1
|
Touzet S, Buchet-Poyau K, Denis A, Occelli P, Jacquin L, Potinet V, Sigal A, Delaroche-Gaudin M, Fayard-Gonon F, Tazarourte K, Douplat M. Impact of the presence of a mediator on patient violent or uncivil behaviours in emergency departments: a cluster randomised crossover trial. Eur J Emerg Med 2024; 31:201-207. [PMID: 38329117 DOI: 10.1097/mej.0000000000001121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
BACKGROUND AND IMPORTANCE Several studies reported that violent behaviours were committed by patients against healthcare professionals in emergency departments (EDs). The presence of mediators could prevent or resolve situations of tension. OBJECTIVE To evaluate whether the presence of mediators in EDs would have an impact on violent behaviours committed by patients or their relatives against healthcare professionals. Design, settings and participants A 6-period cluster randomised crossover trial was performed in 4 EDs during 12 months. Patients aged ≥18 and their relatives were included. INTERVENTION In order to prevent or resolve situations of tension and conflict, four mediators were recruited.Outcome measure and analysis Using a logistic regression mixed model, the rate of ED visits in which at least one act of violence was committed by a patient or their relatives, reported by healthcare professionals, was compared between the intervention group and the control group. RESULTS A total of 50 429 ED visits were performed in the mediator intervention group and 50 851 in the control group. The mediators reported 1365 interventions; >50% of the interventions were to answer questions about clinical management or waiting time. In the intervention group, 173 acts of violence were committed during 129 ED visits, and there were 145 acts of violence committed during 106 ED visits in the control group. The rate of ED visits in which at least one act of violence was committed, was 0.26% in the intervention group and 0.21% in the control group (OR = 1.23; 95% CI [0.73-2.09]); on a 4-level seriousness scale, 41.6% of the acts of violence were rated level-1 (acts of incivility or rudeness) in the intervention group and 40.0% in the control group. CONCLUSION The presence of mediators in the ED was not associated with a reduction in violent or uncivil behaviours committed by patients or their relatives. However, the study highlighted that patients had a major need for information regarding their care; improving communication between patients and healthcare professionals might reduce the violence in EDs. TRIAL REGISTRATION Clinicaltrials.gov (NCT03139110).
Collapse
Affiliation(s)
- Sandrine Touzet
- Hospices Civils de Lyon, Pôle de Santé Publique
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1
| | | | | | - Pauline Occelli
- Hospices Civils de Lyon, Pôle de Santé Publique
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1
| | - Laurent Jacquin
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Accueil des Urgences
| | - Véronique Potinet
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d'Accueil des Urgences
| | - Alain Sigal
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service d'Accueil des Urgences, Lyon, France
| | | | - Florence Fayard-Gonon
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service d'Accueil des Urgences, Lyon, France
| | - Karim Tazarourte
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Accueil des Urgences
| | - Marion Douplat
- Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service d'Accueil des Urgences
| |
Collapse
|
2
|
Mausz J, Piquette D, Bradford R, Johnston M, Batt AM, Donnelly EA. Hazard Flagging as a Risk Mitigation Strategy for Violence against Emergency Medical Services. Healthcare (Basel) 2024; 12:909. [PMID: 38727466 PMCID: PMC11083417 DOI: 10.3390/healthcare12090909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 04/15/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
Paramedics are increasingly being subjected to violence, creating the potential for significant physical and psychological harm. Where a patient has a history of violent behavior, hazard flags-applied either to the individual, their residential address, or phone number-can alert paramedics to the possibility of violence, potentially reducing the risk of injury. Leveraging a novel violence reporting process embedded in the electronic patient care record, we reviewed violence reports filed over a thirteen-month period since its inception in February 2021 to assess the effectiveness of hazard flagging as a potential risk mitigation strategy. Upon reviewing a report, paramedic supervisors can generate a hazard flag if recurrent violent behavior from the patient is anticipated. In all, 502 violence reports were filed, for which paramedic supervisors generated hazard flags in 20% of cases (n = 99). In general, cases were not flagged either because the incident occurred at a location not amenable to flagging or because the supervisors felt that a hazard flag was not warranted based on the details in the report. Hazard flagging was associated with an increased risk of violence during subsequent paramedic attendance (Odds Ratio [OR] 6.21, p < 0.001). Nevertheless, the process appears to reliably identify persons who may be violent towards paramedics.
Collapse
Affiliation(s)
- Justin Mausz
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (D.P.); (M.J.)
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON M5G 1V7, Canada
| | - Dan Piquette
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (D.P.); (M.J.)
| | - Robert Bradford
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON N6A 5C1, Canada;
| | - Mandy Johnston
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (D.P.); (M.J.)
| | - Alan M. Batt
- Faculty of Health Sciences, Queen’s University, 99 University Avenue, Kingston, ON K7L 3N6, Canada;
- Department of Paramedicine, Monash University, Building H, Peninsula Campus, 47-49 Moorooduc Hwy, Frankston, VIC 3199, Australia
| | - Elizabeth A. Donnelly
- School of Social Work, University of Windsor, 167 Ferry Street, Room 213, Windsor, ON N9A 0C5, Canada;
| |
Collapse
|
3
|
Mausz J, D’Eath J, Jackson NA, Johnston M, Batt AM, Donnelly EA. Sexist, Racist, and Homophobic Violence against Paramedics in a Single Canadian Site. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:505. [PMID: 38673416 PMCID: PMC11050378 DOI: 10.3390/ijerph21040505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/12/2024] [Accepted: 03/23/2024] [Indexed: 04/28/2024]
Abstract
Violence against paramedics is widely recognized as a serious, but underreported, problem. While injurious physical attacks on paramedics are generally reported, non-physical violence is less likely to be documented. Verbal abuse can be very distressing, particularly if the harassment targets personal or cultural identities, such as race, ethnicity, gender, or sexual orientation. Leveraging a novel, point-of-event reporting process, our objective was to estimate the prevalence of harassment on identity grounds against paramedics in a single paramedic service in Ontario, Canada, and assess its potentially differential impact on emotional distress. In an analysis of 502 reports filed between 1 February 2021 and 28 February 2022, two paramedic supervisors independently coded the free-text narrative descriptions of violent encounters for themes suggestive of sexism, racism, and homophobia. We achieved high inter-rater agreement across the dimensions (k = 0.73-0.83), and after resolving discrepant cases, we found that one in four violent reports documented abuse on at least one of the identity grounds. In these cases, paramedics were 60% more likely to indicate being emotionally distressed than for other forms of violence. Our findings offer unique insight into the type of vitriol paramedics experience over the course of their work and its potential for psychological harm.
Collapse
Affiliation(s)
- Justin Mausz
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (J.D.); (N.A.J.); (M.J.)
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON M5G 1V7, Canada
| | - Joel D’Eath
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (J.D.); (N.A.J.); (M.J.)
| | - Nicholas A. Jackson
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (J.D.); (N.A.J.); (M.J.)
| | - Mandy Johnston
- Peel Regional Paramedic Services, 1600 Bovaird Drive East, Brampton, ON L6V 4R5, Canada; (J.D.); (N.A.J.); (M.J.)
| | - Alan M. Batt
- Faculty of Health Sciences, Queen’s University, 99 University Avenue, Kingston, ON K7L 3N6, Canada;
- Department of Paramedicine, Monash University, Peninsula Campus, Building H, 47-49 Moorooduc Hwy, Frankston, VIC 3199, Australia
| | - Elizabeth A. Donnelly
- School of Social Work, University of Windsor, 167 Ferry Street, Room 213, Windsor, ON N9A 0C5, Canada;
| |
Collapse
|
4
|
Mausz J. Violence against healthcare and public safety professionals: is bill C-321 a solution? CAN J EMERG MED 2024; 26:221-223. [PMID: 38332454 DOI: 10.1007/s43678-024-00654-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 01/14/2024] [Indexed: 02/10/2024]
Affiliation(s)
- Justin Mausz
- Operations, Peel Regional Paramedic Services, Brampton, ON, Canada.
- Department of Family and Community Medicine, Temerty Faculty of Medicine, The University of Toronto, Toronto, ON, Canada.
| |
Collapse
|
5
|
Haruna J, Uemura S, Niiyama S, Taguchi Y, Muranaka S, Inamura H, Sawamoto K, Mizuno H, Narimatsu E. Influence of Personal and Work Environments on Work-Life Balance Among Emergency Medical Technicians. Cureus 2024; 16:e55447. [PMID: 38576703 PMCID: PMC10994652 DOI: 10.7759/cureus.55447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction Work-life balance (WLB) is a critical concern for emergency medical technicians (EMTs) because it significantly affects the provision of comprehensive emergency medical services (EMS). This study investigated personal and work-related factors influencing work-to-family negative spillover (WFNS), a key element of WLB, among EMTs. Methods A web-based survey was conducted from July 26 to September 13, 2021, among EMTs in Hokkaido, Japan. The study included 21 facilities that were randomly selected from 42 fire stations. The Japanese version of the Survey Work-Home Interaction-NijmeGen (SWING-J) was used to measure WFNS. Personal background factors, such as age, sex, years of work experience, and education, were surveyed. We also evaluated work environment factors, such as weekly working hours, monthly night shifts, monthly overtime hours, and yearly paid vacation days. Unpaired Student's t-tests, one-way analysis of variance (ANOVA), and multilevel generalized linear model (MGLM) analyses were used to explore the relationships between WFNS and personal and work-related factors. Results A total of 912 respondents were included in our analysis. They were predominantly male (98.2%), with an average EMT work experience of 12.7 years and a mean WFNS score of 1.16 (standard deviation (SD) = 1.67). MGLM analysis, adjusting for covariates, identified years of work experience (β = -0.129, p = 0.001), monthly overtime hours (β = 0.184, p < 0.001), and yearly paid vacation days (β = -0.170, p < 0.001) as independent factors associated with WFNS. Conclusion This study suggested that adjusting WFNS among EMTs could be achieved by reducing overtime hours and fostering an organized approach to paid leave within the work environment.
Collapse
Affiliation(s)
- Junpei Haruna
- Department of Intensive Care Medicine, School of Medicine, Sapporo Medical University, Sapporo, JPN
- Department of Emergency Medical Services, Department of Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, JPN
| | - Shuji Uemura
- Department of Emergency Medical Services, Department of Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, JPN
- Department of Emergency Medicine, School of Medicine, Sapporo Medical University, Sapporo, JPN
| | - Sachi Niiyama
- Department of Advanced Critical Care and Emergency Center, Sapporo Medical University Hospital, Sapporo, JPN
| | - Yukiko Taguchi
- Department of Emergency Medical Services, Department of Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, JPN
- Department of Emergency Medicine, School of Medicine, Sapporo Medical University, Sapporo, JPN
- Department of Advanced Critical Care and Emergency Center, Sapporo Medical University Hospital, Sapporo, JPN
- Department of Nursing, School of Health Sciences, Sapporo Medical University, Sapporo, JPN
| | - Saori Muranaka
- Department of Emergency Medical Services, Department of Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, JPN
- Department of Advanced Critical Care and Emergency Center, Sapporo Medical University Hospital, Sapporo, JPN
| | - Hirotoshi Inamura
- Department of Emergency Medical Services, Department of Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, JPN
- Department of Hospital Pharmacy, Sapporo Medical University Hospital, Sapporo, JPN
| | - Keigo Sawamoto
- Department of Emergency Medical Services, Department of Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, JPN
- Department of Emergency Medicine, School of Medicine, Sapporo Medical University, Sapporo, JPN
| | - Hirotoshi Mizuno
- Department of Emergency Medical Services, Department of Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, JPN
- Department of Emergency Medicine, School of Medicine, Sapporo Medical University, Sapporo, JPN
| | - Eichi Narimatsu
- Department of Emergency Medical Services, Department of Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, JPN
- Department of Emergency Medicine, School of Medicine, Sapporo Medical University, Sapporo, JPN
| |
Collapse
|
6
|
Montero-Tejero DJ, Jiménez-Picón N, Gómez-Salgado J, Vidal-Tejero E, Fagundo-Rivera J. Factors Influencing Occupational Stress Perceived by Emergency Nurses During Prehospital Care: A Systematic Review. Psychol Res Behav Manag 2024; 17:501-528. [PMID: 38374938 PMCID: PMC10874882 DOI: 10.2147/prbm.s455224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 01/29/2024] [Indexed: 02/21/2024] Open
Abstract
Objective To assess personal and work-related factors influencing the stress levels of nurses during prehospital care. Specifically, to identify associations between the level of perceived stress, the degree of professional experience, and the level of knowledge. Secondly, to examine the relationship between stress levels and violence in the work environment. And third, to investigate the main protective factors against work-related stress during prehospital care. Methods Systematic review in PubMed, WOS, Enfispo, Cochrane, and LILACS databases following the PRISMA methodology (last search 08/Aug/2023). Following the PECO framework, studies on occupational stress factors in ambulance emergency nurses were investigated. Studies in English or Spanish, from 2013 to 2023, and only research articles were admitted, thus excluding reviews, dissertations, and grey literature. Possible bias and level evidence were assessed using critical appraisal tools and GRADE. This protocol was registered in PROSPERO with code CRD42023446080. Results Fourteen articles were selected, and n=855 prehospital nurses were identified. One study was a clinical trial, and the others were observational and qualitative. The level of evidence was very low (n=7), low (n=6), and moderate (n=1); any study was excluded due to methodological bias. Five categories of stressors were extracted: the management of the health service (ie, workload organisation, and resources), patient care (mainly paediatric care), interpersonal stressors (relationship with peers), environmental factors (exposure to injuries), and personal factors (training, experience, and coping strategies). Violence at work is frequent for prehospital nurses, implying both verbal and physical aggressions. Support from peers was associated with positive results against stress. Conclusion Managing workload and improving resources in the work environment are essential to reduce fatigue and allow emotional processes to be addressed. Providing workers with coping skills also imposes on them the responsibility to cope with stress. Collective awareness is the main element in reducing the incidence of stress.
