Lateral Violence in the Perioperative Setting

Lateral violence is disruptive, bullying, intimidating, or unsettling behavior that occurs between nurses in the workplace.The perioperative setting fosters lateral violence because of the inherent stress of performing surgery; high patient acuity; a shortage of experienced personnel; work demands; and the restriction and isolation of the OR, which allows negative behaviors to be concealed more easily.Lateral violence affects nurses' health and well-being and their ability to care for patients. Interventions to reduce lateral violence include empowerment of staff members and zero tolerance for lateral violence. AORN J 89 (April 2009) 688-696. © AORN, Inc, 2009.     

神经外科护士经历横向暴力的现状调查及分析

目的了解神经外科护士经历横向暴力的现状,以期为制订针对性的干预措施提供参考。方法 2015年7-10月,采用便利抽样法选择在海军总医院神经外科工作的127名注册护士为研究对象,采用经历暴力事件调查量表(sabotage savvy,SS)对其进行调查。结果监护病房护士相对于普通病房护士更多地经历横向暴力(χ~2=4.251,P0.05);经历横向暴力与护士的工作年限有关,工作年限低(5年)的护士相对于工作年限高(≥5年)的护士更多经历横向暴力(χ~2=31.877,P0.05)。结论神经外科护士工作期间普遍经历横向暴力,护理管理者需提高对加强横向暴力的认识,并采取有效的干预措施。     

Levels of Violence Among Nurses in Cape Town Public Hospitals

BACKGROUND.  The paper presents findings from a study examining violence in nursing.
DESIGN.  A combined ethno-phenomenology was identified as the most appropriate approach. Ethnography is to understand the culture of nursing that permits violence to occur within the profession. Phenomenology is to explore and capture nurse-on-nurse experiences of violence. The population is all nurses registered with the South African Nursing Council. The research participants are nurses employed in eight public hospitals in Cape Town during 2005.
METHOD OF DATA COLLECTION.  The first stage of data collection was the distributions of confidential questionnaires to nurses employed in eight hospitals and willing to participate in the study.
ANALYSIS.  Responses to close-ended questions were analyzed using Microsoft Excel. Responses to open-ended questions were grouped per question. The qualitative data were then compared for similarities and differences in information provided.
CONCLUSIONS.  Six levels of violence exist among nurses. The highest forms of violence among nurses occurred at the psychological level, with the least at the physical level of interaction. The other four levels of violence among nurses were vertical, horizontal, covert, and overt. All categories of nurses in the study had resorted to one or more levels of violence against other nurses during their nursing career. Professional nurses and senior nurse managers were identified as the main category of nurses that frequently resort to mistreating other nurses. However, auxiliary nurses were identified as the main perpetrators of physical violence against other nurses.     

Strengthening communication to overcome lateral violence

Ceravolo D.J., Schwartz D.G., Foltz-Ramos K.M. & Castner J. (2012) Journal of Nursing Management  20, 599–606 Strengthening communication to overcome lateral violence Aim This quality improvement project aims to reduce nurse-to-nurse lateral violence and create a more respectful workplace culture through a series of workshops. Background Lateral violence is common and pervasive in nursing, with detrimental physical, psychological and organizational consequences. Methods This project describes the organization-wide pre- and post-intervention survey of registered nurses’ perception of lateral violence and turnover. Results After the workshop series, nurses who reported experiencing verbal abuse fell from 90 to 76%. A greater percentage of nurses perceived a workplace that was respectful to others and in which it was safe to express opinions. After the workshop series, a greater percentage of nurses felt determined to solve the problem after an incident of lateral violence, while a smaller percentage felt powerless. Nursing turnover and vacancy rates dropped. Conclusions Educational workshops that enhanced awareness of lateral violence and improved assertive communication resulted in a better working environment, reduction in turnover and vacancy rates, and reduced incidence of lateral violence. Implications for nursing management Nurse managers must raise awareness of lateral violence with individual and organizational consequences. Nursing leadership can effect organizational change to lesson lateral violence and enhance a healthy workplace culture by replicating our intervention or components of our workshops.     

护士之间横向暴力的研究进展

横向暴力影响着护士的身心健康,加剧了护士的短缺,最终会降低护理服务质量。通过对国内外护士之间横向暴力的表现形式、发生情况、产生原因和负面影响进行综述,以探索和发现有效预防护士之间横向暴力发生的对策,创造健康的工作环境。     

某三级甲等综合医院护理人员伤医事件相关认知行为的调查研究

目的调查护理人员伤医事件相关认知行为的现况,分析伤医事件中认知行为影响因素。方法采用自行设计职业经历与伤医事件认知应对的调查问卷对363名护理人员进行调查。结果护理人员伤医事件认知行为总分为(21.71±5.00)分,条目均分为(2.46±0.56)分,不同职称护理人员对伤医事件的行为反应存在差异,不同性别、职称的护理人员对伤医事件的社会认知存在差异(P0.01)。结论护理管理者应对护理人员进行合理有效的规范化培训和职业指导,关注其行为反应,保证护理队伍的稳定性,促进护理事业可持续发展。     

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.     

