Nursing student evaluation of NIOSH workplace violence prevention for nurses online course

The Prevalence of Type II Workplace Violence in US Nurses 2000 to 2022: A Meta-Analysis

BACKGROUND

Physical violence against nurses is a concern in the United States; however, its prevalence is not well quantified.

OBJECTIVE

We sought to describe the prevalence of workplace violence against nurses in the United States over a 22-year period.

METHODS

A meta-analysis was performed following a literature search of English texts through Scopus, CINAHL Plus, and Ovid MEDLINE. Inclusion criteria included the following: (1) primary reports of workplace violence incidents in the United States against nurses, (2) perpetrator was a patient, family member, or visitor, and (3) publications between January 1, 2000, and June 21, 2022. Reports where prevalence rates for nurses could not be calculated were excluded. Study quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist.

RESULTS

Thirty-seven studies met the inclusion criteria; 27 030 nurses were included. The pooled prevalence of workplace violence was 0.35 (95% confidence interval [CI]: 0.29-0.42; Q = 3189.40; I2 = 98.87). Pooled rates of workplace violence increased from 30% in 2000 to 2004 to 43% in 2020 to 2022; however, the overlapping CIs indicate that the increase may not be statistically significant. The mean prevalence of reported workplace violence among nurses who work in the emergency department, in corrections, and psychiatric mental health settings (pooled prevalence = 0.59, 95% CI: 0.46-0.71) was higher than that of nurses who worked in all other settings (pooled prevalence = 0.24, 95% CI: 0.18-0.30).

CONCLUSIONS

Workplace violence is a significant and potentially increasing problem for nurses in the United States. This critical problem requires an effective response from nurse policymakers.

Workplace aggressions on hospital workers: A current and prevalent problem with a high demand for training

BACKGROUND

Workplace aggressions on hospital workers is a very frequent and under-reported problem.

OBJECTIVE

The novel objective of our study was to analyze the number of workplace aggressions per hospital worker. Other objectives of the study were to analyze the management knowledge and interest in receiving training on aggressions by hospital workers.

METHODS

An anonymous survey was handed out among all professionals in a university hospital.

RESULTS

A total of 1118 anonymous surveys were collected. The responders declared that throughout their working life they had suffered some sort of verbal aggression in the hospital in 766 cases (68.5%) and physical aggression in 393 cases (35.2%). Multiple logistic regression analyses found higher risk of receiving physical and verbal aggression in the nursing category and in the Emergency, Critical Care or Psychiatry Units, and a higher risk of receiving physical aggression in women. The score on the level of personal knowledge regarding the legal, physical, and psychological management of aggressions (score 0-10 for each of the 3 aspects) was 2.91±2.68 in legal management, 2.97±2.77 in psychological management and 2.91±2.76 in physical management. The opinion about the interest of receiving training (score from 0 to 10) on the legal management of hospital aggressions was 8.90±1.72, on psychological management was 8.85±1.78 and on physical management was 8.88±1.78.

CONCLUSIONS

Workplace aggression on hospital workers mainly affects women, the nursing category and the Emergency, Critical Care or Psychiatry Units. Hospital workers showed little knowledge on the topic but a great interest in receiving training.

Supporting learners in prison healthcare work-integrated learning settings through simulation: a cross-sectional study

BACKGROUND

Nursing students and nurse preceptors indicate that a comprehensive orientation is vital to successful work-integrated learning placements in Prison Health Services. The aim of this study was to implement and evaluate a Prison Health Service orientation package that included innovative asynchronous online video simulations with branched decision-making and feedback opportunities to stimulate learning and improve students' feelings of preparedness for a placement in this setting.

METHODS

A cross-sectional pre and post design was used to evaluate the resource. Students were given access to the package and invited to complete a pre-placement survey evaluating the resource and their feelings of preparedness for placement. Following placement, they re-evaluated the resource in terms of how well it prepared them for the placement and how well prepared they felt. Third year Australian undergraduate nursing students from one university who completed a Prison Health Service work-integrated learning placement in 2018, 2021, and 2022 were invited to participate. Placements were unavailable in 2019 and 2020. Independent t-tests were used to determine differences in scale means and level of preparedness between pre- and post-survey responses.

RESULTS

Twenty-three of 40 (57.5%) eligible nursing students completed the pre-placement survey and 13 (32.5%) completed the post placement survey. All respondents to the pre-placement survey indicated that they felt satisfactorily, well, or very well prepared after completing the orientation package prior to their clinical placement. Students were significantly more likely to consider themselves well prepared by the package after they had attended placement (p < .001). All students post placement indicated that overall, the simulation resources and the specific simulation scenario about personal boundaries and management of manipulative behaviours was useful for their placement. The majority of students would recommend the orientation package to other students. Suggestions for improvement included streamlining the resource to reduce the time to complete it.

