An Evaluation of Nurses' Perception and Confidence After Implementing a Workplace Aggression and Violence Prevention Training Program

Implementing Evidence-Based Workplace Violence Prevention Education to Support Frontline Staff at Risk for Workplace Violence

Prior studies assessing workplace violence educational interventions have found positive outcomes including increased frontline staff confidence and reduced restraint utilization. An electronic, evidenced-based educational module was provided to frontline staff across a large healthcare system in response to a gap found during analysis of workplace violence prevention initiatives. This quality improvement project found that education can be feasibly implemented across large healthcare organizations to improve frontline staff vigilance and awareness of workplace violence risks.

Addressing Workplace Violence With Evidence

AIM

The purpose of this article is to describe how regional community assessment survey data specific to healthcare workers' (HCWs') attitudes and actions related to workplace violence (WPV) from 1 participating urban tertiary hospital was compared with current evidence to identify evidence-based interventions to promote a safer work environment. The regional survey assessed real-time data regarding the state of WPV and its impact on HCWs, and to drive proposed interventions to prevent and reduce WPV in the healthcare community.

BACKGROUND

Incidents of WPV in healthcare continue to increase, resulting in calls for action from staff, leadership, and regulatory organizations.

METHODS

Data were collected from the HCWs who completed the survey. Experiences with WPV were analyzed. Qualitative data were evaluated for themes. A review of external evidence was conducted to identify best practices in preparing proposed next steps for the organization.

RESULTS

Healthcare worker attitudes and practices related to WPV were described as unreported and not addressed. Violence was more readily perceived as a part of the job. External evidence indicated that education and training alone seemed to have minimal effect on preventing WPV. Evidence from best practices and staff feedback were recommended to be incorporated into plans for the organization.

The effectiveness of a workplace violence prevention strategy based on situational prevention theory for nurses in managing violent situations: a quasi-experimental study

BACKGROUND

Workplace violence (WPV) poses a significant occupational hazard for nurses. The efficacy of current education and training programs in mitigating WPV incidence among nurses remains uncertain, possibly due to insufficient consideration of clinical contexts and nurses' specific needs. Therefore, this study developed a WPV prevention strategy based on the actual requirements of clinical nurses and situational prevention theory and aimed to explore its application effects.

METHODS

Under the guidance of situational prevention theory, a WPV prevention strategy for nurses was constructed through literature review, semi-structured interviews and focus group discussion. This study adopted a self-controlled research design, and trained 130 nurses selected from a comprehensive tertiary grade A hospital in Suzhou in this WPV prevention strategy. Data were collected through structured questionnaires, including the revised WPV questionnaire, WPV severity grading scale, and hospital WPV coping resources scale. The WPV incidence, severity, and WPV coping resource scores of nurses were collected before the intervention, as well as at 3 months, 6 months, and 9 months after training.

RESULTS

The WPV prevention strategy comprised 11 prevention plans based on 11 high-risk situational elements of WPV. Each prevention plan included the WPV prevention flowchart, treatment principle, and communication strategy. The strategy demonstrated excellent feasibility and practicality. Following the intervention, the overall incidence of WPV among nurses significantly decreased from 63.85% (baseline) to 46.15% (9 months after training) (P < 0.05). After the training, the severity of psychological violence (Wald χ² = 20.066, P < 0.001) and physical violence (Wald χ² = 9.100, P = 0.028) reported by nurses decreased compared to the baseline (P < 0.05). Moreover, the overall WPV coping resource score significantly increased from [66.50 (57.00, 77.25) points] (baseline) to [80.00 (68.00, 97.25) points] (9 months after training) (P < 0.05).

CONCLUSIONS

The described WPV prevention strategy, grounded in situational prevention theory and tailored to the needs of clinical nurses, effectively reduced WPV incidence, mitigated its severity, and enhanced nurses' WPV coping resources. This approach offered new avenues for nurses in the prevention of WPV.

Post-traumatic responses to workplace violence among nursing professionals: a collaborative and comparative study in South Korea and Hong Kong

BACKGROUND

Workplace violence has had a significant and negative psychological impact on nursing professionals worldwide. Concerted worldwide efforts to improve work environments have not yet removed nursing professionals from the threat of violence. It is highly essential to conduct comparative research in various working environments where the nurses of each country have unique experiences of workplace violence. The aim of this study was to examine the differences in the rate, associated factors, and post-traumatic responses to workplace violence between South Korean and Chinese nurses in Hong Kong among East Asian countries.