Collapse
Affiliation(s)
- Diego José Montero-Tejero
- Department of Emergency, Hospital Universitario Lucus Augusti, Galician Health Service, Lugo, Galicia, Spain
| | - Nerea Jiménez-Picón
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Andalusia, Spain
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Andalusia, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | - Elena Vidal-Tejero
- Department of Cardiology, Hospital Universitario Virgen Del Rocío, Andalusian Health Service, Sevilla, Andalusia, Spain
| | - Javier Fagundo-Rivera
- Centro Universitario de Enfermería Cruz Roja, University of Seville, Sevilla, Andalusia, Spain
| |
Collapse
|
7
|
Glawing C, Karlsson I, Kylin C, Nilsson J. Work-related stress, stress reactions and coping strategies in ambulance nurses: A qualitative interview study. J Adv Nurs 2024; 80:538-549. [PMID: 37530409 DOI: 10.1111/jan.15819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 07/07/2023] [Accepted: 07/22/2023] [Indexed: 08/03/2023]
Abstract
AIM To describe experiences of work-related stress, stress reactions and coping strategies among registered nurses (RNs) in the ambulance service (AS). DESIGN A descriptive and qualitative design. METHODS Participants were recruited from eight different ambulance stations from different geographical locations in central Sweden. Data were collected from 14 RNs during the period from January 2022 to May 2022 using a semi-structured interview guide. Qualitative content analysis was used to analyse data using an abductive approach. RESULTS Three categories describe the RNs' experiences; (1) Situations that cause work-related stress, (2) Reactions and feelings that occur and (3) Management of work-related stress. These three main categories included a total of 12 subcategories. Work-related stress was experienced when participants were a part of traumatic events or experienced insufficient cooperation or a disturbing event in the work environment. The different causes lead to different kinds of reactions with feelings of frustration, fear and loneliness being prominent. To manage the work-related stress, RNs used different kinds of strategies and support from colleagues or lack thereof seemed to have a major impact. CONCLUSIONS Findings revealed the importance of having competent colleagues in the AS. Working with a competent colleague can reduce experiences of stress and prevent feelings of loneliness. It is important for the AS to provide stress-reduction support, to promote cooperation and to maintain and develop RNs' professional competence to ensure quality care and patient safety in the AS.
Collapse
Affiliation(s)
- Carina Glawing
- Department of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
| | - Ingela Karlsson
- Department of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
| | - Camilla Kylin
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Jan Nilsson
- Department of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| |
Collapse
|
8
|
Ose SO, Lohmann-Lafrenz S, Kaspersen SL, Berthelsen H, Marchand GH. Registered nurses' exposure to workplace aggression in Norway: 12-month prevalence rates, perpetrators, and current turnover intention. BMC Health Serv Res 2023; 23:1272. [PMID: 37974173 PMCID: PMC10655393 DOI: 10.1186/s12913-023-10306-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Identifying occupational health hazards among Registered Nurses (RNs) and other health personnel and implementing effective preventive measures are crucial to the long-term sustainability of health services. The objectives of this study were (1) to assess the 12-month prevalence rates of exposure to workplace aggression, including physical violence, threats of violence, sexual harassment, and bullying; (2) to identify whether the perpetrators were colleagues, managers, subordinates, or patients and their relatives; (3) to determine whether previous exposure to these hazards was associated with RNs' current turnover intention; and (4) to frame workplace aggression from an occupational health and safety perspective. METHODS The third version of the Copenhagen Psychosocial Questionnaire (COPSOQ III) was used to assess RNs' exposure to workplace aggression and turnover intention. A national sample of 8,800 RNs in Norway, representative of the entire population of registered nurses in terms of gender and geography, was analysed. Binary and ordinal logistic regression analyses were conducted, and odds for exposure and intention to leave are presented, with and without controls for RNs' gender, age, and the type of health service they work in. RESULTS The 12-month prevalence rates for exposure were 17.0% for physical violence, 32.5% for threats of violence, 12.6% for sexual harassment, and 10.5% for bullying. In total, 42.6% of the RNs had experienced at least one of these types of exposure during the past 12 months, and exposure to more than one of these hazards was common. Most perpetrators who committed physical acts and sexual harassment were patients, while bullying was usually committed by colleagues. There was a strong statistical association between exposure to all types of workplace aggression and RNs' intention to leave. The strongest association was for bullying, which greatly increased the odds of looking for work elsewhere. CONCLUSIONS Efforts to prevent exposure to workplace aggression should be emphasised to retain health personnel and to secure the supply of skilled healthcare workers. The results indicate a need for improvements. To ensure the sustainability of health services, labour and health authorities should join forces to develop effective workplace measures to strengthen prevention, mitigation, and preparedness regarding incidents of workplace aggression in health services and the response and recovery regarding incidents that could not be prevented.
Collapse
Affiliation(s)
| | | | | | - Hanne Berthelsen
- Centre for WorkLife and Evaluation Studies, Malmö University, Malmö, Sweden
| | | |
Collapse
|
9
|
Ipek M, Özlük B. Patients' opinion on violence against healthcare workers and their level of satisfaction in emergency department in Turkey: A cross-sectional study. Int Emerg Nurs 2023; 71:101350. [PMID: 37708667 DOI: 10.1016/j.ienj.2023.101350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 07/07/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Violence, with an increasing rate of cases in the health care system which adversely affects the quality of provision of services, has become a social health issue that also has negative impacts both on healthcare workers and patients. This study was conducted to determine the opinion of patients, who had been admitted to the emergency department, towards violence against healthcare workers, and their level of satisfaction with health services. METHODS The study employed a cross-sectional design and was conducted with 348 patients who had received healthcare services in the adult emergency department in Turkey. The Emergency Department Patient Satisfaction Survey and An eight-item questionnaire prepared by the researchers consisting of the patient's characteristics and their statements on violence were used to collect the data. RESULTS Among the patients, 26.7% stated that they had been violent toward healthcare workers. It was determined that 91.4% of the cases were verbal and 8.6% were physical. Among the patients, 82.2% had not known about the legal sanctions for violence against healthcare workers. The low level of propensity for violence in patients who were satisfied with the emergency department service was statistically significant (p < 0.05). CONCLUSIONS As a result of the study, it was found that one in four patients had been violent to healthcare workers, and the vast majority had a lack of information about legal sanctions. Policymakers should take deterrent measures to prevent the occurrence of violence and develop more critical sanctions.
Collapse
Affiliation(s)
- Muhammet Ipek
- Emergency Unit Nurse, Konya Numune Hospital, Konya, Turkey
| | - Bilgen Özlük
- Necmettin Erbakan University, Faculty of Nursing, Department of Nursing Management, Konya, Turkey.
| |
Collapse
|
10
|
Nordquist H, Kouvonen A. Critical incident experiences, related stress and support among Finnish paramedics: A cross-sectional survey study. Int Emerg Nurs 2023; 71:101367. [PMID: 37852062 DOI: 10.1016/j.ienj.2023.101367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 09/11/2023] [Accepted: 09/23/2023] [Indexed: 10/20/2023]
Abstract
INTRODUCTION Paramedics work in diverse, demanding prehospital settings. We examined the prevalence of critical incident (CI) experiences, critical incident stress (CI-S), and CI-S association with the intention to leave the paramedic profession, as well as the needed and received support for CI-S among Finnish paramedics. METHODS In 2022, n = 427 Finnish paramedics from eight different organizations responded to a modified Emergency Medical Services (EMS) Critical Incident Stress Inventory and reported the CIs experienced during their EMS careers and the related CI-S within the last six months. Statistical analyses were stratified by gender. RESULTS All the listed 31 CIs had been experienced by the Finnish paramedics, and the experiences increased with work experience, especially among men. CI-S had wide variation, seemed to increase with work experience, and was mainly not associated with the intention to leave the profession. Support for coping with CI-S was most often received from colleagues, then from family members, friends, and to some extent, managers. CONCLUSIONS Because of the inherent nature of the demands and features of the paramedic work, experiencing CIs is unavoidable. Examining effective coping strategies, organizational support, and managerial practices are needed to support highly skilled paramedics in their demanding work.
Collapse
Affiliation(s)
- Hilla Nordquist
- South-Eastern Finland University of Applied Sciences, Kotka, Finland; Faculty of Social Sciences, University of Helsinki, Helsinki, Finland; Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland; Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland.
| |
Collapse
|
11
|
Haruna J, Uemura S, Taguchi Y, Muranaka S, Niiyama S, Inamura H, Sawamoto K, Mizuno H, Narimatsu E. Influence of work and family environment on burnout among emergency medical technicians. Clin Exp Emerg Med 2023; 10:287-295. [PMID: 36796782 PMCID: PMC10579723 DOI: 10.15441/ceem.22.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 01/09/2023] [Accepted: 01/31/2023] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVE Burnout among emergency medical technicians is a serious problem affecting delivery of quality emergency medical services. Although the repetitive nature of the job and lower education level requirements for technicians have been reported as risk factors, little is known about the influence of burden of responsibility, degree of supervisor support, and home environment on burnout among emergency medical technicians. This study aimed to test the hypothesis that burden of responsibility, degree of supervisor support, and home environment increase burnout probability. METHODS A web-based survey was conducted among emergency medical technicians in Hokkaido, Japan from July 26, 2021 to September 13, 2021. A total of 21 facilities were randomly selected from 42 fire stations. Prevalence of burnout was measured using the Maslach Burnout-Human Services Survey Inventory (MBI-HSS). Burden of responsibility was measured using a visual analog scale. Occupational background was also measured. Supervisor support was measured using the Brief Job Stress Questionnaire (BJSQ). Family-work negative spillover was measured using the Japanese version of Survey Work-Home Interaction-NijmeGen (SWING). The cutoff value for burnout syndrome was defined as emotional exhaustion≥27 and/or depersonalization≥10. RESULTS A total of 700 survey respondents were included, and 27 surveys with missing data were excluded. The suspected burnout frequency was 25.6%. Covariates were adjusted using multilevel logistic regression model analysis. Low supervisor support (odds ratio, 1.421; 95% confidence interval, 1.136-1.406; P<0.001) and high family-work negative spillover (odds ratio, 1.264; 95% confidence interval, 1.285-1.571; P<0.001) were independent factors associated with higher probability of burnout. CONCLUSION This study indicated that focusing on improvement of supervisor support for emergency medical technicians and creating supportive home environments may assist in reducing burnout frequency.
Collapse
Affiliation(s)
- Junpei Haruna
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Intensive Care Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shuji Uemura
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yukiko Taguchi
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Nursing, Sapporo Medical University School of Health Sciences, Sapporo, Japan
| | - Saori Muranaka
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Advanced Critical Care and Emergency Center, Sapporo Medical University Hospital, Sapporo, Japan
| | - Sachi Niiyama
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Advanced Critical Care and Emergency Center, Sapporo Medical University Hospital, Sapporo, Japan
| | - Hirotoshi Inamura
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Hospital Pharmacy, Sapporo Medical University Hospital, Sapporo, Japan
| | - Keigo Sawamoto
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hirotoshi Mizuno
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Eichi Narimatsu
- Department of Emergency Medical Services, Life Flight and Disaster Medicine, Sapporo Medical University, Sapporo, Japan
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| |
Collapse
|
12
|
Kearney J, Muir C, Smith K, Meadley B. Exploring factors associated with paramedic work-related psychological injury through data linkage. JOURNAL OF SAFETY RESEARCH 2023; 86:213-225. [PMID: 37718050 DOI: 10.1016/j.jsr.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/01/2023] [Accepted: 05/16/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION In comparison to the general population and other emergency services workers, paramedics experience high rates of work-related psychological injury. However, there is limited understanding of the case and practitioner-related factors that increase the risk of psychological injury among these workers. This paper aims to identify case and practitioner-related factors associated with paramedic work-related psychological injury in Victoria, Australia, through data linkage. METHODS Data linkage of 7,223 paramedic injury reports with electronic patient care records, and paramedic demographic data from the single state-wide ambulance service in Victoria, Australia - Ambulance Victoria. Injuries reported between 1 January 2015 and 30 June 2020 were included. Factors associated with paramedic psychological injury were assessed using multivariable logistic regression analysis. RESULTS A total of 4,641 (64%) injury reports were successfully linked, of which, 244 (5%) were psychological injuries. Shift hours between 0401 and 0800 (AOR 1.83; 95%CI: 1.12-2.97), cardiac arrest or deceased patient attendances (AOR 2.15; 95%CI: 1.06-4.34), hospital or medical center case locations (AOR 2.44; 95%CI: 1.22-4.91), and Priority 0 (AOR 2.27; 95%CI: 1.26-4.09), Priority 2 (AOR 1.56; 95%CI: 1.04-2.33), and Priority 3 (AOR 1.95; 95%CI: 1.15-3.32) dispatch codes were associated with increased odds of psychological injury. Increasing patient age (AOR 0.98; 95%CI: 0.97-0.99), and the absence of other emergency services on scene (AOR 0.50; 95%CI: 0.34-0.72) were associated with decreased odds of paramedic psychological injury. CONCLUSIONS This is the first study to collectively examine and identify EMS case and practitioner-related characteristics associated with paramedic psychological injury through data linkage of EMS agency-level data sources. PRACTICAL APPLICATION The findings of this study highlight the dispatch case characteristics that may increase the risk of a paramedic sustaining a work-related psychological injury, and consequently facilitate the early identification, intervention, and support of the individuals most at risk.
