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.     

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.     

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.     

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。     

Emergency nurses' perspective of workplace violence in Jordanian hospitals: A national survey

BackgroundEmergency departments are considered high-risk areas, where violence against nurses is a serious and prevalent problem. Such violence has negative effects on nurses, and therefore on the quality of care provided.Aims of the studyTo explore the risk factors behind violence, and to specify reasons for the level of low reporting of violence among Jordanian nurses in emergency departments.MethodA cross-sectional design through conducting a survey in emergency departments in Jordanian hospitals.ResultsThe total number of emergency department nurses who participated in the study was 227. Of these, 172 (75%) had experienced some form of violence. Verbal violence was the most reported (63.9%), compared to physical violence (48%). The most reported reasons for violence from the nurses' perspective were waiting time, overcrowding, and patient and family expectations not being met, with frequencies of 54.3%, 53.3%, and 46% respectively. The treatment room was the most common place where the violence occurred. Only 16.6% of the nurses who experienced violence actually reported it. Being accustomed to workplace violence is the most stated reason for not reporting violence to the hospital administration or the authorities.ConclusionViolence against emergency department nurses is a significant issue that cannot be ignored. There are multiple reasons. The key point in dealing with the problem is to treat its specific causes.     

医院工作场所暴力对急诊科护士心理健康的影响

目的探讨医院工作场所暴力对急诊科护士心理健康的影响。方法根据世界卫生组织（WHO）发布的工作场所暴力定义设计调查表及应用症状自评量表（SCL-90）,对广州市6所三级甲等综合医院96名急诊科护士在半年内遭受过工作场所暴力后进行问卷调查。结果急诊科护士遭受工作场所暴力事件42．16％发生在深夜凌晨,心理暴力发生率为72．55％,患者和患者家属是主要肇事者,暴力事件的危险因素依次为患者或家属的要求未得到满足、对服务不满意、肇事者酗酒。遭受工作场所暴力后,急诊科护士在躯体化、强迫症状、抑郁、焦虑、敌对、恐怖、精神病性等方面的因子得分均高于国内常模,差异有统计学意义（t分别为4．676,3．745,2．892,8．236,2．796,8．012,5．177,23．801;P〈0．05或P〈0．01）。结论工作场所暴力对急诊科护士的心理健康有严重影响,应采取有效措施预防和控制工作场所暴力的发生。     

Incidence and risk factors of workplace violence against nurses in a Chinese top-level teaching hospital: A cross-sectional study

PurposeTo investigate the incidence of workplace violence involving nurses and to identify related risk factors in a high-quality Chinese teaching hospital.MethodsA cross-sectional study design was used. The final sample comprised responses from 1831 registered nurses collected with a whole-hospital survey from June 1 to June 15, 2016. The demographic characteristics of the nurses who had experienced any form of violence were collected, and logistic regression analysis was applied to evaluate the risk factors for nurses related to workplace violence.ResultsOut of the total number of nurses surveyed, 904 (49.4%) nurses reported having experienced any type of violence in the past year. The frequencies of exposure to physical and non-physical violence were 6.3% (116) and 49.0% (897), respectively. All the incidence rates of violence were lower than those of other studies based on regional hospitals in China and were at the same level found in developed countries and districts. Binary logistic regression analysis revealed that nurses at levels 2 to 4 and female nurses in clinical departments were the most vulnerable to non-physical violence. For physical violence, the two independent risk factors were working in an emergency department and having 6–10 years of work experience.ConclusionsWorkplace violence directly threatens nurses from high-quality Chinese teaching hospitals. However, the incidence of WPV against nurses in this teaching hospital was better than that in regional hospitals. This study also provides reference material to identify areas where nurses encounter relatively high levels of workplace violence in high-quality Chinese teaching hospitals.     

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.     

急诊科护士工作场所暴力与职业紧张现状及其相关性分析

目的:探讨急诊科护士工作场所暴力与职业紧张之间的关系,为预防急诊科护士工作场所暴力提供理论依据。方法:采用医院工作场所暴力调查量表和职业紧张目录问卷对广州市5家急诊科护士进行调查。结果:80.2%的急诊科护士在过去一年中遭受过工作场所暴力,其中辱骂、威胁、身体攻击的发生率分别为77.6%、62.0%、22.3%。急诊科护士的职业紧张平均得分为296.62分,职业任务平均得分为132.08分,紧张反应平均得分为67.52分,应对资源平均得分为87.11分。影响工作场所暴力的职业紧张因素从大到小排列依次是工作环境、休闲应对资源、心理紧张反应、任务不适、躯体紧张反应、任务过重、任务冲突。结论:急诊科护士工作场所暴力发生率高,急诊科护士工作场所暴力受职业紧张影响。     

Assessing Preoperative Anxiety: Nurses Versus Health Care Assistants

PurposeOur objective was to compare the difference in anxiety levels self-reported by patients and those estimated by health care assistants and nurses in two ambulatory surgery settings.DesignWe performed a prospective study.MethodsPatients’ preoperative anxiety was graded using a visual analog scale.FindingsBetween September 1 and November 31, 2019, a total of fifteen health care assistants and fourteen nurses assessed anxiety scores of 170 patients, including 92 women and 78 men. At admission, the mean visual analog scale anxiety score declared to health care assistants and nurses was 5.3 (SD = 2.9) and 4.2 (SD = 3.1), respectively (P = .02). The correlation between health care assistants’ assessment of the patients' anxiety and the declared level of anxiety was significantly higher than nurses' assessment (r = 0.83 vs r = 0.12; P < .001).ConclusionsNurse assistants estimate patients’ preoperative anxiety with more accuracy than nurses in our hospital. Nursing education curriculum should continue to include addressing preoperative patient anxiety.