METHODS

A cross-sectional, correlational study design recruited a total of 471 registered nurses (319 South Korean nurses and 152 Chinese nurses in Hong Kong; overall response rate = 78.5%) at online communities in South Korea and Hong Kong. The data were collected by conducting a Qualtrics survey from January 15, 2020, to July 24, 2021. A structured questionnaire was administered for data collection, including rate of workplace violence, perception of workplace violence, attitudes toward workplace violence, coping styles, post-traumatic cognitions, post-traumatic stress disorder, post-traumatic growth, and mental health indicators (depression, anxiety, and stress). T-test, chi-squared, and binary logistic regression analyses were conducted.

RESULTS

In our sample, 30.7% South Korean nurses and 31.6% Chinese nurses in Hong Kong had experienced workplace violence. South Korean and Chinese nurses in Hong Kong with experience of workplace violence had lower perceptions of it. Nurses with experience of workplace violence reported lower levels of mental health, and this trend was more prominent among South Korean nurses.

CONCLUSIONS

Our study findings showed a positive association between workplace violence and post-traumatic responses in both settings. We found that the close monitoring of post-traumatic responses associated with workplace violence could be improved by enhancing nurses' perception of workplace violence.

Enhancing satisfaction and respect for health care personnel: a mixed-methods case study of a community-based intervention

Health care personnel (HCP) face violence as a result of lack of satisfaction and respect among community members. It is imperative for HCP to engage in social work by involving communities for enhancing satisfaction and respect for them. This study attempted to provide insight on this phenomenon by using a mixed-methods concurrent embedded approach. Communities were selected based on modified Solomon four-group design from Karachi in southern province and from three cities of northern province, Khyber Pakhtunkhwa of Pakistan. Focus group discussions and in-depth interviews took place for formulating the quantitative tool. Six hundred pretests were done prior to introducing low-cost community-based interventions followed by 601 posttests. We found increased levels of satisfaction in both provinces, whereas level of respect increased significantly in Karachi in the southern province only. Qualitative interviews revealed the important role played by media and religious leaders. These findings suggest that satisfaction and respect for HCP can be enhanced through community support, involvement of religious leaders, and effective media campaigns.

Patient and visitor aggression de-escalation training for nurses in a teaching hospital in Cairo, Egypt

BACKGROUND

Workplace violence (WPV) has been recognized as a major occupational hazard worldwide. Healthcare professions are particularly at a higher risk of WPV. Patients and their relatives are commonly the most common perpetrators for WPV against physicians. Trainings on the universal precautions of violence, how to effectively anticipate, recognize and manage potentially violent situation is recommended by OSHA as a part of a written, effective, comprehensive, and interactive WPV prevention program.

OBJECTIVE

To implement and evaluate the effectiveness of a training session delivered to nurses. The training session aimed to increase nurses' ability to identify potentially violent situations and to effectively manage these situations in a teaching hospital in Egypt.

METHODOLOGY

A total of 99 nurses attended the training sessions. Confidence in coping with aggressive patient scale, along with nurses' attitudes toward WPV, were used to assess the effectiveness of the training sessions.

RESULTS

Nurses' perceived confidence to deal with aggression increased after attending the training sessions. Nurses' attitudes toward WPV positively changed after attending the training session.

CONCLUSION AND RECOMMENDATIONS

Increasing awareness of the problem among healthcare professions as well as the public is warranted. Violence prevention program with a zero-tolerance policy is warranted.

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.

The Role of Institution-Based Peer Support for Health Care Workers Emotionally Affected by Workplace Violence

BACKGROUND

Academic health centers with peer support programs have identified a significant increase in requests linked to workplace violence (WPV) exposure. However, no known research has focused on supportive interventions for health care workers exposed to WPV. This study aimed to describe the expansion of two long-standing programs-University of Missouri Health Care's (MU Health Care) forYOU Team, The Johns Hopkins Hospital's (JHH) RISE (Resilence in Stressful Events) team-to WPV support, retrospectively summarize the related data, and share generalizable lessons.

METHODS

A retrospective extraction and summary of the forYOU and RISE databases and the MU Health Care and JHH databases was performed tracking hospitalwide data on WPV. Two cases describe the experience of WPV victims.

RESULTS

Between 2009 and 2019, forYOU documented 834 peer support interventions, 75 (9.0%) related to WPV (57 one-on-one encounters, 18 group support encounters). In 2018-2019 the forYOU Team experienced an increase in WPV encounters, with 43 of the team's activations (20%) related to WPV. Between 2011 and 2019, RISE recorded 367 peer support interventions, 80 (21.8%) of which were WPV-related (61 group support encounters, 19 one-on-one encounters). Forty-eight (60.0%) of these 80 encounters occurred in 2018-2019 alone, marking an increase in WPV encounters. Nurses were the most frequent callers of both programs.

CONCLUSION

This study indicates the growing need for health care workers' support in the aftermath of WPV exposure in today's health care environment. Health care institutions should take a holistic approach to WPV, including timely access to interventional peer support programs.