Collapse
Affiliation(s)
- Jason Kearney
- Monash University Accident Research Centre, Monash University, Clayton, Victoria, Australia.
| | - Carlyn Muir
- Monash University Accident Research Centre, Monash University, Clayton, Victoria, Australia.
| | - Karen Smith
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia; Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia; Silverchain Group, Melbourne, Victoria, Australia.
| | - Ben Meadley
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia; Ambulance Victoria, Melbourne, Victoria, Australia.
| |
Collapse
|
13
|
Mausz J, Johnston M, Arseneau-Bruneau D, Batt AM, Donnelly EA. Prevalence and Characteristics of Violence against Paramedics in a Single Canadian Site. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6644. [PMID: 37681784 PMCID: PMC10487157 DOI: 10.3390/ijerph20176644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 07/24/2023] [Accepted: 08/11/2023] [Indexed: 09/09/2023]
Abstract
Violence against paramedics has been described as a 'serious public health problem' but one that remains 'vastly underreported', owing to an organizational culture that stigmatizes reporting-hindering efforts at risk mitigation in addition to creating a gap in research. Leveraging a novel reporting process developed after extensive stakeholder consultation and embedded within the electronic patient care record, our objective was to provide a descriptive profile of violence against paramedics in a single paramedic service in Ontario, Canada. Between 1 February 2021 and 31 January 2023, a total of 374 paramedics in Peel Region (48% of the workforce) generated 941 violence reports, of which 40% documented physical (n = 364) or sexual (n = 19) assault. The violence was typically perpetrated by patients (78%) and primarily took place at the scene of the 9-1-1 call (47%); however, violent behavior frequently persisted or recurred while in transit to hospital and after arrival. Collectively, mental health, alcohol, or drug use were listed as contributing circumstances in 83% of the violence reports. In all, 81 paramedics were physically harmed because of an assault. On average, our data correspond to a paramedic filing a violence report every 18 h, being physically assaulted every 46 h, and injured every 9 days.
Collapse
Affiliation(s)
- Justin Mausz
- Peel Regional Paramedic Services, Fernforest Division, 1600 Bovaird Drive East, Brampton, ON L6R 4R5, Canada;
- Department of Family and Community Medicine, Temerty Faculty of Medicine, The University of Toronto, 500 University Avenue, Toronto, ON M5G 1V7, Canada
| | - Mandy Johnston
- Peel Regional Paramedic Services, Tomken Division, 6825 Tomken Road, Mississauga, ON L5T 1N4, Canada;
| | - Dominique Arseneau-Bruneau
- Peel Regional Paramedic Services, Fernforest Division, 1600 Bovaird Drive East, Brampton, ON L6R 4R5, Canada;
| | - Alan M. Batt
- Faculty of Health Sciences, Queen’s University, 99 University Avenue, Kingston, ON K7L 3N6, Canada;
- Department of Paramedicine, Monash University, Building H, 47-49 Moorooduc Hwy, Frankston, VIC 3199, Australia
| | - Elizabeth A. Donnelly
- School of Social Work, The University of Windsor, 167 Ferry Street, Windsor, ON N9A 0C5, Canada;
| |
Collapse
|
14
|
Chazel M, Alonso S, Price J, Kabani S, Demattei C, Fabbro-Peray P. Violence against nurses in the emergency department: an observational study. BMJ Open 2023; 13:e067354. [PMID: 37015789 PMCID: PMC10083775 DOI: 10.1136/bmjopen-2022-067354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the number and risk factors of violent events encountered in the emergency department. An observation grid was developed following interviews with emergency department staff to target the most pertinent information to collect in a prospective study design. DESIGN Observational study. SETTING Emergency department of a tertiary hospital in France. OUTCOME MEASURES Number of violent events occurring during a single shift, recorded over 6 months by two observers. Information collected included time and date of incident; number of male/female staff; number of patients and accompaniers present in the service and the waiting room and length of staff debriefing. Perpetrator, victim and patient information were collected. Victims were followed-up 72 hours later. RESULTS Eighty-two periods were observed between November 2015 and April 2016 recording 35 violent incidents affecting 37 perpetrators and 48 victims, equally distributed over the days of the week and months of the year. The median interval until violence was 0 [0-96] min from entry. Eight (23%) events were officially reported, with two (6%) resulting in charges being pressed. No risk factors were significantly associated with violent incidents in multivariate analysis, although there was a tendency towards significance for fewer senior female doctors present (p=0.0787) and a resulting longer debriefing session (p=0.0712). CONCLUSIONS We confirm the high rate of violence in the emergency department and poor level of official reporting. Strategies should be implemented to anticipate and reduce incidence and encourage reporting by affected staff. TRIAL REGISTRATION NUMBER NCT02116439.
Collapse
Affiliation(s)
- Muriel Chazel
- Department of Cardiology, Centre Hospitalier Universitaire de Nimes, Nimes, Languedoc-Roussillon, France
| | - Sandrine Alonso
- Department of Biostatistics, Clinical Epidemiology, Public Health and Innovation in Methodology (BESPIM), Centre Hospitalier Universitaire de Nimes, Nimes, Languedoc-Roussillon, France
| | - Jane Price
- Nursing Department, Centre Hospitalier Universitaire de Nimes, Nimes, Languedoc-Roussillon, France
| | - Sarah Kabani
- Department of Biostatistics, Clinical Epidemiology, Public Health and Innovation in Methodology (BESPIM), Centre Hospitalier Universitaire de Nimes, Nimes, France
| | - Christophe Demattei
- Department of Biostatistics, Clinical Epidemiology, Public Health and Innovation in Methodology (BESPIM), Centre Hospitalier Universitaire de Nimes, Nimes, Languedoc-Roussillon, France
| | - Pascale Fabbro-Peray
- Department of Biostatistics, Clinical Epidemiology, Public Health and Innovation in Methodology (BESPIM), Centre Hospitalier Universitaire de Nimes, Nimes, Languedoc-Roussillon, France
| |
Collapse
|
15
|
Maguire BJ, O'Neill BJ, Al Amiry A. A Cohort Study of Occupational Fatalities among Paramedicine Clinicians: 2003 through 2020. Prehosp Disaster Med 2023; 38:153-159. [PMID: 36880160 DOI: 10.1017/s1049023x23000250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
INTRODUCTION/STUDY OBJECTIVES Emergency medical technicians (EMTs) and paramedics respond to 40 million calls for assistance every year in the United States; these paramedicine clinicians are a critical component of the nation's health care, disaster response, public safety, and public health systems. The study objective is to identify the risks of occupational fatalities among paramedicine clinicians working in the United States. METHODS To determine fatality rates and relative risks, this cohort study focused on 2003 through 2020 data of individuals classified as EMTs and paramedics by the United States Department of Labor (DOL). Data provided by the DOL and accessed through its website were used for the analyses. The DOL classifies EMTs and paramedics who have the job title of fire fighter as fire fighters and so they were not included in this analysis. It is unknown how many paramedicine clinicians employed by hospitals, police departments, or other agencies are classified as health workers, police officers, or other and were not included in this analysis. RESULTS An average of 206,000 paramedicine clinicians per year were employed in the United States during the study period; approximately one-third were women. Thirty percent (30%) were employed by local governments. Of the 204 total fatalities, 153 (75%) were transportation-related incidents. Over one-half of the 204 cases were classified as "multiple traumatic injuries and disorders." The fatality rate for men was three-times higher than for women (95% confidence interval [CI], 1.4 to 6.3). The fatality rate for paramedicine clinicians was eight-times higher than the rate for other health care practitioners (95% CI, 5.8 to 10.1) and 60% higher than the rate for all United States workers (95% CI, 1.24 to 2.04). CONCLUSIONS Approximately 11 paramedicine clinicians are documented as dying every year. The highest risk is from transportation-related events. However, the methods used by the DOL for tracking occupational fatalities means that many cases among paramedicine clinicians are not included. A better data system, and paramedicine clinician-specific research, are needed to inform the development and implementation of evidence-based interventions to prevent occupational fatalities. Research, and the resulting evidence-based interventions, are needed to meet what should be the ultimate goal of zero occupational fatalities for paramedicine clinicians in the United States and internationally.
Collapse
Affiliation(s)
- Brian J Maguire
- Leidos, Reston, VirginiaUSA
- School of Health, Medical, and Applied Sciences, Central Queensland University, New London, ConnecticutUSA
| | - Barbara J O'Neill
- School of Nursing, University of Connecticut, Storrs, Connecticut USA; School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Australia
| | - Ala'a Al Amiry
- College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| |
Collapse
|
16
|
Mausz J, Donnelly EA. Violence Against Paramedics: Protocol for Evaluating 2 Years of Reports Through a Novel, Point-of-Event Reporting Process. JMIR Res Protoc 2023; 12:e37636. [PMID: 36928257 PMCID: PMC10131719 DOI: 10.2196/37636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 12/05/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Violence against paramedics has been described as a serious public health problem with the potential for significant physical and psychological harm, but the organizational culture within the profession encourages paramedics to consider violence as just "part of the job." Therefore, most incidents of violence are never formally documented. This limits the ability of researchers and policy makers to develop strategies that mitigate the risk and enhance paramedic safety. OBJECTIVE Following the development and implementation of a novel, point-of-event violence reporting process in February 2021, our objectives are to (1) estimate the prevalence of violence and generate a descriptive profile for incidents of reported violence; (2) identify potentially high-risk service calls based on characteristics of calls that are generally known to the responding paramedics at the point of dispatch; and (3) explore underpinning themes, including intolerance based on gender, race, and sexual orientation, that contribute to incidents of violence. METHODS Our work is situated in a single paramedic service in Ontario, Canada. Using a convergent parallel mixed methods approach, we will retrospectively review 2 years of quantitative and qualitative data gathered from the External Violence Incident Report (EVIR) system from February 1 2021 through February 28, 2023. The EVIR is a point-of-event reporting mechanism embedded in the electronic patient care record (ePCR) developed through an extensive stakeholder engagement process. When completing an ePCR, paramedics are prompted to file an EVIR if they experienced violence on the call. Our methods include using descriptive statistics to estimate the prevalence of violence and describe the characteristics of reported incidents (Objective 1), logistic regression modeling to identify high-risk service calls (Objective 2), and qualitative content analysis of incident report narratives to identify underpinning themes that contribute to violence (Objective 3). RESULTS As of January 1, 2023, 377 paramedics-approximately 1 in 5 active-duty paramedics in the service-have filed a total of 975 violence reports. Early analysis suggests 40% of reports involved a physical assault on the reporting paramedic. Our team is continuing to collect data with more fulsome analyses beginning in March 2023. Our findings will provide much-needed epidemiological data on the prevalence of violence against paramedics in a single paramedic service, its contributing themes, and potential risk factors. CONCLUSIONS Our findings will contribute to a growing body of literature demonstrating that violence against paramedics is a complex problem that requires a nuanced understanding of its scope, risk factors, and contributing circumstances. Collectively, our research will inform larger, multisite prospective studies already in the planning stage and inform organizational strategies to mitigate the risk of harm from violence. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/37636.
Collapse
Affiliation(s)
- Justin Mausz
- Peel Regional Paramedic Services, Brampton, ON, Canada
| | | |
Collapse
|
17
|
Hokee MY, Makkink AW, Vincent-Lambert C. Workplace violence against paramedic personnel: a protocol for a scoping review. BMJ Open 2023; 13:e067246. [PMID: 36639208 PMCID: PMC9843223 DOI: 10.1136/bmjopen-2022-067246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION There is evidence to suggest that violence against paramedic personnel is increasing. Several authors report adverse effects linked to exposure to workplace violence. There remain gaps in the knowledge related to specific aspects of workplace violence experienced by paramedics in the prehospital setting. METHODS AND ANALYSIS This scoping review will consider evidence relating to workplace violence against paramedic personnel. All types of evidence will be considered, including quantitative and qualitative studies, systematic reviews, opinion papers, grey literature, text and papers as well as unpublished materials. This scoping review will be designed and conducted in accordance with the JBI methodology for scoping reviews. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews will guide the reporting process. Sources will include ERIC, Scopus, PubMed, CINAHL, Cochrane Library, ScienceDirect, Web of Science, Sabinet and the DOAJ as well as OpenGrey (https://opengrey.eu/). All sources published in English will be considered for inclusion and no date limit will be applied. The searching of the databases will begin 16 January 2023 and will be concluded by 30 January 2023. Three independent reviewers will conduct the study selection and data extraction process. In the event of disagreement related to a particular source, this will be resolved by discussion. The findings of the proposed review will be presented in a narrative style that uses diagrams and tables for reporting. ETHICS AND DISSEMINATION This scoping review will use published literature available in the public domain and will involve no participants, meaning that ethical approval is not required. The findings of the proposed review will be published in topic relevant peer-reviewed journals and will be presented at associated conferences.