Health promotion model for childhood violence prevention and exposure

Aims and objectives. To discuss the Health Promotion Model for Violence Prevention and Exposure and intervention strategies for implementation. Background. Violence causes physical and psychosocial harm to children. Because little collaboration exists between specialties in the USA, a model that incorporates both a public health and psychosocial approach is needed to assess the risk for exposure to violence and the effects of violence as well as developing prevention strategies. Prevention and intervention includes primary, secondary and tertiary levels that focus on either the community or individual. However, primary and secondary prevention, such as anticipatory guidance and screening, can be implemented by both community and primary care nurses. Methods. A review of the literature and on‐line resources focusing on children's exposure to violence provided the basis for discussion of the commonalities and differences between the public health and psychosocial approach to assessing, preventing and intervening with children exposed to violence. This discussion led to the development of the proposed model. Conclusions. This model can identify more children at risk for social, physical and psychological harm because of exposure to violence. Implementing prevention or treatment interventions can decrease the impact of violence on children. Relevance to clinical practice. This model can be implemented by public health, psychiatric and primary care nurses by incorporating the model into the well‐child exam, school screenings and after‐school programs. Collaboration between specialties will increase referrals for participation in anti‐violence programs or treatment interventions.     

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 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.     

Incidence,Type, Related Factors,and Effect of Workplace Violence on Mental Health Nurses: A Cross-sectional Survey

OBJECTIVE

Workplace violence and its impact on mental health nurses have yet to be thoroughly explored in China. This study aims to investigate the incidence, type, related factors, and effects of workplace violence on mental health nurses as well as identifying coping strategies.

精神科护士遭受工作场所身体暴力事件的现况调查

目的 探讨精神科护士遭受工作场所暴力的形式及心理情况的现状,为临床护士及管理者提供研究依据.方法 采取整群抽样的调查方法,对该院一年内遭受工作场所身体暴力的精神科护士的遭受暴力形式和心理状态调查,采用χ2以及单因素方差分析进行统计分析.结果 仅有9.9%的精神科护士掌握暴力防范技巧.精神科女护士较精神科男护士更易遭受暴力行为在身体性袭击(χ2=9.611)、遭遇患者或家属打砸(χ2=4.085)、和被威胁(χ2=5.172)等三方面,差异均有统计学意义(均P<0.05).71.8%的人认同医院暴力事件越来越多;83.0%的人认为不信任家属,对家属感到恐惧;74.6%的人认为经常失眠、伴有焦虑,但男女比较,差异无统计学意义(P>0.05).结论 精神科护士缺乏掌握工作场所暴力攻击的知识,大部分护士遭受过工作场所暴力,并且出现不良的心理状态(尤其是女护士),为管理者提供一定依据,以制定相应对策,降低工作场所暴力.     

护理人员遭受工作场所暴力情况的调查与分析

目的探讨在医院中护理人员遭受工作场所暴力的流行特征及危险因素。方法根据WHO关于医院工作场所暴力的定义,采用自行设计问卷,调查我市两所三级甲等医院中护理人员在2004年4月~2005年4月遭受工作场所暴力的情况。结果420名被调查者中,1年内有234名遭受过工作场所暴力,发生率为55.71%,其中以心理暴力为主(40.24%)。媒体导向(48.29%)、肇事者酗酒(38.89%)、患者病情无好转或自认为无好转(35.47%),是发生医院工作场所暴力的主要原因。结论护理人员中医院工作场所暴力的发生率较高,需针对医院特点开展工作场所暴力防范与应对教育,提高护士应对各种医院工作场所暴力的能力和整体素质。     

The Effects of Exposure to Community Violence on Aspects of Adolescent Identity Development

PROBLEM:    A gap exists in our understanding of the impact of exposure to community violence on identity development. The purpose of this study was to explore how exposure to community violence affects adolescents' identity development. Data were collected to describe the perceptions, interpretations, and meanings adolescents ascribe to their experiences with community violence.
METHODS:    Male and female inner-city adolescents (13–18 years) were invited to share their personal stories about exposure to community violence. A constant comparative approach was employed to analyze data from personal narratives.
RESULTS:    All adolescents in this study reported exposure to violence and shared stories about living and coping with the prevalence of violence. Aspects of identity development that emerged in the data included self-perceptions, coping patterns, efficacy, and a moral self. Some stories revealed psychological distress that had potential for long-term developmental consequences. Personal strengths and positive attributes of the participants were also evident in the data.
CONCLUSIONS:    Exposure to community violence affected the identity development of these adolescents. When working with adolescents, it is important for nurses to assess for community violence exposure and promote coping strategies that reduce distress and foster healthy intimacy.     