CONCLUSIONS

Asynchronous online simulation with the capacity for branched decision making and feedback along with a comprehensive online orientation package were perceived as useful to prepare undergraduate students for placement in the Prison Health Service work-integrated learning setting.

Association between Workplace Violence and Depressive Symptoms among Primary Healthcare Professionals in Shandong, China: Meaning in Life as a Moderator

BACKGROUND

Workplace violence (WPV) is common in healthcare settings. However, the association between WPV and depressive symptoms has not been explored among primary healthcare professionals, especially in China. The assumption of the moderating effort of meaning in life on the association has also not been tested. The purposes of the study are to investigate the relationship between WPV and depressive symptoms and identify the moderating role of meaning in life among primary healthcare professionals in China.

METHODS

In this study, we collected 2530 valid questionnaires. The participants were composed of primary healthcare professionals in Shandong province, China. WPV, meaning in life (including presence of life and search for life), depressive symptoms, and some social-demographic variables were evaluated. The SPSS macro was used to build the moderating relationship.

RESULTS

WPV was positively correlated with depressive symptoms (β = 9.09, p < 0.001), and meaning in life was negatively associated with WPV and depressive symptoms (β = -0.13, p < 0.05) among primary healthcare professionals in China. For primary healthcare professionals with low presence of life, presence of life aggravated the relationship.

CONCLUSIONS

The current study has verified the association between WPV and meaning in life, and the relationship between WPV and depressive symptoms has been supported among primary healthcare professionals in China. Meaning in life and presence of life as moderators play crucial roles in the relationship between WPV and depressive symptoms.

Violence management proficiency scale in application areas for nursing students: A Turkish validity and reliability study

AIM

The aim of this study is to perform the validity and reliability study of the Turkish version of the Management of Workplace Violence Competence Scale (MWVCS) for Nursing Students.

METHOD

The methodological and cross-sectional study design was used in the method of the study. The research was carried out with 300 nursing students in Turkey. Data were collected using the personal information form and MWVCS.

RESULTS

Explanatory factor analysis and confirmatory factor analysis results confirmed the four-factor structure of the scale. Cronbach's α, item-total correlation, test-retest analysis, and equivalent form analysis showed high reliability. The MWVCS consists of 28 items on a five-point Likert-type scale. Four factors explained 88.729 of the total variance explained. The content validity index of the scale is 0.99. Cronbach's α of the scale was 0.880 and test-retest correlations were found as 0.76.

CONCLUSION

The Turkish version of the MWVCS is a valid and reliable tool for assessing students' workplace violence.

A Virtual, Simulated Code White for Undergraduate Nursing Students

Background

Nurses and nursing students are increasingly vulnerable to workplace violence, both verbal and physical, as health care settings and clients cope with unprecedented challenges including the COVID-19 pandemic. Concurrently, clinical learning opportunities for nursing students have been curtailed by public health restrictions and limited capacity. While virtual simulations have been promoted as an alternative to clinical hours, their effectiveness as an educational intervention on workplace violence has yet to be assessed.

Purpose

The authors sought to evaluate a virtual, simulated code white—a set of organized responses to a client, visitor, or staff member exhibiting the potential for violence—involving 4th year undergraduate nursing students, randomly sorted into an intervention group and a control group.

Methods

Pre and post test measures of knowledge and attitudes about mental health, workplace violence and virtual simulation were collected, as well as qualitative data from focus groups.

Findings

While the sample size (n = 24) was insufficient to detect meaningful differences between the intervention and control groups, descriptive statistics and focus group data revealed significant gaps in participants’ knowledge around managing workplace violence. Participants rated the virtual simulation highly for its realism and the opportunity to experience working in a virtual environment, while they felt the preamble and debrief were too short.

Conclusions

The findings illustrate a virtual code white simulation has clear educational benefits, and that multiple iterations, both virtual and in person, would most likely increase the benefits of the intervention.