Collapse
Affiliation(s)
- Muhammad Yaaseen Hokee
- Department of Emergency Medical Care, University of Johannesburg - Doornfontein Campus, Johannesburg, Gauteng, South Africa
| | - Andrew William Makkink
- Department of Emergency Medical Care, University of Johannesburg - Doornfontein Campus, Johannesburg, Gauteng, South Africa
| | - Craig Vincent-Lambert
- Department of Emergency Medical Care, University of Johannesburg - Doornfontein Campus, Johannesburg, Gauteng, South Africa
| |
Collapse
|
18
|
Alacahan ÖF, Güllüoğlu AN, Karagöz N. Occupational safety perceptions of prehospital emergency health services employees: A sample of Sivas central district. Work 2023; 76:1441-1453. [PMID: 37393470 DOI: 10.3233/wor-220425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND Prehospital emergency health services ambulance workers are in the risky class in terms of occupational health and safety, and they are faced with more risks due to the fact that they are the first responders to the events, especially regarding COVID-19. OBJECTIVE The aim of the present study is to determine the occupational risk perceptions of health care workers and their relations with demographic variables. METHODS A literature review was performed to develop a questionnaire. This questionnaire was used in a survey with 250 respondents. The collected data was analysed through factor analysis. Cronbach's Alpha was calculated to verify the reliability of the data. RESULTS The risk perceptions of the employees (Factor 1 and Factor 3) differ significantly according to gender. Another important point is that 60.3% of the participants stated that they "agree" with the statement that health workers "experience violence" during work. CONCLUSION The risk perception of women was found to be higher, and the reason for this is that women are less physically strong than men along with social gender roles and gender discrimination.
Collapse
Affiliation(s)
| | - Arif Nihat Güllüoğlu
- Metallurgy and Materials Engineering Department, Faculty of Engineering, Marmara University, Istanbul, Turkey
| | - Naim Karagöz
- Public Health Department, School of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
| |
Collapse
|
19
|
Grant SL, Hartanto S, Sivasubramaniam D, Heritage K. Occupational violence and aggression in urgent and critical care in rural health service settings: A systematic review of mixed studies. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3696-e3715. [PMID: 36165419 PMCID: PMC10086783 DOI: 10.1111/hsc.14039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 07/27/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Rural/remote health services are vulnerable to occupational violence and aggression due to factors such as weapon accessibility, poor network coverage and distance to backup. This systematic review investigated (1) the nature of occupational violence and aggression perpetrated in rural/remote health service urgent care settings and (2) the availability and effectiveness of policies/interventions/recommendations that address occupational violence and aggression in this context. We searched Business Source Complete, CINAHL Complete, Health & Society, APAIS Health, Health Collection, PsycINFO, PubMed, Scopus, SocIndex and Web of Science. Included articles (peer-reviewed, no grey literature and English language) addressed occupational violence and aggression in rural health service urgent care settings. Fifteen articles matched these criteria (total [rural/remote only, where specified] N ~ 2555) and were included in the final analysis. The Mixed Methods Appraisal Tool was applied to assess the risk of bias. A data extraction table and narrative synthesis are presented. The most common occupational violence and aggression type was verbal aggression. The primary perpetrator was patients. Risk factors reflected practitioner age, remoteness, sector, staffing, shift type and area of practice. Precipitating factors were alcohol/drugs, dissatisfaction and mental health conditions. Policy content and limitations and education/training programme effectiveness were not addressed. Community collaboration supported occupational violence and aggression prevention/management. Organisational culture should promote reporting, debriefing and post-incident care for staff well-being. Work environment and job/task design are priorities for safety, but with possible limitations for traumatised clients. Occupational violence and aggression policies/interventions in rural health settings must be systematically evaluated to inform best practices. Co-funded by Swinburne Social Innovation Research Institute Interdisciplinary Seed Funding Scheme and SMART Rural Health Network.
Collapse
Affiliation(s)
- Sharon L. Grant
- Department of Psychological SciencesSwinburne University of TechnologyHawthornVictoriaAustralia
| | | | - Diane Sivasubramaniam
- Department of Psychological SciencesSwinburne University of TechnologyHawthornVictoriaAustralia
| | - Kaye Heritage
- Institute of Health and WellbeingFederation University AustraliaBallaratVictoriaAustralia
| |
Collapse
|
20
|
Nurse, Provider, and Emergency Department Technician: Perceptions and Experiences of Violence and Aggression in the Emergency Department. J Emerg Nurs 2022; 49:431-440. [PMID: 36180265 DOI: 10.1016/j.jen.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Patient/visitor violence and aggression (V&A) in the emergency department occurs daily. Few interventions exist to decrease V&A. Research describing prevalence, severity, and perceived safety among ED clinicians is limited. METHODS A descriptive survey explored V&A against ED clinicians in one urban emergency department. A sample of nurses, ED technicians, physicians and advanced practice providers participated. Participants completed a demographic survey, Personal Workplace Safety Instrument for Emergency Nurses (PWSI-EN), and ENA V&A frequency checklist. Analysis of Variance (ANOVA) for unadjusted and Analysis of Covariance (ANCOVA) for adjusted associations were used to assess differences in the PWSI-EN survey composite score and "feeling safe in the ED" among ED roles. ANCOVA was adjusted for potential confounders: sex, race, years working in emergency department, and shift worked. RESULTS Sixty-five (46.4%) of the 140 ED clinicians returned surveys, which were almost evenly distributed between ED clinician roles and sex. Mean age was 37.2 (range: 21-64) years. All (100%) nurses and providers reported being verbally abused. More nurses reported physical violence (n = 21, 87.5%) than providers (n = 7, 36.8%) and ED technicians (n = 11, 55%). Nurses and ED technicians reported experiencing greater prevalence of physical violence than providers (p < .05). Nurses (mean 3.29, range 2.95 to 3.63) were more fearful for their personal safety than ED technicians (mean 3.88, range 3.48 to 4.28) (p < .03). DISCUSSION V&A are common creating a fearful environment. However, little research regarding clinician perceptions exists. Our study aids in identifying areas for clinician-targeted strategies to prevent ED V&A.
Collapse
|
21
|
Hou Y, Corbally M, Timmins F. Violence against nurses by patients and visitors in the emergency department: A concept analysis. J Nurs Manag 2022; 30:1688-1699. [PMID: 35700325 PMCID: PMC9795924 DOI: 10.1111/jonm.13721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 06/10/2022] [Accepted: 06/13/2022] [Indexed: 12/30/2022]
Abstract
AIM This analysis investigates the concept of violence against nurses by patients and visitors in the emergency department. It aims to differentiate, clarify, and clearly identify this specific concept, which will facilitate more apt measurement and reporting, ultimately to contribute violence reduction measures. BACKGROUND Due to contextual factors, occupational risk and patient characteristics, violence against nurses by patients and visitors in the emergency department varies from other types of violence against other health care staff. METHODS This study employed Walker and Avant's concept analysis technique. RESULTS The analysis found that violence against nurses by patients and visitors in the emergency department is primarily an occurrence of interpersonal violence based on the working relationship, whereby the patient and/or visitor becomes an assailant, and a nurse becomes a target in the absence of capable guardianship. There is also an intentional use of physical force or power, which results in or has a high chance of causing harm. CONCLUSION A clearer understanding of the antecedents, attributes, and consequences of violence against nurses by patients and visitors arising from this concept analysis provides a framework that will assist in the understanding, measurement, reporting, and prevention of violence and inform future research. IMPLICATIONS FOR NURSING MANAGEMENT Nursing managers are encouraged to adopt strategies that act on the factors related to attributes and antecedents that will serve to reduce the occurrence of intentional violent acts.
Collapse
Affiliation(s)
- Yongchao Hou
- Emergency DepartmentShanXi Provincial People's HospitalTaiyuanShanXiChina
| | - Melissa Corbally
- School of Nursing and MidwiferyTrinity College DublinDublinIreland
| | - Fiona Timmins
- School of Nursing, Midwifery & Health SystemsUniversity College DublinDublinIreland
| |
Collapse
|
22
|
Sheikhbardsiri H, Afshar PJ, Baniasadi H, Farokhzadian J. Workplace Violence Against Prehospital Paramedic Personnel (City and Road) and Factors Related to This Type of Violence in Iran. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP11683-NP11698. [PMID: 33107378 DOI: 10.1177/0886260520967127] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Medical personnel such as those working in emergency medical systems are in direct contact with the patient or the injured and are exposed to workplace violence. This study aimed to determine workplace violence against prehospital paramedical personnel and factors related to this type of violence in Iran. The cross-sectional study was conducted in 72 prehospital emergency centers affiliated with Kerman University of Medical Sciences in 2019. Using a researcher-made questionnaire, we assessed workplace violence and factors associated with this type of violence in prehospital paramedical personnel with a census method (N = 308). Data were analyzed using descriptive statistics including mean and standard deviation (SD), frequency, percentage, and analytic statistics, such as the Kolmogorov-Smirnov, ANOVA, t test, and multiple linear regression tests. The results of this study showed that the most frequent types of workplace violence were verbal violence (47%), physical violence (32.50%), cultural violence (16%), and no violence (4.50%), respectively. From the perspective of paramedical personnel, the total mean score of workplace violence was at a moderate level (52.19 ± 10.72). The most important factors affecting workplace violence from the perspective of paramedical personnel were "lack of awareness of people about the duties of emergency medical personnel" and "lack of specialists in prehospital (city or road) bases." Majority of the paramedical personnel believed that "no reaction and observance of patients and their families' rights" were the most important types of reactions. They also believed that violence was normal at the workplace and should not be considered in emergency medical services. Results suggest that national and local policies in Iran should provide prehospital paramedical personnel with various training courses about how to decrease the rate of workplace violence, promote public health, and decrease their psychological stresses and occupational burnout.
Collapse
|
23
|
NJ EMS Line of Duty Deaths. J Occup Environ Med 2022; 64:573-577. [DOI: 10.1097/jom.0000000000002524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
24
|
Saudi female paramedics' perceptions of challenges in the workplace: A qualitative study. Int Emerg Nurs 2022; 63:101176. [PMID: 35738056 DOI: 10.1016/j.ienj.2022.101176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/23/2022] [Accepted: 05/04/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND It is immensely important that Saudi women become involved in the field of paramedicine in larger numbers; however, anecdotally they continue to experience significant challenges that limit their opportunities for recruitment and deployment in the field. This study set out to explore working female paramedics' perceptions of challenges in their workplace in the Kingdom of Saudi Arabia (KSA). METHODS This study utilised a descriptive qualitative approach. Fifteen Saudi female paramedics were recruited to attend one of four focus groups in Riyadh, Saudi Arabia. Data were assessed using thematic analysis. RESULTS Three themes emerged from the focus groups that described the perceptions of Saudi female paramedics: personal factors, social factors and employment-related factors. They faced several challenges that could affect their family responsibilities, workplace duties and capacity to work in the field of paramedicine. Saudi society also challenged female paramedics, as the culture and traditions of the KSA limited their participation in the paramedicine workforce. Furthermore, they reported experiencing many employment issues related to recruitment to pre-hospital settings, resulting from organisational policies and procedures. CONCLUSION This study investigated the perceptions held by a cohort of female Saudi paramedics of the personal and professional challenges they faced in the workplace in the KSA. The study findings and their implications for female paramedics suggest further research is required to understand the unique challenges they face and to develop various strategies to manage them.
Collapse
|
25
|
Garner DG, DeLuca MB, Crowe RP, Cash RE, Rivard MK, Williams JG, Panchal AR, Cabanas JG. Emergency medical services professional behaviors with violent encounters: A prospective study using standardized simulated scenarios. J Am Coll Emerg Physicians Open 2022; 3:e12727. [PMID: 35475121 PMCID: PMC9023872 DOI: 10.1002/emp2.12727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 03/07/2022] [Accepted: 03/18/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction To evaluate emergency medical services (EMS) professional response to escalating threats of violence during simulated patient encounters and describe differences in behaviors by characteristics. Methods EMS professionals of a large county‐based system participated in 1 of 4 standardized patient care scenarios. Each 8‐minute scenario included escalated threats of violence such that EMS personnel should escape the scene for safety. Trained evaluators recorded EMS professionals' performance using standardized data elements. Outcomes included EMS personnel escape and verbal de‐escalation attempts. Descriptive statistics and univariable odds ratios (OR) with 95% confidence intervals (95% CI) are reported. Results There were 270 EMS professionals evaluated as individual members of 2‐person crews. Overall, 54% escaped the unsafe scene and 54% made an adequate de‐escalation attempt; 20% did not make an adequate de‐escalation attempt nor escape the unsafe scene. Paramedics demonstrated lower odds of escaping compared to emergency medical technicians (OR: 0.40; 95% CI: 0.17–0.94), yet greater odds of adequate de‐escalation (OR: 3.17, 95% CI: 1.38–7.31). EMS professionals with more than 20 years of experience (OR: 0.32, 95% CI: 0.13–0.79, ref:2 years or less) and those with military experience (OR: 0.37; 95% CI: 0.17–0.81) demonstrated reduced odds of escaping. Crisis intervention team (CIT) training was associated with reduced odds of escape (OR: 0.38; 95% CI: 0.21–0.69), but increased odds of adequate de‐escalation (OR: 2.19; 95% CI: 1.19–4.04). Conclusions Nearly half of EMS professionals did not remove themselves from a simulated patient care scenario with an escalating threat of physical violence. EMS‐specific training for de‐escalation as a first‐line technique, recognizing imminent violence, and leaving a dangerous environment is needed.
