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.     

A cross-sectional survey on workplace psychological violence among operating room nurses in Mainland China

AimTo investigate the status of workplace psychological violence (WPV) from managers, coworkers, or subordinates against operating room (OR) nurses in mainland China and identify risk factors.BackgroundWPV is a serious problem for nurses. However, limited information is available regarding the prevalence and risk factors of WPV against OR nurses in mainland China.MethodsA multi-center, cross-sectional study was conducted. OR nurses (n = 1557) from 26 hospitals, located in 13 cities of China, participated in this study.ResultsOf the participants, 92.1% experienced WPV (30.9% from surgeons and 18.1% from senior nurses). Only 30.1% of the sufferers would report WPV. A logistic regression analysis revealed that nurses who had been in service longer and with senior professional titles were more likely to experience WPV.ConclusionNursing managers should identify and resolve issues in a timely manner. Measures that promote effective team communication and facilitate teamwork, as well as inter-disciplinary educational workshops may be effective.     

门诊护士遭受工作场所暴力的现状及影响因素研究

目的 ：描述三级甲等综合医院门诊护士遭受工作场所暴力的现状和影响因素。方法 ：采用医院工作场所暴力调查问卷修订版对浙江省8家三级甲等综合医院的204名门诊护士进行问卷调查。结果 ：204名调查对象中,1年内工作场所暴力事件发生率为74.4%。Logistic回归分析结果表明职位、是否为独生子女、积极的应对方式和医院是否采用有效预防暴力的措施4个因素进入回归模型。结论 ：门诊护士遭受工作场所暴力的发生率高。职位、是否为独生子女、积极的应对方式和医院是否采用有效预防暴力的措施是工作场所暴力的影响因素。建议进行进一步的干预研究,以减少门诊工作场所暴力的发生。     

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.     

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。     

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.     

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.     

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.

Workplace violence against nurses,job satisfaction,burnout, and patient safety in Chinese hospitals

BackgroundMost nurses have experienced some form of workplace violence, which could lead to physical or psychological harm and reduced job performance. Previous studies have examined the effects of workplace violence on nurses' job satisfaction and patient safety, but there have been very few examinations of whether workplace violence affects patient safety through nurse job satisfaction and burnout.PurposeTo investigate the relationships among workplace violence, nurse outcomes and patient safety. To explore whether nurse burnout and job satisfaction play mediating roles in the association of workplace violence and patient safety.MethodsA cross-sectional survey was conducted in 23 hospitals in Guangdong province in China to collect data from 1502 nurses. A structural equation model design was tested with validated measurement instruments.FindingsNurse-reported workplace violence was found to be associated directly with higher incidences of burnout, less job satisfaction, lower patient safety and more adverse events. Nurse burnout was associated directly with lower patient safety and more adverse events. Higher nurse job satisfaction was associated directly with higher patient safety. Nurse burnout and job satisfaction played mediating roles in workplace violence and patient safety. The model explained 19.8% and 35.0% of nurse-reported patient safety and adverse events, respectively.DiscussionIt is important for administrators to consider how to protect nurses from workplace violence, to improve their wellbeing at work, and to deliver safe patient care. When nurses experience workplace violence, it is necessary to pay attention to their emotional reactions and job attitudes, and to provide them with support in order to avoid adverse impacts on patient safety. Further practices and research initiatives to support nurses' safety at work are recommended.     

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.     

A reputational risk for the profession: Workplace violence toward nursing students

BackgroundWorkplace violence (WV) within nursing has been recognised internationally as a significant problem. In developing countries, such as Turkey, where nurses face WV frequently, it is an under-researched area and there is an absence of an effective system for reporting such acts.AimThis study aimed to identify the incidence of WV experienced by Turkish nursing students, and to explore the implications and actions needed to reduce the incidence and impact.MethodsThis study employed a cross-sectional design. Data were collected from 1216 nursing students using the student nurse datasheet and the workplace violence scale.FindingsThe workplace has a considerable impact on nursing students and to varying degrees, WV affects more than half of nursing students in Turkey. The types of WV ranged from receiving racist remarks and being shouted at, to being kicked or having an unwanted advances for intimate physical contact.DiscussionThe findings from this study add to the evidence that violence amongst nursing students is almost a daily occurrence, and is also underreported. Having an understanding of nursing students’ experiences and the impacts of WV, along with effective systems for reporting, can help mitigate the risk of violence occurring during clinical practice. Undergraduate nursing programs and continuing education for nurses should include preparation and role play on how to handle and report WV to improve the resilience of students. It is only through such a concerted and proactive approach will we promote more positive perceptions towards nursing programmes and the nursing profession as a whole.