Violence Against Nurses in the Triage Area: A Mixed-Methods Study

IntroductionWorkplace violence is a serious occupational problem among nurses in emergency departments. The aim of this study was to better understand workplace violence experienced by triage nurses.MethodsA mixed-methods study was carried out with 27 Italian nurses involved in the triage area of an emergency department. Quantitative data were collected using the Violent Incident Form and qualitative data were obtained from 3 focus groups.ResultsNinety-six percent of triage nurses had suffered an episode of violence during the previous year. Participants reported that perpetrators of violence were primarily patients' relatives or friends (62%), usually male and in a lucid state of consciousness. The aggressor was a male patient in 31% of violent episodes. Male nurses reported only verbal abuse, unlike female nurses who suffered both physical and verbal episodes. Females received assistance from other staff during the aggression event more frequently than males, and females more frequently suffered from physical injury. Only physical and verbal aggressions were associated with physical injury. Four main themes emerged from the focus groups.DiscussionNurses reported that high exposure to workplace violence in triaging had significant consequences on their psychological well-being and on their behavior at work and at home. Violence, perceived as a personal and/or professional injury owing to insufficient organizational support, led professionals to experience feelings of resignation and to believe that abuse was an inevitable part of the job. Nevertheless, in our study, the precipitating factors were investigated, suggesting several possible solutions to limit this phenomenon.     

Nurse exposure to physical and nonphysical violence,bullying, and sexual harassment: A quantitative review

Objectives

This paper provides a quantitative review that estimates exposure rates by type of violence, setting, source, and world region.

Design

A quantitative review of the nursing violence literature was summarized.

Data sources

A literature search was conducted using the CINAHL, Medline and PsycInfo data bases. Studies included had to report empirical results using a nursing sample, and include data on bullying, sexual harassment, and/or violence exposure rates. A total of 136 articles provided data on 151,347 nurses from 160 samples.

Procedure

Articles were identified through a database search and by consulting reference lists of review articles that were located. Relevant data were coded by the three authors. Categories depended on the availability of at least five studies. Exposure rates were coded as percentages of nurses in the sample who reported a given type of violence. Five types of violence were physical, nonphysical, bullying, sexual harassment, and combined (type of violence was not indicated). Setting, timeframe, country, and source of violence were coded.

Results

Overall violence exposure rates were 36.4% for physical violence, 66.9% for nonphysical violence, 39.7% for bullying, and 25% for sexual harassment, with 32.7% of nurses reporting having been physically injured in an assault. Rates of exposure varied by world region (Anglo, Asia, Europe and Middle East), with the highest rates for physical violence and sexual harassment in the Anglo region, and the highest rates of nonphysical violence and bullying in the Middle East. Regions also varied in the source of violence, with patients accounting for most of it in Anglo and European regions, whereas patents’ families/friends were the most common source in the Middle East.

Conclusions

About a third of nurses worldwide indicated exposure to physical violence and bullying, about a third reported injury, about a quarter experienced sexual harassment, and about two-thirds indicated nonphysical violence. Physical violence was most prevalent in emergency departments, geriatric, and psychiatric facilities. Physical violence and sexual harassment were most prevalent in Anglo countries, and nonphysical violence and bullying were most prevalent in the Middle East. Patients accounted for most physical violence in the Anglo region and Europe, and patient family and friends accounted for the most in the Middle East.     

Confronting the Monster of Family Violence

Family violence has been a harrowing manifestation stalking the lives of families, resulting in physical, emotional, and sexual abuse predominately among women and children. This article identifies beliefs that disregards domestic violence, outlines characteristics of abused persons, and describes primary and secondary prevention strategies. The author outlines the role of nurses to provide preventive education, do case finding, and assist their community to confront family violence through professionally, socially, and personally responsible actions.     

Experience of Violence from the Clients and Coping Methods Among Intensive Care Unit Nurses Working in a Hospital in South Korea

Purpose

It is difficult to develop a good defense system that can prevent nurses from experiencing physical and verbal violence from patients and families in intensive care units, which are closed spaces. This study aimed to identify intensive care nurses' experience of violence from patients and families and investigate their coping methods, if there are any, in a tertiary hospital in South Korea.