers, and they were individually and professionally affected by the violence.ConclusionNurses are negatively affected by workplace violence. Pediatric emergency nurses should be supported with training programs and policies to be developed for the prevention and solution of violence.     

工作场所暴力对急诊护士影响及医院应对现状的调查

目的 了解工作场所暴力对急诊护士的影响及医院应对现状.方法 采用工作场所暴力调查表对164名急诊护士进行调查.结果 124名(75.6%)护士遭受过暴力,对护士的生理、心理和职业态度产生较大影响,医院缺乏规范、有效的应对暴力措施.结论 急诊护士是遭受工作场所暴力的高危人群.医院应建立预防和应对暴力的系统模式,创造和谐的医疗环境.     

北京市三级甲等医院急诊科护士职业暴露与防护行为的现状调查

目的了解北京市三级甲等医院急诊科护士锐器伤、血液暴露及工作场所暴力3种职业暴露的发生状况及防护行为现状。方法便利抽取21所北京市三级甲等医院,依据每所医院急诊科排班整群抽取1组护士作为调查对象,采用自制问卷进行调查,问卷内容包括一般资料及锐器伤、采血过程中血液暴露、工作场所暴力的发生现状及防护行为,调查对象匿名填写问卷。结果共收集问卷1 150份,有效问卷1 102份,有效回收率为95.83%。在过去1年中,急诊科护士至少经历过1次锐器伤、采血中的血液暴露、语言暴力、身体暴力及性骚扰的发生率分别为37.8%、36.4%、68%、12%和5.3%;急诊科不同的工作区域,锐器伤(χ2=16.805,P=0.010)、语言暴力(χ2=98.509,P<0.001)、身体暴力(χ2=79.916,P<0.001)发生率不同。在发生职业暴露的护士中,92.8%的护士在发生锐器伤后能够挤血,同时用流动水冲洗并消毒;69.8%的护士在采血过程发生血液暴露后能够冲洗暴露部位并消毒;在工作场所暴力发生时,41.3%的护士耐心解释,30.0%的护士忍让回避。3种职业暴露的上报率均较低(<...     

Incidence and Cost of Nurse Workplace Violence Perpetrated by Hospital Patients or Patient Visitors

Introduction

Workplace violence against nurses is a serious problem. Nurses from a US urban/community hospital system employing more than 5,000 nurses researched the incidence of workplace violence against nurses perpetrated by patients or visitors in their hospital system.

Methods

Survey research and retrospective database review methods were used. Nurse participants (all system-employed nurse types) completed a 34-item validated survey in electronic format. Retrospective database review provided annual nurse workplace violence injury treatment and indemnity charges. Institutional review board approval was received.

Results

Survey research participants (N = 762) were primarily white female registered nurses, aged 26 to 64 years, with more than 10 years of experience. Over the past year, 76.0% experienced violence (verbal abuse by patients, 54.2%; physical abuse by patients, 29.9%; verbal abuse by visitors, 32.9%; and physical by visitors, 3.5%), such as shouting or yelling (60.0% by patients and 35.8% by visitors), swearing or cursing (53.5% by patients and 24.9% by visitors), grabbing (37.8% by patients and 1.1% by visitors), and scratching or kicking (27.4% by patients and 0.8% by visitors). Emergency nurses (12.1%) experienced a significantly greater number of incidents (P < .001). Nurses noted more than 50 verbal (24.3%) and physical (7.3%) patient/visitor violence incidents over their careers. Most serious career violence incidents (n = 595, 78.1%) were physical (63.7%) (60.8% by patients and 2.9% by visitors), verbal (25.4%) (18.3% by patients and 7.1% by visitors), and threatened physical assault (10.9%) (6.9% by patients and 4.0% by visitors). Perpetrators were primarily white male patients, aged 26 to 35 years, who were confused or influenced by alcohol or drugs. Per database review, annual workplace violence charges for the 2.1% of nurses reporting injuries were $94,156 ($78,924 for treatment and $15,232 for indemnity).

Discussion

Nurses are too commonly exposed to workplace violence. Hospitals should enhance programs for training and incident reporting, particularly for nurses at higher risk of exposure, caring for patients with dementia or Alzheimer disease, patients with drug-seeking behavior, or drug- or alcohol-influenced patients.     

上海市三级甲等医院急诊科护士工作场所暴力情况与工作倦怠现状及相关性调查

目的探讨上海市三级甲等医院急诊科护士遭受工作场所暴力情况与工作倦怠的现状及二者之间的相关性。方法采用医院工作场所暴力调查问卷与工作倦怠问卷对上海市两家三级甲等医院急诊科的150名护士进行工作场所暴力和工作倦怠两个方面的调查,并分析两者的相关性。结果急诊科护士遭受工作场所暴力发生率为65．3％;本组护士的情绪衰竭、个人成就感丧失维度得分分别为（19．56±6．63）,（34．13±7．02）分,均高于常模的（22．19±9．53）,（36．53±7．34）分,差异均有统计学意义（t分别为3．281,3．776;P〈0．01）;本组护士与常模去人格化倾向维度得分比较,差异无统计学意义（P〉0．05）;遭受暴力组护士情绪衰竭、去人格化倾向维度得分分别为（20．13±8．65）,（7．53±3．03）分,均高于未遭受暴力护士组的（17．57±7．12）,（6．43±2．15）分,差异均有统计学意义（t分别为2．023,2．324;P〈0．05）;是否遭受暴力和年龄是情绪衰竭和去人格化倾向的影响因素,职称和年龄是个人成就感丧失的影响因素。结论急诊护士遭受工作场所暴力伤害可引起护士工作倦怠产生,采取减少暴力伤害的措施对减轻急诊护士工作倦怠是十分必要的。     