Collapse
Affiliation(s)
- Donald G. Garner
- Wake County Government Emergency Medical Services Raleigh North Carolina USA
| | - Mallory B. DeLuca
- Wake County Government Emergency Medical Services Raleigh North Carolina USA
| | | | - Rebecca E. Cash
- Massachusetts General Hospital Department of Emergency Medicine Boston Massachusetts USA
| | | | - Jefferson G. Williams
- Wake County Government Emergency Medical Services Raleigh North Carolina USA
- University of North Carolina Department of Emergency Medicine Chapel Hill North Carolina USA
| | - Ashish R. Panchal
- National Registry of Emergency Medical Technicians Columbus Ohio USA
- Wexner Medical Center, Department of Emergency Medicine The Ohio State University Columbus Ohio USA
| | - Jose G. Cabanas
- Wake County Government Emergency Medical Services Raleigh North Carolina USA
- University of North Carolina Department of Emergency Medicine Chapel Hill North Carolina USA
| |
Collapse
|
26
|
Thomas B, O'Meara P, Edvardsson K, McCann D, Spelten E. Perpetrator and situational characteristics associated with security alerts in regional Australian emergency departments. BMC Emerg Med 2022; 22:48. [PMID: 35331156 PMCID: PMC8943498 DOI: 10.1186/s12873-022-00608-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 03/15/2022] [Indexed: 11/24/2022] Open
Abstract
Background Workplace violence is a regular feature of emergency departments (ED) and reported to be increasing in frequency and severity. There is a paucity of data from regional EDs in Australia. The aim of this study was to identify the perpetrator and situational characteristics associated with security alerts in regional emergency departments. Methods This retrospective descriptive study was conducted in two regional Australian hospital EDs. All incident reports, hospital summary spreadsheets, and patient medical records associated with a security alert over a two-year period (2017 - 2019) were included. The situational and perpetrator characteristics associated with security alerts in the ED were recorded. Results One hundred fifty-one incidents were reported in the two-year period. Incidents most frequently occurred on late shifts and in an ED cubicle. Most incidents included multiple disciplines such as ED staff and paramedics, police and psychiatric services. One hundred twenty-five incidents had sufficient information to categorise the perpetrators. Mental and behavioural disorders (MBD) were the most frequent perpetrator characteristic present in security alerts (n = 102, 81.6%) and were associated with increased severity of incidents. MBDs other than psychoactive substance use (PSU) were associated with 59.2% (n = 74) of incidents and 66.7% (n = 18) of injuries. PSU was associated with 42.4% (n = 53) of incidents. Following PSU and MBDs other than PSU, repeat perpetrators were the next most prominent perpetrator category (24.8% n = 31) and were almost always associated with an MBD (93.5% n = 29). Conclusions Violence incidents in the ED are often complex, patients present with multiple issues and are managed across disciplines. Interventions need to extend from one size fits all approaches to targeting specific perpetrator groups. Since MBDs are one of the most significant perpetrator factors, interventions focussing on this characteristic are needed to address workplace violence in EDs.
Collapse
Affiliation(s)
- Brodie Thomas
- La Trobe Rural Health School, La Trobe University, Mildura, Australia.
| | - Peter O'Meara
- Department of Paramedicine, Monash University, Frankston, Australia
| | - Kristina Edvardsson
- School of Nursing and Midwifery, La Trobe University, Bundoora, Australia.,Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - Damhnat McCann
- School of Nursing, University of Tasmania, Launceston, Australia
| | - Evelien Spelten
- La Trobe Rural Health School, La Trobe University, Mildura, Australia
| |
Collapse
|
27
|
Jacob A, Van Vuuren J, Kinsman L, Spelten E. Daily reality of violence in a rural emergency department: Is violence becoming the new normal? Emerg Med Australas 2022; 34:555-558. [PMID: 35212148 DOI: 10.1111/1742-6723.13942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/05/2021] [Accepted: 01/10/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Violence in emergency healthcare is a persistent and concerning problem. The objective of the present study was to explore and understand rural nurses' views on the daily experience and impact of violence, and its perpetrators. METHODS The present study took a descriptive exploratory approach. Two focus groups were held with nurses from an ED at a rural hospital in New South Wales, Australia. RESULTS Violence occurred regularly and had a significant impact on staff. Nurses go to work expecting to search patients for weapons and be physically and verbally abused. Tolerating and being able to manage violence has become a rite of passage. CONCLUSIONS The present study shows that rural workers, like metropolitan workers, feel experiences of violence are a routine part of their roles. Violence in healthcare is a societal issue, that cannot be solved without a multifactor approach that considers the characteristics of the perpetrators.
Collapse
Affiliation(s)
- Alycia Jacob
- Murtupuni Centre for Rural and Remote Health, James Cook University, Mount Isa, Queensland, Australia.,Faculty of Nursing, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Julia Van Vuuren
- Department of Public Health, Latrobe University, Melbourne, Victoria, Australia
| | - Leigh Kinsman
- Faculty of Nursing and Midwifery, The University of Newcastle, Newcastle, New South Wales, Australia.,Mid North Coast Local Health District, Coffs Harbour, New South Wales, Australia
| | - Evelien Spelten
- Department of Public Health, Latrobe University, Bendigo, Victoria, Australia
| |
Collapse
|
28
|
Caruso R, Toffanin T, Folesani F, Biancosino B, Romagnolo F, Riba MB, McFarland D, Palagini L, Belvederi Murri M, Zerbinati L, Grassi L. Violence Against Physicians in the Workplace: Trends, Causes, Consequences, and Strategies for Intervention. Curr Psychiatry Rep 2022; 24:911-924. [PMID: 36445636 PMCID: PMC9707179 DOI: 10.1007/s11920-022-01398-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/07/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Violence against healthcare professionals has become an emergency in many countries. Literature in this area has mainly focused on nurses while there are less studies on physicians, whose alterations in mental health and burnout have been linked to higher rates of medical errors and poorer quality of care. We summarized peer-reviewed literature and examined the epidemiology, main causes, consequences, and areas of intervention associated with workplace violence perpetrated against physicians. RECENT FINDINGS We performed a review utilizing several databases, by including the most relevant studies in full journal articles investigating the problem. Workplace violence against doctors is a widespread phenomenon, present all over the world and related to a number of variables, including individual, socio-cultural, and contextual variables. During the COVID-19 pandemic, incidence of violence has increased. Data also show the possible consequences in physicians' deterioration of quality of life, burnout, and traumatic stress which are linked to physical and mental health problems, which, in a domino effect, fall on patients' quality of care. Violence against doctors is an urgent global problem with consequences on an individual and societal level. This review highlights the need to undertake initiatives aimed at enhancing understanding, prevention, and management of workplace violence in healthcare settings.
Collapse
Affiliation(s)
- Rosangela Caruso
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Via Fossato di Mortara 64a, 44121 Ferrara, Italy ,Integrated Department of Mental Health and Pathological Addictions, S. Anna University Hospital and Local Health Trust, Ferrara, Italy
| | - Tommaso Toffanin
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Via Fossato di Mortara 64a, 44121 Ferrara, Italy
| | - Federica Folesani
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Via Fossato di Mortara 64a, 44121, Ferrara, Italy.
| | - Bruno Biancosino
- Integrated Department of Mental Health and Pathological Addictions, S. Anna University Hospital and Local Health Trust, Ferrara, Italy
| | - Francesca Romagnolo
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Via Fossato di Mortara 64a, 44121 Ferrara, Italy
| | - Michelle B. Riba
- Department of Psychiatry, University of Michigan, Ann Arbor, MI USA
| | - Daniel McFarland
- Department of Medicine, Northwell Health Cancer Institute, Lenox Hill Hospital, New York, NY USA
| | - Laura Palagini
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Via Fossato di Mortara 64a, 44121 Ferrara, Italy ,Integrated Department of Mental Health and Pathological Addictions, S. Anna University Hospital and Local Health Trust, Ferrara, Italy
| | - Martino Belvederi Murri
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Via Fossato di Mortara 64a, 44121 Ferrara, Italy ,Integrated Department of Mental Health and Pathological Addictions, S. Anna University Hospital and Local Health Trust, Ferrara, Italy
| | - Luigi Zerbinati
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Via Fossato di Mortara 64a, 44121 Ferrara, Italy ,Integrated Department of Mental Health and Pathological Addictions, S. Anna University Hospital and Local Health Trust, Ferrara, Italy
| | - Luigi Grassi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Via Fossato di Mortara 64a, 44121 Ferrara, Italy ,Integrated Department of Mental Health and Pathological Addictions, S. Anna University Hospital and Local Health Trust, Ferrara, Italy
| |
Collapse
|
29
|
Kearney J, Muir C, Smith K. Occupational injury among paramedics: a systematic review. Inj Prev 2021; 28:175-184. [PMID: 34972683 DOI: 10.1136/injuryprev-2021-044405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 12/10/2021] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Paramedics are frequently exposed to acute and/or chronic environmental, operational and patient-related factors that increase their risk of physical and psychological injury. However, there has been wide variation in reported paramedic injury rates. This systematic review aims to synthesise the evidence to examine the incidence and nature of occupational injury among paramedics. METHODS This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO 2020: CRD42020164556). A systematic search of four electronic databases was conducted for the years 2004-2019. Peer-reviewed studies examining the incidence and proportions of paramedic occupational injury within civilian emergency medical services (EMS) were included. Injury types, mechanisms, contributing factors and incidence of injury were synthesised narratively. RESULTS Twelve studies met the inclusion criteria. The incidence of injury ranged from 29.7 to 345.6 injuries per 1000 workers per year. Sprains and strains were the most reported injury types, and the trunk and upper limbs were the main sites. Body motion was the most frequently reported mechanism of injury, accounting for 35%-55% of all injuries. Female paramedics had a proportionally higher rate of injury compared with male paramedics. Paramedics aged 25-34 years accounted for the majority of fatal (mean 34.0%) and non-fatal (mean 51.7%) injuries. CONCLUSION This review highlights the increased risk of occupational injury among paramedics and provides further insight into their overall injury profile.
Collapse
Affiliation(s)
- Jason Kearney
- Monash University Accident Research Centre, Monash University, Clayton, Victoria, Australia
| | - Carlyn Muir
- Monash University Accident Research Centre, Monash University, Clayton, Victoria, Australia
| | - Karen Smith
- Research and Evaluation, Ambulance Victoria, Melbourne, Victoria, Australia
| |
Collapse
|
30
|
Afshari A, Borzou SR, Shamsaei F, Mohammadi E, Tapak L. Emergency Medical Service Providers' Perception of Health-Threatening Stressors in Emergency Missions: A qualitative Study. Ethiop J Health Sci 2021; 31:517-524. [PMID: 34483608 PMCID: PMC8365476 DOI: 10.4314/ejhs.v31i3.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 01/12/2021] [Indexed: 11/26/2022] Open
Abstract
Background Unknown and unpredictable situations cause emergency medical service (EMS) providers to experience various stressful factors. These factors are affected by sociocultural conditions and expectations of the casualty and affect EMS providers' performance and health at the incident scene. The present study was conducted to explore EMS providers' perception of stressful and health-threatening factors in emergency missions. Method This qualitative conventional content analysis was conducted in 2020. The participants included 16 EMS providers working at the Emergency Medical Services Department in Hamadan Province, Iran. The participants were selected using purposive sampling and underwent semi-structured interviews until data saturation. Data were analyzed using the Graneheim and Lundman method. Results Analysis of the interview data yielded six subcategories (i.e., incident scene hazards, violence-related injuries, physical injuries caused by patient care/handling, ambulance crash-related injuries, emotional impact of patients' suffering and ailments, and highly stressful missions), two main categories (i.e., physical injuries and psychological tensions), and a theme of occupational injuries. Conclusions According to the results, in addition to having concerns about caring for patients and saving the injured, EMS providers also worry about potential threats to their own health. The present study identified and described some major stressors in emergency missions. Thus, for a better and more effective efficiency, the present study results can be used to reduce or modify stressors in EMS providers.
Collapse
Affiliation(s)
- Ali Afshari
- Nursing and Midwifery School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Reza Borzou
- Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Farshid Shamsaei
- Maternal and Child Care Research Center, Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Eesa Mohammadi
- Faculty of Medical Sciences, Nursing Department, Tarbiat Modares University, Tehran, Iran
| | - Leili Tapak
- Department of Biostatistics, School of Public Health, Modeling of Noncommunicable diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
31
|
Self-reported incidence of verbal and physical violence against emergency medical services (EMS) personnel in Singapore. Australas Emerg Care 2021; 24:230-234. [DOI: 10.1016/j.auec.2020.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/31/2020] [Accepted: 09/06/2020] [Indexed: 11/19/2022]
|
32
|
Afshari A, Borzou SR, Shamsaei F, Mohammadi E, Tapak L. Perceived occupational stressors among emergency medical service providers: a qualitative study. BMC Emerg Med 2021; 21:35. [PMID: 33757433 PMCID: PMC7988920 DOI: 10.1186/s12873-021-00430-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 03/12/2021] [Indexed: 01/23/2023] Open
Abstract
Introduction Emergency medical services (EMS) providers are at continuous exposure to occupational stressors which negatively affect their health and professional practice. This study explored perceived occupational stressors among EMS providers. Methods This qualitative study was conducted from December 2019 to April 2020 using conventional content analysis. Sixteen EMS providers were purposively selected from EMS stations in Hamadan, Iran. Semi-structured interviews (with length of 45–60 min) were held for data collection. Data were analyzed through Graneheim and Lundman’s conventional content analysis approach. Findings Data analysis resulted in the development of two themes, namely critical conditions of EMS provision, and personal and professional conflicts. The six categories of these two themes were complexity of patients’ clinical conditions, interruption of EMS provision, health hazards, interpersonal problems, interprofessional interactions, and legal conflicts. Conclusion Besides the stress associated with emergency patient care, EMS providers face many different occupational stressors. EMS managers can use the findings of the present study to develop strategies for reducing occupational stress among EMS providers and thereby, improve their health and care quality.