Effects of Integrated Workplace Violence Management Intervention on Occupational Coping Self-Efficacy, Goal Commitment, Attitudes, and Confidence in Emergency Department Nurses: A Cluster-Randomized Controlled Trial

Patient and visitor violence (PVV), the most prevalent source of workplace violence, is largely ignored, underreported, and a persistent problem in emergency departments. It is associated with physical injuries, psychological distress, and occupational stress in nurses. A randomized controlled trial was conducted in Taiwan from January to December 2020. This study aimed to test the efficacy of an integrated Workplace Violence Prevention and Management Training Program on PVV in 75 emergency department (ED) nurses from a hospital. Cluster sampling was used because the policy of subdivision strategy was enforced during the COVID-19 pandemic. ED nurses received either the intervention or 1-hour in-service class. Data were collected from questionnaires. Data were analyzed mainly by the repeated measure analysis of variance and generalized estimating equations. The intervention had positive effects on developing stronger goal commitment, improving occupational coping self-efficacy, increasing confidence in ability to deal with violent situations, and modifying attitudes toward the causes and management of PVV in ED nurses (p < 0.05). The marginal R2 of the generalized estimating equation model for goal commitment, occupational coping self-efficacy, confidence, attitudes toward aggression in ED and aggressive behavior variables was high as 0.54 (p < 0.001), 0.45 (p < 0.001), 0.58 (p < 0.001), 0.29 (p < 0.05), and 0.72 (p < 0.001), respectively. These study models could effectively predict changes in the mean values. The benefit was driven by the effect of the intervention in ED nurses. Thus, the intervention, when applied in conjunction with routine in-service class, could exert synergistic improvements on outcomes measured in nurses.

Workplace violence directed at nursing and medical students - What can students tell us about it?

BACKGROUND

Workplace violence (WPV) directed at healthcare teams is a widespread growing phenomenon that affects students as well. The negative consequences of WPV may impede patient care and future retention rates.

PURPOSE

To explore (a) the incidence and type of WPV experienced by nursing and medical students during their clinical rotations; (b) the associations between the emotional consequences of WPV events for students and their perceived professional performance; (c) students' preparedness and current training on WPV.

METHOD

One hundred and fifty-one Israeli nursing and medical students completed an online questionnaire that included closed and open-ended questions. Quantitative data and qualitative data were analyzed separately, before their integration.

RESULTS

More than half the students reported having experienced verbal violence during their clinical rotations. Experiencing WPV caused some students (14.6%) to consider leaving the profession and about one third (27.8%) reported that it had affected patients' care. The vast majority of students did not report experiencing incidents of physical violence.

CONCLUSIONS

There is an essential need to promote and implement multidisciplinary programs aimed at eliminating WPV, beginning at the students' level. Students need preparation and practical tools for coping with WPV. At the same time, health organizations must act to examine how cases of WPV against students are handled.

Trajectories of the current situation and characteristics of workplace violence among nurses: a nine-year follow-up study

Background

Workplace violence (WPV) among nurses has become an increasingly serious public health issue worldwide. Investigating the status quo and characteristics of WPV among nurses in different time periods can help hospital managers understand the current status of WPV and its trends over time. This study aimed to understand the current situation of WPV among nurses in Suzhou general hospitals from 2010 to 2019 and analyze changes over time.

Methods

A cross-sectional study was conducted to investigate 942, 2,110 and 2,566 nurses in 6 fixed polyclinic hospitals in Suzhou in 2010, 2015 and 2019, respectively. This study used the revised version of the hospital WPV questionnaire. The count data are described as frequencies and percentages, and the measurement data are represented as means and standard deviations. The general data of nurses during different time periods, the incidence of WPV, nurses’ cognition and attitudes toward WPV and the attitudes and measures of hospitals regarding WPV were analyzed by the chi-square test.

Results

The incidence of WPV among nurses in Suzhou general hospitals in 2015 (69.0 %) and in 2019 (68.4 %) was higher than the incidence of 62.4 % in 2010 (P<0.05), and there were significant differences among periods in the specific types of violence (P˂0.05). Nurses who participated in the surveys in 2015 and 2019 scored higher on “having heard of WPV before”, “thinking WPV coping management organizations are needed” and “supporting a zero-tolerance policy” than those who participated in 2010 (P<0.05). The attitudes and responses of hospitals with regard to WPV among nurses have greatly improved, as evidenced by the results for the items “offering training”, “encouraging reporting of WPV to supervisors”, “equipped with a WPV managing department”, “handling WPV efficiently” and “hospital’s attitudes” (P<0.005).

Conclusions

Despite an increase in nurses’ awareness and attitudes regarding WPV and significant improvements in hospitals’ attitudes and responses to WPV, the incidence of WPV remains high. Hospitals should continue to explore scientific training modes that are in accordance with the needs of nurses to reduce the incidence of WPV.

Nursing students' experiences of violence and aggression: A mixed-methods study

BACKGROUND

Violence and aggression cause significant problems for nursing staff and students working across healthcare.

OBJECTIVES

To identify the prevalence of aggression experienced by nursing students whilst on clinical placement in one UK city, and rates and experiences of reporting of aggression.