Workplace violence against nurses – Prevalence and association with hospital organizational characteristics and health-promotion efforts: Cross-sectional study

Purpose/objectivesTo determine the prevalence of workplace violence and explore the role of hospital organizational characteristics and health promotion efforts in reducing hospital violence among nurses in Taiwan.DesignCross-sectional survey.SettingOne hundred hospitals across Taiwan.SampleThe final sample in our study comprised responses from 26,979 nurses.MethodsThe data were obtained from a nationwide hospital survey, Physical and Mental Health and Safety Needs in Full-Time Health Care Staff, which was developed and conducted by the Bureau of Health Promotion, Taiwan, in 2011.Main research variablesThe main dependent variable was whether nurses had experienced violence within the past year. Physical violence, threatened or intimidated personal safety, verbal violence or sexual harassment were all included.FindingsOf the 26,979 nurses, 13,392 nurses (49.6%) had experienced at least one episode of any type of violence in the past year; 5150 nurses (19.1%) had been exposed to physical violence, and 12,491 nurses (46.3%) had been exposed to non-physical violence. The prevalence of having experienced any violence varied widely and ranged from the highest (55.5%) in an emergency room or intensive care unit to the lowest (28.3%) among those aged 55–65 years. After adjusting for other characteristics, younger nurses were significantly more likely to be exposed to any violent threat. Nurses working in public hospitals had a significantly higher risk of workplace violence than those working in private hospitals. Significant variations were also observed among work units. Although nurses working in a certified health promoting hospital (HPH) did not have a lower risk of workplace violence, those working in an outstanding HPH had a significantly lower risk of workplace violence. A similar pattern was observed for non-physical violence.ConclusionsWorkplace violence is a major challenge to workplace safety for nurses in hospitals. This large scale nurse survey identified individual, work and hospital characteristics associated with workplace violence among hospital nurses. Preventive efforts in reducing hospital violence shall be targeted these high risk groups and settings.Implications for nursingThis nationwide nurse survey assisted us in more clearly understanding the scope of the hospital violence facing nurses and identifying critical risk factors. The findings not only identified the most common locations of violence in hospitals but also suggested that extensive investments and efforts by hospitals in health promotion are crucial.     

The impact of workplace violence on nurses in South Taiwan

The purpose of this study was to explore the prevalence of workplace violence (WPV) committed by patients and their family members against healthcare workers in south Taiwan. WPV incident questionnaires were completed by 205 nurses from a medical facility in south Taiwan. Sixty-two percent of the nurses reported experiencing WPV. The majority of the cases consisted of verbal abuse including threats of violence or threatening words from patients or families. The verbal expressions of violence were mainly due to misunderstanding and drunkenness on the part of patients and their families, and personal problems in the nurses' relationships with doctors and co-workers. The cases of physical WPV reported by the nurses were perpetrated by patients who were mentally unstable. The findings of this study may help hospitals and nurses in avoiding, reducing, and controlling incidents of WPV.     

Prevalence of verbal and physical workplace violence against nurses in psychiatric hospitals in China

ObjectiveWorkplace violence (WPV) is common in mental health services in China, but its multi-center prevalence measured using standardized rating scales has rarely been reported. This study aimed to explore the prevalence of verbal and physical violence against nurses working in psychiatric hospitals and examine its independent socio-demographic correlates in China.MethodsThis was a cross-sectional study conducted in 11 major psychiatric hospitals in China using a 9-item self-reported workplace violence scale.ResultsA total of 1906 psychiatric nurses were recruited to participate in this study. The one-year prevalence of verbal and/or physical workplace violence (WPV) was 84.2% (95% CI: 82.4–85.8). The prevalence rates of verbal abuse, threats and physical violence were 79.3% (95% CI: 77.4–81.1), 70.9% (95% CI: 68.8–73.0) and 57.9% (95% CI: 55.7–60.2), respectively. Multiple logistic regression analysis revealed that working in department of psychiatry (OR = 3.42, P < 0.001), having moderate (OR = 2.05, P = 0.009), severe (OR = 2.04, P = 0.015) or extremely severe (OR = 3.21, P < 0.001) anxiety level of WPV and working in hospitals with a WPV reporting system (OR = 1.88, P < 0.001) were significantly associated with WPV.ConclusionWPV against nurses is a serious occupational and public health concern in Chinese psychiatric hospitals. Appropriate preventive measures should be undertaken to reduce the risk of WPV in healthcare settings.