Collapse
Affiliation(s)
- Ali Afshari
- Nursing and Midwifery School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Reza Borzou
- Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Farshid Shamsaei
- Maternal and Child Care Research Center,Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Eesa Mohammadi
- Faculty of Medical Sciences, Nursing Department, Tarbiat Modares University, Tehran, Iran
| | - Leili Tapak
- Department of Biostatistics, School of Public Health, Modeling of Noncommunicable diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
33
|
Drew P, Tippett V, Devenish S. Paramedic occupational violence mitigation: a comprehensive systematic review of emergency service worker prevention strategies and experiences for use in prehospital care. Occup Environ Med 2021; 78:841-848. [PMID: 33658324 DOI: 10.1136/oemed-2020-107037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/23/2020] [Accepted: 12/30/2020] [Indexed: 11/03/2022]
Abstract
Occupational violence is a significant issue within the context of prehospital healthcare with the majority of paramedics reporting some form of abuse, intimidation, physical or sexual assault during their career. Though the paramedic literature acknowledges the severity of this issue, there is limited literature examining occupational violence mitigation strategies. Despite this, the operational and environmental similarities that exist between paramedics and other emergency service workers such as the police and firefighters, provide an opportunity to review relatable occupational violence mitigation strategies and experiences.This review used Joanna Briggs Institute guidance for systematic reviews of both qualitative evidence and effectiveness. Studies included in this review incorporated those published in English from 1990 to January 2020.Two qualitative studies met the criteria for review. From these, a total of 22 findings were extracted and combined to form four categories from which two syntheses were developed. Twenty-four quantitative studies, encompassing six unique fields, met the criteria for review.Mitigation strategies for emergency service worker occupational violence are not easily defined. They are dynamic, multilayered and encompass a variety of complex social, medical and psychological influences. In spite of this, there are clear benefits to their application in regard to the approaches and training of violence mitigation. The paramedic environment would benefit from strategies that are flexible to the ongoing needs of the workers and the specific cultural, environmental and social factors that encompass the paramedic organisation.
Collapse
Affiliation(s)
- Peter Drew
- Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Vivienne Tippett
- Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Scott Devenish
- Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| |
Collapse
|
34
|
Karlsson K, Nasic S, Lundberg L, Mårtensson J, Jonsson A. Health problems among Swedish ambulance personnel: long-term risks compared to other professions in Sweden - a longitudinal register study. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:1130-1135. [PMID: 33533685 DOI: 10.1080/10803548.2020.1867400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives. This study aimed to investigate whether Swedish ambulance personnel differ in the extent of suffering from health problems compared to other occupational groups. Methods. Two cohorts of ambulance personnel from 2001 and 2008, with 1778 and 2753 individuals, respectively, were followed regarding assignment of diagnostic coding (International Classification of Diseases codes) until 2016. These two cohorts represent all who were employed as ambulance personnel by public employers during these years. Two comparison groups were added: other healthcare workers and other professions. All data were retrieved from national registers. The χ2 test was were used for statistical calculation. Results. Swedish ambulance personnel are at a significantly higher risk of being affected by 'Paroxysmal tachycardia, atrial fibrillation and flutter, other cardiac arrhythmias', by 'Other intervertebral disc disorders' and by 'Arthropathies', when compared to both comparison groups in both cohorts. Almost similar results were seen for 'Gonarthrosis' and for 'Dorsopathies'. Conclusions. Swedish ambulance personnel run the risk of being affected by certain diseases and injuries to a greater extent compared to other professions.
Collapse
Affiliation(s)
- Kåre Karlsson
- Ambulance Services, Skaraborg Hospital, Sweden.,Research and Development Centre, Skaraborg Hospital, Sweden.,School of Health and Welfare, Jönköping University, Sweden
| | - Salmir Nasic
- Research and Development Centre, Skaraborg Hospital, Sweden
| | | | - Jan Mårtensson
- School of Health and Welfare, Jönköping University, Sweden
| | - Anders Jonsson
- School of Health Sciences, Borås University, Sweden.,The Swedish Armed Forces, Centre for Defence Medicine, Sweden
| |
Collapse
|
35
|
Thomas B, McGillion A, Edvardsson K, O'Meara P, Van Vuuren J, Spelten E. Barriers, enablers, and opportunities for organisational follow-up of workplace violence from the perspective of emergency department nurses: a qualitative study. BMC Emerg Med 2021; 21:19. [PMID: 33579206 PMCID: PMC7880205 DOI: 10.1186/s12873-021-00413-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 01/31/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND A lack of follow-up of violence incidents and assaulted staff has been associated with high levels of workplace violence. There is a paucity of literature on the barriers, enablers and opportunities for organisational follow-up of workplace violence. The aim of this study was to explore the barriers, enablers and opportunities for organisational follow-up of workplace violence from the perspective of Emergency Department nurses. METHODS This qualitative study comprised two focus groups with Emergency Department nurses. Data were analysed thematically. COREQ guidelines were followed for the design and reporting of the study. RESULTS The barriers to follow-up in this study relate to the type of perpetrator, the initial incident response, the incident reporting process and organisational action. The enablers included hospital initiatives to manage violence and support staff wellbeing. The opportunities included strategies to improve follow-up and ideas for new follow-up strategies. CONCLUSIONS Organisational follow-up is important for the emotional and professional wellbeing of staff who experience workplace violence. Opportunities for follow-up include exploring different approaches to patients with mental health issues and focussing on reoffenders by providing appropriate support and consequences. Managers should advocate for efficient and standardised reporting processes and ensure assaulted staff have a clear perception of follow-up and are included in the follow-up process. Including the perpetrators in the follow-up process may reduce workplace violence.
Collapse
Affiliation(s)
- Brodie Thomas
- La Trobe Rural Health School, La Trobe University, 471 Benetook Ave, Mildura, VIC, 3500, Australia.
| | - Anthony McGillion
- School of Nursing and Midwifery, La Trobe University, Plenty Rd & Kingsbury Dr, Bundoora, VIC, 3086, Australia
| | - Kristina Edvardsson
- School of Nursing and Midwifery, La Trobe University, Plenty Rd & Kingsbury Dr, Bundoora, VIC, 3086, Australia
- Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - Peter O'Meara
- Department of Emergency Health and Paramedic Practice, Monash University, McMahons Road, Frankston, VIC, 3199, Australia
| | - Julia Van Vuuren
- La Trobe Rural Health School, La Trobe University, 471 Benetook Ave, Mildura, VIC, 3500, Australia
| | - Evelien Spelten
- La Trobe Rural Health School, La Trobe University, 471 Benetook Ave, Mildura, VIC, 3500, Australia
| |
Collapse
|
36
|
Rahmani A, Dadashzadeh A, Hassankhani H, Boyle M, Mohammadi E, Campbell S. Iranian Nurses' Experiences of Workplace Violence in Prehospital Emergency Care: A Qualitative Study. Adv Emerg Nurs J 2021; 42:137-149. [PMID: 32358430 DOI: 10.1097/tme.0000000000000292] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Prehospital emergency care nurses experience severe workplace violence. However, despite the widespread violence they experience, this phenomenon has not been well studied among these nurses. Therefore, the purpose of this study was to explore the experiences of Iranian nurses working in prehospital setting regarding workplace violence with a focus on the factors leading to such violence. In this qualitative descriptive study, 23 prehospital nurses participated purposefully. The data were collected by individual face-to-face semistructured interviews and analyzed using content analysis methodology. Data analysis led to the identification of 4 main themes, including job competency mismatch, inadequate resources, criticality of the situation and circumstances, and inadequate awareness and misplaced expectations of society. These nurses have not completed specialized training courses, work in a system that is in a critical situation, and face many barriers and deficiencies in terms of intra- and interorganizational coordination. On the other hand, people in the community do not have sufficient awareness about the duties and services provided by prehospital nurses and thus have unrealistic expectations to receive services. The results showed that there was a deep gap between the prehospital emergency realities and public expectations, leading to workplace violence. Therefore, efforts to improve the working conditions of nurses with an emphasis on teaching specialized prehospital emergency courses, especially violence control courses, promoting intra- and interorganizational coordination, and increasing the equipment and personnel of ambulances for special missions, as well as raising the public awareness and outlining more realistic expectations, may reduce the prevalence of violence against prehospital nurses.
Collapse
Affiliation(s)
- Azad Rahmani
- Medical Education Research Center (Dr Rahmani), Nursing and Midwifery Faculty (Dr Dadashzadeh), and Center of Qualitative Studies, School of Nursing and Midwifery (Dr Hassankhani), Tabriz University of Medical Sciences, Tabriz, Iran; Medical-Surgical Department, Nursing & Midwifery Faculty, Tabriz, East Azerbaijan Province, Iran (Drs Rahmani and Hassankhani and Dr Dadashzadeh); Griffith University, School of Medicine, Queensland, Australia (Dr Boyle); Faculty of Medical Sciences, Nursing Department, Tarbiat Modares University, Tehran, Iran (Dr Mohammadi); and School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada (Dr Campbell)
| | | | | | | | | | | |
Collapse
|
37
|
Touriel R, Dunne R, Swor R, Kowalenko T. A Pilot Study: Emergency Medical Services-Related Violence in the Out-of-Hospital Setting in Southeast Michigan. J Emerg Med 2021; 60:554-559. [PMID: 33485743 DOI: 10.1016/j.jemermed.2020.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/03/2020] [Accepted: 12/06/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Emergency Medical Services (EMS) personnel in the out-of-hospital setting continue to be at high risk for violence, in spite of continued research on a national scale. OBJECTIVE Our aim was to determine the prevalence and type of violence perpetrated against Southeast Michigan EMS personnel, and characteristics of victims in the out-of-hospital setting. METHODS EMS personnel from urban and suburban counties in Southeastern Michigan were surveyed online about their experience with violence, including description and outcomes, while working in the out-of-hospital setting within the previous 6 months. Gift card incentive and recruitment scripts were provided and read to participants. This was a pilot study that was limited to 150 respondents and ran for 3 months. Descriptive statistical analysis was done with an odds ratio, p value, and two-sample independent t-test analysis. RESULTS There were 137 surveys respondents. Most respondents, 75 of 128 (58.6%) reported being a victim of violence within the previous 6 months. Perpetrators were primarily patients and occasionally family members. Substance abuse or mental health issues were frequently associated with violence. Although not common, women reported violence perpetrated by a coworker more often than men (odds ratio 5.17; 95% confidence interval 1.67-16.0). Only 55 of 117 respondents (47.0%) felt that the training did an adequate job protecting them from violence. CONCLUSIONS More than one-half of responding EMS personnel experienced work-related violence within the previous 6 months in Southeast Michigan. This high rate of violence supports the need for additional research and policies that ensure the safety of EMS providers in this region.
Collapse
Affiliation(s)
- Ross Touriel
- Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Robert Dunne
- Department of Emergency Medicine, St. John Hospital and Medical Center, Detroit, Michigan
| | - Robert Swor
- Department of Emergency Medicine, William Beaumont Hospital, Royal Oak, Michigan
| | - Terry Kowalenko
- Department of Emergency Medicine, William Beaumont Hospital, Royal Oak, Michigan
| |
Collapse
|
38
|
Çaltekin I, Hamamcı M. Is working in the emergency department a risk factor for sleep disorders for healthcare workers? Sleep Sci 2021; 14:129-135. [PMID: 34381576 PMCID: PMC8340894 DOI: 10.5935/1984-0063.20200051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE This study aims to investigate the relationship between work-related stress and sleep disorders in healthcare personnel working in emergency department and in other departments. MATERIAL AND METHODS This cross-sectional study included 34 emergency department healthcare personnel (emergency group [EG]) and 35 healthcare personnel working in other departments (non-emergency group [NEG]) and was conducted between November 10, 2019 and March 1, 2020. All participants were administered the following questionnaires: work-related strain inventory (WRSI), Epworth sleepiness scale (ESS), Berlin questionnaire, insomnia severity index (ISI), Pittsburgh sleep quality index (PSQI), Beck depression inventory (BDI), and Beck anxiety inventory (BAI). RESULTS While the mean WRSI score of EG was 39.53±7.77, the mean WRSI score of NEG was 30.06±7.26 (t=5.236, p<0.001). According to PSQI, 79.4% of EG and 57.1% of NEG were found to have poor sleep quality (X2=3.938, df=1, p=0.047). Median PSQI overall score was 12 (IQR 25th-75th percentiles: 10-14) in EG, and 7 (IQR 25th-75th percentiles: 4-9) in NEG (U=285.5, p<0.001). While the mean anxiety score of EG was 13.35±5.70, the mean anxiety score of NEG was 9.06±6.00 (t=3.046, p=0.003). Median depression score was 12 (IQR 25th-75th percentiles: 10-16) in EG, and was 8 (IQR 25th-75th percentiles: 4-12) in NEG (U=354, p=0.004). A significant positive correlation was found between work-related strain scores and sleep quality, sleepiness, and insomnia severity scores (r=0.541, p<0.001; r=0.310, p=0.010; r=0.357, p=0.004; respectively). CONCLUSION It was determined that healthcare personnel working in the emergency department were at higher risk of developing sleep disorders compared to healthcare personnel working in other departments and that there was a significant relationship between sleep disorders and work-related stress.