DESIGN

A convergent mixed method design, with mixing occurring at the objective and inference stages.

PARTICIPANTS

Preregistration nursing students who had completed at least one clinical placement.

METHODS

A cross-sectional survey and concurrent focus groups were conducted between May and December 2018. Students completed the 'Students' Experiences of Violence and Aggression Survey' (SEVAS) and were separately invited to participate in focus groups.

RESULTS

There were 129 responses to the survey and 36 students participated in five focus groups. Only about a third of non-physical aggression was reported and around half of the physical aggression and sexual harassment. Very few incidents were reported to the university. Themes from the focus groups encompassed ideas of the ubiquity of violence, that students did not know what they were doing, and issues of racism, bullying, and compassion.

CONCLUSIONS

Universities have a responsibility to students; this includes preparing them adequately to manage aggression, and ensuring reporting is easy to do and adequately dealt with. A majority of students who responded to the survey had experienced non-physical aggression in the past year (81%), over half had experienced physical aggression (56%) and more than one in three had experienced sexual harassment (40%).

Development and Validation of a Management of Workplace Violence Competence Scale for Nursing Practicum Students

PURPOSE

The aim of this study was to develop a scale to measure nursing students' competence in managing violence from patients and relatives in the hospital where nursing students perform clinical practicum.

METHODS

Literature review and Delphi expert consultation were utilized to develop the content of the management of workplace violence competence scale (MWVCS). A convenience sample of 797 nursing students responded to the questionnaire. Exploratory factor analysis of the scale was performed. Internal consistency and test-retest reliability were examined.

RESULTS

The MWVCS consisted of 40 items with a five-point scale. Seven factors explained 63.2% of the total explained variance. The content validity index for the scale was .99. Cronbach's α of the scale was .96, and test-retest correlations were found to be ≥ .76.

CONCLUSION

The MWVCS is a reliable and valid scale for nursing educators to assess the level of students' competence in violence management and to evaluate the effectiveness of education to enhance their ability to manage workplace violence.

The Development and Effectiveness of a Clinical Training Violence Prevention Program for Nursing Students

The study aimed to develop and evaluate a violence prevention program for nursing students to improve communication self-efficacy, problem-focused coping style, emotion-focused coping style, and the ability to cope with violence. Using an eight-session violence prevention program, the study was designed as quasi experimental, with a pretest, posttest, and follow-up assessment with a nonequivalent control group. Nursing students from the fourth year of a university were selected as participants; 22 students were assigned to the experimental group and 23 to the control group. Data analysis included Chi-square, Fisher's exact test, Levene's Test, Mann-Whitney U-test, and repeated measures ANOVA. Results showed that the experimental group showed significantly higher posttest scores for the problem-focused coping style (F = 20.77, p < 0.001), intra-individual and interaction effects for the emotion-focused coping style (F = 12.03, p < 0.001), and the ability to cope with violence (U = 70, p < 0.001) than the control group. Thus, the workplace violence prevention program was effective for nursing students.

The Professional Behaviors New Nurses Need: Findings From a National Survey of Hospital Nurse Leaders

AIM

The purpose of this study was to survey hospital nurse leaders throughout the United States to determine which professional behaviors they believe are essential for nursing students to learn in the classroom.

BACKGROUND

This study was part of a multiphase study. The survey was revised from a previous survey administered to nurse leaders in the Midwest.

METHOD

Participants were surveyed using 46 items in the categories of Change, Communication, Conflict, Leadership, and Self-Awareness.

RESULTS

The highest ranked category was Communication, followed by Self-Awareness, Change, Leadership, and Conflict. The highest rated items in each category were communication with patients, accept constructive criticism, manage change, prioritization, and conflict resolution techniques.

CONCLUSION

Nurse educators and leaders can use the findings to continue to refine nursing education.

Determinants of Workplace Injuries and Violence Among Newly Licensed RNs

Workplace injuries, such as musculoskeletal injuries, needlestick injuries, and emotional and physical violence, remain an issue in U.S. hospitals. To develop meaningful safety programs, it is important to identify workplace factors that contribute to injuries. This study explored factors that affect injuries in a sample of newly licensed registered nurses (NLRNs) in Florida. Regressions were run on models in which the dependent variable was the degree to which the respondent had experienced needlesticks, work-related musculoskeletal injuries, cuts or lacerations, contusions, verbal violence, physical violence, and other occupational injuries. A higher probability of these injuries was associated with greater length of employment, working evening or night shifts, working overtime, and reporting job difficulties and pressures. A lower probability was associated with working in a teaching hospital and working more hours. Study findings suggest that work environment issues must be addressed for safety programs to be effective.