Factors that expose nurses to patient aggression in psychiatric and nonpsychiatric settings – an observational study

The overall aim of this study is to describe nurses’ individual characteristics and relationship and work environment factors that expose them to patient aggression in psychiatric and non-psychiatric care settings (emergency, and medical and surgical specialties). The Socio-Ecological Model for the prevention of patientto-worker aggression in hospitals was used as a theoretical framework. The setting of this study was made up of the 21 hospitals that were included in the Finnish Public Sector Study. The participants were the nurses who participated in the Finnish Public Sector Study in 2012 and 2015. First, the extent of the problem was described by determining the occurrence, characteristics and consequences of aggression in psychiatric and two non-psychiatric settings by using cross-sectional data from 5228 nurses. Second, cross-sectional approaches were used to identify how nurses’ individual characteristics, relationship and work environment factors were associated with their experiences of patient aggression in psychiatric specialties (758–923 nurses). Third, a longitudinal approach was used to investigate the associations identified in the cross-sectional analysis, in all three nursing groups (2981 nurses). Different types of statistical methods were used to analyze the data, e.g., descriptive statistics, logistic regression and advanced modeling techniques. The results reveal that aggression was experienced by 41% of nurses (N=5228). The most commonly experienced type of aggression was mental abuse, and the rarest type was armed threats. The consequences of aggression in terms of sleep problems and psychological distress may have been more severe in non-psychiatric nursing groups compared to the psychiatric nursing group. Regarding exposing factors, significant associations between nurses’ individual characteristics and patient aggression were identified in the psychiatric, and medical and surgical nursing group, while none were found in the emergency nursing group. In the nonpsychiatric nursing groups, the relationship factor of poor team climate, and the work environment factors of high effort-reward imbalance, high job strain and poor organizational justice at baseline were associated with increased patient aggression at the follow-up. However, these associations differed between the two nonpsychiatric nursing groups. The results of this study show the complex nature of patient aggression in healthcare. Improving nurses’ relationship and work environment factors when aiming to reduce patient aggression may be useful. However, the results of this study indicate that the non-psychiatric care environments may be more vulnerable to patient aggression related to problems at the relationship and work environment levels. More studies are needed to support the findings of the study

Violence exposure and burnout in healthcare sector: Mediating role of work ability

Background: One of the most difficult problems faced by health care professionals is experiencing verbal and physical abuse from patients and their family members. Some studies have shown that health care workers, es-pecially nurses, are up to 16 times more likely to be subject to violence than other workers. Aims: The aim of this study was to analyze the relationship between exposure to violence, work ability and burnout. Methods: Data were collected through a questionnaire to investigate health care workers’ exposure to violence (Violent Incident Form), burnout (Maslach Burnout Inventory) and work ability (Work Ability Index). A sample of 300 nurses was obtained for the study. Results: A total of 36% of nurses indicated that they had been a victim of violence in the past 12 months. The data analysis highlighted highly significant differences in work ability, emotional exhaustion and depersonalization between health care workers who had been victims of violence and those who had not experienced violence. Finally, work ability was shown to have a mediating effect on emotional exhaustion (indirect effect: b = 2.7, BCa CI: 1.37–4.33) and depersonalization (indirect effect: b = 1.1, BCa CI: 0.48–1.87). Discussion: This study is one of the first to consider the mediation effect of work ability between workplace violence experienced and burnout in the healthcare sector; it reports the complexity and severity of the consequences of workplace violence in this sector

Working Conditions in Central Public Administration

During the last few decades, public administration workers have been subject to a number of structural, modernising reforms, in a framework often designated as ‘new public management’. The current economic and financial crisis has also meant that the steep rise in public debt has prompted many authorities to try to reduce public expenditure by introducing freezes and reductions in pay and employment for civil servants. This report sets out to provide an overview of the main causes and reasons for change in central public administration in the European member states plus Norway. It also looks at the impact these changes have had on the sector\u27s working conditions, as well as exploring how this situation is expected to evolve