Collapse
Affiliation(s)
- Ibrahim Çaltekin
- Yozgat Bozok University Faculty of Medicine, Department of
Emergency Medicine - Yozgat - Center - Turkey. ,Corresponding author: Ibrahim
Çaltekin. E-mail:
| | - Mehmet Hamamcı
- Yozgat Bozok University Faculty of Medicine, Department of
Neurology - Yozgat - Center - Turkey
| |
Collapse
|
39
|
Amit-Aharon A, Warshawski S, Itzhaki M. Association Between Witnessing and Justifying Workplace Violence Towards Nurses in Israel. J Nurs Scholarsh 2020; 52:713-721. [PMID: 33085176 DOI: 10.1111/jnu.12603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Workplace violence perpetrated by patients and their families towards nurses has become a global problem. PURPOSE The present study explores associations between individuals' having witnessed violent incidents in the past and holding attitudes justifying violence in the present, and their intention to behave violently in a nurse-patient interaction at a healthcare facility. DESIGN A cross-sectional study sampled 1,350 participants from among the general public in Israel. METHODS A self-administered questionnaire measured attitudes regarding violence towards nurses and confronted the participants with two vignettes eliciting verbal and physical violence towards nurses. Multiple logistic regression was conducted to explore the association between attitudes and intention to act violently. A mediation analysis (using the PROCESS macro) was conducted to explore the mediation factors. RESULTS Over half of the participants witnessed an incident of verbal violence in health care and substantially fewer witnessed a physically violent event (51.5% and 16.1%, respectively). An attitude of highly justifying violence was found to be directly associated with the intention to act verbally and physically violent. Past witnessing of verbal or physical violence in healthcare settings had an indirect association through an attitude that justifies violence, which served as a mediating factor for the intention to act verbally and physically violent in a situation presented via the vignettes. CONCLUSIONS Witnessing a violent event in healthcare systems has social consequences that may cause normalization of violence and lead to the intention to use verbal or even physical violence towards nurses. CLINICAL RELEVANCE Nurses should be encouraged to report incidents of violence, while healthcare and judicial systems must address this issue seriously. It is recommended that systems alerting for risk indicators be applied, to identify patients with a potential for violence in healthcare facilities. Healthcare policymakers and workers must act to promote an environment of zero tolerance for violence in order to minimize such events. In order to prevent violence towards healthcare staff, a holistic multisystem approach should be implemented, involving a focus by sociocultural elements on social values and structures, as violence in healthcare reflects violence in society at large.
Collapse
Affiliation(s)
- Anat Amit-Aharon
- Nursing Department, Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sigalit Warshawski
- Nursing Department, Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Itzhaki
- Chair of Nursing Department, Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
40
|
Okubo CVC, Silveira RCCP, Galdino MJQ, Fernandes DR, Moreira AAO, Martins JT. Effectiveness of interventions for the prevention of occupational violence against professionals in health services: a protocol for a systematic review. BMJ Open 2020; 10:e036558. [PMID: 32998918 PMCID: PMC7528362 DOI: 10.1136/bmjopen-2019-036558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Occupational violence affects several categories of workers; however, the health sector category has been considered at a high risk, exposing workers to physical and psychological abuse. Thus, occupational violence has decreased the quality of care in health service. This review aims to evaluate the effectiveness of interventions for the prevention and reduction of occupational violence against health professionals. METHODS AND ANALYSIS This protocol is consistent with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Searches will be conducted in PubMed, Embase, Cochrane Library, LILACS, Web of Science, Scopus, CINAHL and LIVIVO along with a comprehensive review of grey literature. The search will be conducted on August 1 st 2020, without language and time restrictions. Following the eligibility criteria, two independent reviewers will select the titles and abstracts and subsequently screen the full articles. If necessary, a third reviewer will assess any disagreements. All references will be imported into EndNote, and any duplicates will be removed. The data will be extracted using an extraction-based form from Cochrane. Statistical analyses will be performed using the software Cochrane Review Manager, and a meta-analysis will be performed if possible for the statistical combination of at least two studies. The risk of bias of the randomised clinical trials will be evaluated by the Risk of Bias tool from Cochrane, and the risk of bias of the non-randomised intervention studies will be evaluated using the Downs and Black scale. The quality of the evidence and strength of the classification recommendations will be assessed by the Grading of Recommendations, Assessment, Development and Evaluation. ETHICS AND DISSEMINATION This review will not evaluate individual patient information and therefore does not require ethical approval. The results will be disseminated through publications in peer-reviewed journals, presentations at conferences and the doctoral thesis of the leading author. PROSPERO REGISTRATION NUMBER CRD42018111383.
Collapse
Affiliation(s)
- Caroline Vieira Cláudio Okubo
- PhD student in Nursing, State University of Londrina, Londrina, Paraná, Brazil
- Nurse, Federal University of Paraná Clinics Hospital, Curitiba, Paraná, Brazil
| | | | | | | | | | | |
Collapse
|
41
|
Spelten E, Thomas B, O’Meara P, van Vuuren J, McGillion A. Violence against Emergency Department nurses; Can we identify the perpetrators? PLoS One 2020; 15:e0230793. [PMID: 32240231 PMCID: PMC7117706 DOI: 10.1371/journal.pone.0230793] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 03/08/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Violence against health care workers is a major issue in health care organisations and is estimated to affect 95% of workers, presenting an enormous risk for workers and employers. Current interventions generally aim at managing rather than preventing or minimising violent incidents. To create better-targeted interventions, it has been suggested to shift attention to the perpetrators of violence. The aim of this study was to identify and discuss the perceptions, held by Emergency Department nurses, about perpetrators of occupational violence and aggression. METHODS Two focus groups were conducted with Emergency Department nurses at a major metropolitan hospital in Australia. In the focus groups, the nurses' perceptions about perpetrators of violence against health care workers were identified and discussed. The results were analysed using descriptive analysis. RESULTS This study confirmed that violence is a major issue for Emergency Department nurses and has a considerable impact on them. Participants acknowledged that violence at work had become an intrinsic part of their job and they tend to focus on coping mechanisms. The nurses identified six overlapping groups of perpetrators and described their approach to dealing with these perpetrators. The results highlighted additional factors that impact on the occurrence and management of violence, such as the presence of security, wait times, and the triage system. CONCLUSIONS Based on the focus groups with Emergency Department nurses we conclude that violence at work is an everyday danger for Emergency Department nurses, who feel vulnerable and recognise that it is not within their power to solve this issue given the societal component. Our conclusion is that attention needs to shift from equipping workers with tools to manage violence to the perpetrator and the development of interventions to reduce violence from targeted perpetrator groups.
Collapse
Affiliation(s)
- Evelien Spelten
- Department of Psychology and Public Health, Rural Health School, La Trobe University, Melbourne, Australia
| | - Brodie Thomas
- La Trobe Rural Health School, La Trobe University, Mildura, Australia
| | - Peter O’Meara
- Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Australia
| | - Julia van Vuuren
- Department of Psychology and Public Health, Rural Health School, La Trobe University, Melbourne, Australia
| | - Anthony McGillion
- School of Nursing and Midwifery, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| |
Collapse
|
42
|
Dexter E, Vitacco MJ. Strategies for Assessing and Preventing Inpatient Violence in Forensic Hospitals: A Call for Specificity. EUROPEAN PSYCHOLOGIST 2020. [DOI: 10.1027/1016-9040/a000393] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Abstract. Violence within inpatient forensic hospitals is a significant and enduring problem that leads to harm to staff and patients and causes significant expenditures. This paper provides comprehensive recommendations for developing and implementing violence reduction strategies within forensic settings that are predicated on appropriate evaluation for violence risk. This paper posits that proper strategies must take into account subtypes of violence and classifying risk with systematic and continuous evaluations. Treatment interventions should be geared to patients most at-risk for violence. By recognizing the dynamic nature of violence, hospital administrators can work closely with institution staff to provide support for improving the environment of forensic hospitals. By employing empirically based treatment interventions on both acute and long-term units, forensic hospitals can provide a safer environment.
Collapse
Affiliation(s)
- Erin Dexter
- Department of Psychiatry and Health Behavior, Augusta University, GA, USA
| | - Michael J. Vitacco
- Department of Psychiatry and Health Behavior, Augusta University, GA, USA
| |
Collapse
|
43
|
Reardon M, Abrahams R, Thyer L, Simpson P. Review article: Prevalence of burnout in paramedics: A systematic review of prevalence studies. Emerg Med Australas 2020; 32:182-189. [PMID: 32067408 DOI: 10.1111/1742-6723.13478] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 01/16/2020] [Indexed: 01/20/2023]
Abstract
Paramedic wellness is an increasing priority within the profession. Burnout has been described as having areas of 'emotional exhaustion, depersonalisation and reduced personal accomplishment'. Prevalence of burnout is unclear, hampering evaluation of protective initiatives. The aim of this systematic review was to identify prevalence and predictors of burnout in paramedic populations. A systematic review was registered via PROSPERO and conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE, CINAHL, ERIC, PsycINFO and PsycARTICLES were searched from 2000 to present. Abstract screening and selection of articles was undertaken with good agreement. Quality assessment of included articles used Hoy's validated quality assessment tool, with excellent inter-rater agreement (K = 0.9). Qualitative synthesis of included studies was performed. Each step of the process was performed independently by two authors, with a third arbitrating disputes as required. Five studies met inclusion criteria; two were from the USA, and one each from Australia, South Africa and Israel. Burnout measurement varied; three used Copenhagen Burnout Inventory (CBI), one Maslach's Burnout Inventory (MBI), and one General Burnout Measure (GBM). Prevalence of burnout ranged between 16% and 56%. Higher prevalence was reported in CBI studies (30%, 38% and 56%), while lower prevalence was seen with other tools (MBI 18%, GBM 16%). Included studies were of low to moderate quality. The prevalence of burnout in paramedics varies from 16% to 56%. Existing evidence describing burnout in paramedics is weak; research of good methodological rigour is needed to quantify prevalence of burnout, providing a reliable baseline against which protective interventions could be measured.
Collapse
Affiliation(s)
- Matthew Reardon
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Raquel Abrahams
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Liz Thyer
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - Paul Simpson
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| |
Collapse
|
44
|
Nambiar D, Pearce JW, Bray J, Stephenson M, Nehme Z, Masters S, Brink D, Smith K, Arendts G, Fatovich D, Bernard S, Haskins B, Grantham H, Cameron P. Variations in the care of agitated patients in Australia and New Zealand ambulance services. Emerg Med Australas 2019; 32:438-445. [PMID: 31840407 DOI: 10.1111/1742-6723.13431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/13/2019] [Accepted: 10/25/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The objective of the present study is to examine variations in paramedic care of the agitated patient, including verbal de-escalation, physical restraint and sedation, provided by ambulance services in Australia and New Zealand. METHODS To examine the care of agitated patients, we first identified and reviewed all clinical practice guidelines for the management of agitated patients in Australian and New Zealand ambulance services between September and November 2018. We then conducted a structured questionnaire to obtain further information on the training, assessment and care of agitated patients by the ambulance services. Two authors extracted the data independently, and all interpretations and results were reviewed and confirmed by relevant ambulance services. RESULTS There were 10 independent clinical practice guidelines for the care of agitated patients in the 10 ambulance services. All services reported training in the management of agitated patients, and two services used a validated tool to assess the level of agitation. All services used physical restraint, although six services required police presence to restrain the patient. All ambulance services used some form of sedation, typically divided into the management of mild to moderate, and severe agitation. The most common agent for sedation was midazolam, while ketamine was the most common agent for sedating severely agitated patients. The maximum dose was varied, and contraindications for sedating agents varied between services. CONCLUSIONS There were wide variations across the ambulance services in terms of the assessment of agitation, as well as the use of physical restraint and sedation.
Collapse
Affiliation(s)
- Dhanya Nambiar
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - James W Pearce
- South Australian Ambulance Service, Adelaide, South Australia, Australia
| | - Janet Bray
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | - Ziad Nehme
- Ambulance Victoria, Melbourne, Victoria, Australia
| | - Stacey Masters
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Deon Brink
- St John Ambulance Western Australia, Perth, Western Australia, Australia
| | - Karen Smith
- Ambulance Victoria, Melbourne, Victoria, Australia
| | - Glenn Arendts
- Faculty of Medicine and Health Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Daniel Fatovich
- Faculty of Medicine and Health Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | | | | | - Hugh Grantham
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Peter Cameron
- Emergency and Trauma Centre, Alfred Hospital, Melbourne, Victoria, Australia
| |
Collapse
|
45
|
Coomber K, Curtis A, Vandenberg B, Miller PG, Heilbronn C, Matthews S, Smith K, Wilson J, Moayeri F, Mayshak R, Lubman DI, Scott D. Aggression and violence at ambulance attendances where alcohol, illicit and/or pharmaceutical drugs were recorded: A 5-year study of ambulance records in Victoria, Australia. Drug Alcohol Depend 2019; 205:107685. [PMID: 31704380 DOI: 10.1016/j.drugalcdep.2019.107685] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/23/2019] [Accepted: 10/10/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND This study describes the frequency and characteristics of aggression and/or violence in ambulance attendances involving alcohol, illicit and/or pharmaceutical drug use in Victoria, Australia between January 2012 and January 2017. METHODS Patient characteristics, context, and substance use involvement in ambulance attendances were examined to determine associations with attendances where aggression and/or violence was recorded. RESULTS There were 205,178 ambulance attendances where use of alcohol, pharmaceutical drugs or illicit substances contributed to the reason for the attendance. Paramedics recorded acts of aggression and/or violence in 11,813 (5.76 %) of these attendances. Aggression/violence was more likely to be recorded in certain contexts. Compared with attendances where aggression/violence was not recorded, attendances where aggression/violence was recorded were significantly more likely to involve younger and male patients, and occur on Friday and Saturday nights. Alcohol intoxication was involved in more than half of attendances where aggression/violence was recorded, and was almost twice as prevalent as those involving illicit drug use where aggression/violence was recorded. This pattern was consistent across all hours, high-alcohol hours only, by metropolitan/regional location, and by police co-attendance. CONCLUSIONS Aggression and violence are frequently recorded in ambulance attendances involving alcohol, pharmaceutical drugs or illicit substances, and, most often involve alcohol. This violence poses a recurring threat to the health and safety of paramedics, bystanders, and patients. Greater priority should be given to reducing alcohol-related violence through evidence-based policy measures targeting high-risk groups (e.g. young adult males) and contexts (e.g. weekends, late at night) where harm is most likely to occur.
Collapse
Affiliation(s)
- Kerri Coomber
- School of Psychology, Faculty of Health, Deakin University, Geelong, Australia.
| | - Ashlee Curtis
- School of Psychology, Faculty of Health, Deakin University, Geelong, Australia.
| | - Brian Vandenberg
- School of Social Sciences, Monash University, Victoria, Australia.
| | - Peter G Miller
- School of Psychology, Faculty of Health, Deakin University, Geelong, Australia.
| | - Cherie Heilbronn
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; Turning Point, Eastern Health, Richmond, Victoria, Australia.
| | - Sharon Matthews
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; Turning Point, Eastern Health, Richmond, Victoria, Australia.
| | - Karen Smith
- Ambulance Victoria, Doncaster, Victoria, Australia; Department of Epidemiology and Preventative Medicine and Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, Victoria, Australia.
| | - James Wilson
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; Turning Point, Eastern Health, Richmond, Victoria, Australia.
| | - Foruhar Moayeri
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; Turning Point, Eastern Health, Richmond, Victoria, Australia.
| | - Richelle Mayshak
- School of Psychology, Faculty of Health, Deakin University, Geelong, Australia.
| | - Dan I Lubman
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; Turning Point, Eastern Health, Richmond, Victoria, Australia.
| | - Debbie Scott
- Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; Turning Point, Eastern Health, Richmond, Victoria, Australia.
| |
Collapse
|
46
|
Acquadro Maran D, Cortese CG, Pavanelli P, Fornero G, Gianino MM. Gender differences in reporting workplace violence: a qualitative analysis of administrative records of violent episodes experienced by healthcare workers in a large public Italian hospital. BMJ Open 2019; 9:e031546. [PMID: 31712339 PMCID: PMC6858178 DOI: 10.1136/bmjopen-2019-031546] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES This study aims to analyse, from a descriptive and qualitative point of view, the episodes of violence reported by healthcare workers (HCWs) in a large public Italian hospital. Qualitative analysis permits us to collect the victims' words used to describe the event and the ways in which they dealt with it. A comparison between genders was performed to better understand what type of different strategies could be used to improve the prevention of workplace violence for HCWs. DESIGN AND SETTING The retrospective observational study was carried out in 'Città della Salute e della Scienza', a complex of four interconnected hospitals situated in Northern Italy. This study analysed aggression data from the 4-year period of 2015-2018 that included all HCW categories. The data were obtained from the aggression reporting form. PARTICIPANTS The analysed records were supplied by 396 HCWs (3.6% of all HCWs in the hospital). RESULTS Male HCWs aged <30 years did not report violent episodes that occurred in the workplace, while male HCWs with 6-15 years of work experience reported more violent episodes than their female counterparts. Among the HCW professions, nursing was the profession, in which HCWs were more prone to experience a violent episode, while male medical doctors were more prone to report violent episodes than female medical doctors. Moreover, female HCWs experienced more verbal violence (insults) than male HCWs did, while male HCWs experienced more physical violence (bodily contact) than female HCWs did. CONCLUSIONS The findings from this explorative study suggest that there is a gender difference in the characteristics of workplace violence perpetrated by patients, patients' relatives and visitors and in the way in which these episodes are described. Consequently, it is important for informative and preventive courses to consider gender differences in experiencing a violent episode.
Collapse
Affiliation(s)
| | | | - Pierluigi Pavanelli
- Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Giulio Fornero
- Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Maria Michela Gianino
- Department of Public Health Sciences and Pediatrics, University of Turin, Torino, Italy
| |
Collapse
|
47
|
Wright JY, Davis AL, Brandt‐Rauf S, Taylor JA. "Felony assault should stick:" Assaulted EMS responders' frustration and dissatisfaction with the legal system. Am J Ind Med 2019; 62:938-950. [PMID: 31418880 PMCID: PMC6790657 DOI: 10.1002/ajim.23036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 07/26/2019] [Accepted: 07/29/2019] [Indexed: 11/26/2022]
Abstract
Introduction The prevalence of violence to first responders is reported in ranges of approximately 40% to 90%. Pennsylvania has a felonious assault statute to address such violence, but the prosecutorial process has been noted to cause first‐responder dissatisfaction. Methods An exploratory qualitative study using individual interviews with snowball sampling was conducted with the Philadelphia District Attorney's office to understand the prosecutorial process when a first responder is assaulted and injured in a line of duty. The Philadelphia Fire Department provided a list of first responders who sustained a work‐related injury from a patient or bystander assault so that particular cases could be discussed during the interviews. Results Emergent themes fell into two categories: factors that lead to a charge (prosecutorial merit, intent, and victim investment), and the judge's discretion in sentencing (“part of the job” mentality, concern for the defendant, and the justice system's offender focus). Immediately actionable tertiary prevention recommendations for fire departments, labor unions, and district attorney's offices were developed. Conclusion Violence against fire‐based emergency medical service (EMS) responders is a persistent and preventable workplace hazard. While felonious assault statutes express society's value that it is unacceptable to harm a first responder, this study found that such statutes failed to provide satisfaction to victims and that support when going through the court process is lacking. Assaulted EMS responders, their employers, and labor unions would benefit from the recommendations provided herein to help them extract a stronger sense of procedural justice from the legal process.
Collapse
Affiliation(s)
- Jasmine Y. Wright
- Department of Environmental & Occupational HealthDornsife School of Public Health at Drexel University Philadelphia Pennsylvania
| | - Andrea L. Davis
- Department of Environmental & Occupational HealthDornsife School of Public Health at Drexel University Philadelphia Pennsylvania
| | - Sherry Brandt‐Rauf
- Department of Environmental & Occupational HealthDornsife School of Public Health at Drexel University Philadelphia Pennsylvania
| | - Jennifer A. Taylor
- Department of Environmental & Occupational HealthDornsife School of Public Health at Drexel University Philadelphia Pennsylvania
| |
Collapse
|
48
|
Wang PY, Fang PH, Wu CL, Hsu HC, Lin CH. Workplace Violence in Asian Emergency Medical Services: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203936. [PMID: 31623179 PMCID: PMC6843119 DOI: 10.3390/ijerph16203936] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 10/09/2019] [Accepted: 10/15/2019] [Indexed: 01/01/2023]
Abstract
Workplace violence among Asian emergency medical services (EMS) has rarely been examined. A cross-sectional, mainly descriptive study using a standardized, paper-based, self-reported questionnaire survey was conducted between August and October 2018 among emergency medical technicians (EMTs) in the Tainan City Fire Bureau, Taiwan. A total of 152 EMT-paramedics responded to the questionnaire survey, constituting an overall response rate of 96.2%. The participants were predominantly male (96.1%), college-educated (4-year bachelor’s degree) (49.3%), and middle-aged (35–44 years old) (63.8%). Among them, 113 (74.3%) and 75 (49.3%) participants had experienced verbal and physical assaults at work, respectively. Only 12 (7.9%) participants were familiar with relevant regulations or codes. The assaults predominantly occurred during evening shifts (16:00–24:00) and at the scene of the emergency. The most predominant violence perpetrators included patients, patients’ families, or patients’ friends. Nearly 10% of participants had experienced verbal assaults from hospital personnel. EMTs who encountered workplace violence rarely completed a paper report, filed for a lawsuit, or sought a psychiatric consultation. Fifty-eight (38.2%) and 16 (10.5%) participants were victims of frequent (at least once every 3 months) verbal and physical forms of violence, respectively; however, no statistically significant association was observed in terms of EMT gender, age, working years, education level, or the number of EMS deployments per month. The prevalence of workplace violence among Asian EMS is considerable and is comparable to that in Western countries. Strategies to prevent workplace violence should be tailored to local practice and effectively implemented.
Collapse
Affiliation(s)
- Pei-Yu Wang
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
| | - Pin-Hui Fang
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
| | - Chen-Long Wu
- Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
| | - Hsiang-Chin Hsu
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
| | - Chih-Hao Lin
- Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
| |
Collapse
|
49
|
Liu J, Gan Y, Jiang H, Li L, Dwyer R, Lu K, Yan S, Sampson O, Xu H, Wang C, Zhu Y, Chang Y, Yang Y, Yang T, Chen Y, Song F, Lu Z. Prevalence of workplace violence against healthcare workers: a systematic review and meta-analysis. Occup Environ Med 2019; 76:927-937. [PMID: 31611310 DOI: 10.1136/oemed-2019-105849] [Citation(s) in RCA: 306] [Impact Index Per Article: 61.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 09/09/2019] [Accepted: 09/22/2019] [Indexed: 11/04/2022]
Abstract
We aim to quantitatively synthesise available epidemiological evidence on the prevalence rates of workplace violence (WPV) by patients and visitors against healthcare workers. We systematically searched PubMed, Embase and Web of Science from their inception to October 2018, as well as the reference lists of all included studies. Two authors independently assessed studies for inclusion. Data were double-extracted and discrepancies were resolved by discussion. The overall percentage of healthcare worker encounters resulting in the experience of WPV was estimated using random-effects meta-analysis. The heterogeneity was assessed using the I 2 statistic. Differences by study-level characteristics were estimated using subgroup analysis and meta-regression. We included 253 eligible studies (with a total of 331 544 participants). Of these participants, 61.9% (95% CI 56.1% to 67.6%) reported exposure to any form of WPV, 42.5% (95% CI 38.9% to 46.0%) reported exposure to non-physical violence, and 24.4% (95% CI 22.4% to 26.4%) reported experiencing physical violence in the past year. Verbal abuse (57.6%; 95% CI 51.8% to 63.4%) was the most common form of non-physical violence, followed by threats (33.2%; 95% CI 27.5% to 38.9%) and sexual harassment (12.4%; 95% CI 10.6% to 14.2%). The proportion of WPV exposure differed greatly across countries, study location, practice settings, work schedules and occupation. In this systematic review, the prevalence of WPV against healthcare workers is high, especially in Asian and North American countries, psychiatric and emergency department settings, and among nurses and physicians. There is a need for governments, policymakers and health institutions to take actions to address WPV towards healthcare professionals globally.
Collapse
Affiliation(s)
- Jianxin Liu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Heng Jiang
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Liqing Li
- Department of Management Science and Engineering, School of Economics and Management, Jiangxi Science and Technology Normal University, Nanchang, China
| | - Robyn Dwyer
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Kai Lu
- Office of Student Affairs, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shijiao Yan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Opoku Sampson
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongbin Xu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chao Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Zhu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuanyuan Chang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yudi Yang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tingting Yang
- Department of Nutrition, Henan Provincial People's Hospital, Zhengzhou, China
| | - Yawen Chen
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fujian Song
- Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Norwich, UK
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
50
|
Zhang Q, Dong H, Zhu C, Liu G. Low back pain in emergency ambulance workers in tertiary hospitals in China and its risk factors among ambulance nurses: a cross-sectional study. BMJ Open 2019; 9:e029264. [PMID: 31537564 PMCID: PMC6756463 DOI: 10.1136/bmjopen-2019-029264] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Low back pain (LBP) could cause serious consequences and has been shown to be prevalent among emergency ambulance workers. Studies on the prevalence of and risk factors for LBP among emergency ambulance workers are scarce in China. The study aimed to determine the prevalence of LBP among ambulance workers, including doctors, nurses and drivers, and to explore the risk factors for ambulance nurses' chronic LBP (lasting for at least 3 months). DESIGN Cross-sectional study. SETTING Emergency ambulance systems from 38 tertiary hospitals in Shandong, China were selected by random cluster sampling. PARTICIPANTS A total of 1560 ambulance workers completed the study. OUTCOME MEASURES A paper-based questionnaire that included the Nordic Musculoskeletal Questionnaire, which evaluated LBP, the Dutch Musculoskeletal Questionnaire, which assessed ergonomic factors, and the Job Content Questionnaire, which assessed stress, was used. Multivariate logistic regression analysis was conducted to quantify the association of potential risk factors with chronic LBP among ambulance nurses. RESULTS The 1 year prevalence of LBP lasting for at least 24 hours, 7 days and 3 months was 86.1%, 50.6% and 21.1%, respectively, among 498 ambulance nurses; 70.5%, 36.4% and 15.8% among 519 doctors; and 57.5%, 23.8% and 12.3% among 543 drivers. The factors contributing to chronic LBP among ambulance nurses were the frequent bending of the trunk, heavy or awkward lifting, shift work, low job satisfaction, high psychological fatigue, high psychological job demand, low job control, low supervisor support, older age, female sex and obesity. CONCLUSIONS LBP was more prevalent among ambulance nurses than among ambulance doctors and drivers. Many factors, especially psychosocial and ergonomic factors, contributed to ambulance nurses' chronic LBP. Comprehensive measures might be needed to control LBP.
Collapse
Affiliation(s)
- Qiong Zhang
- Shouguang People's Hospital, Shouguang, Weifang, Shandong Province, China
| | - Hongyun Dong
- Shouguang People's Hospital, Shouguang, Weifang, Shandong Province, China
| | - Chunji Zhu
- Shouguang People's Hospital, Shouguang, Weifang, Shandong Province, China
| | - Guangzeng Liu
- Shouguang People's Hospital, Shouguang, Weifang, Shandong Province, China
| |
Collapse
|