Strategies to Increase Compassion Satisfaction and Reduce Compassion Fatigue Among Hospital Nurses

Nursing is one of the most rewarding, but also one of the most difficult professions related to the toll it can take physically, mentally, emotionally, and spiritually on its members. Standards and expectations for nurses are high, as they should be, given the nature of the work and the manner in which nurses interact with their patients and communities. The American Nurses Association (ANA) Code of Ethics for Nurses describes the values, virtues, and obligations of nursing practice in this way: Nursing encompasses the protection, promotion, and restoration of health and well-being; the prevention of illness and injury; and the alleviation of suffering, in the care of individuals, families, groups, communities, and populations. All of this is reflected, in part, in nursing’s persisting commitment both to the welfare of the sick, injured, and vulnerable in society and to social justice. Nurses act to change those aspects of social structures that detract from health and well-being. (ANA, 2015, p. vii) Both the profession of nursing and healthcare organizations are beginning to recognize and address the personal and professional cost of caring for others. It is a dialogue that is needed not only to protect the workforce, but to promote patient safety. For individual nurses, the conversation represents recognition for deeper self-awareness and support in order to prevent and to heal from the effects of burnout, secondary traumatic stress, and compassion fatigue. This process is challenging in light of the personal and daily expectations nurses encounter in practice and the calling nurses feel to their profession. The conversation carries with it the recognition of personal limits and the need to seek support in demanding, challenging work environments. It also recognizes, as Native American culture teaches, that “each time you heal someone you give away a piece of yourself until at some point, you will require healing” (Houck, 2014, p. 455)

Effects of Interventions on Violence Against Nurses

Violence against nurses is a problem in the healthcare system that is becoming more prevalent. The purpose of this systematic review is to critically appraise the evidence about the effectiveness of interventions to outcomes indicating that nurses are better prepared to handle violent situations and possibly prevent them all together in acute care settings. The following PICOT question, a question that addresses patient problem, intervention, comparison, outcome, and time, will be answered: What effect does preventative and educational interventions have on violence against nurses in the hospital setting and influence nurses’ perceptions regarding their ability to handle episodes of violence? Relevant publications were identified in CINAHL, PubMed, and Academic Search Complete with key search words of: violence, nurses, prevention, and intervention. Interventions across twenty studies were reviewed. The research showed that educational interventions increased nurses’ perceived level of preparedness to respond to a violent event. However, further research needs to be conducted and strict policies put in place

An investigation into violence against nurses in the southern region of Malawi Chimwemwe Chikoko.

Includes bibliographical references.Incidences of violence in nursing have been reported in local media in Malawi. Although violence in the health sector is not a new concept, it has become a global concern in the 21st century (Needham, Kingma, O'Brien-Pallas, McKenna, Tucker & Oud, 2008:6). The aim of the study was to investigate and describe the nature and extent of violence against nurses and the perceived effects thereof on nurses in selected health facilities in the southern region of Malawi

The prospective effects of workplace violence on physicians' job satisfaction and turnover intentions : the buffering effect of job control

Peer reviewe

Redefining Our Understanding of The Impact of Firearm-Related Injury in the State of Georgia: A White Paper by the Violence Prevention Task Force of IPRCE

Abstract: Background: Firearm-related injury is a crisis that afflicts vulnerable populations of all ages, ethnicities, races and gender. The purpose of this white paper is to delineate the impact of firearm-related violence on the health and well-being of citizens and communities across Georgia based on the available literature and data. The aim of this white paper is to examine and characterize the currently available data on the impact of firearm violence and injury from a statewide perspective, principally as it relates to the National Violent Death Reporting System (NVDRS) report for Georgia. Materials and method: We performed a literature review to analyze data obtained through the the Web-based Injury Statistics Query and Reporting System (WISQARS™) and NVDRS. We used the data to characterize the types and extent of firearm injuries and deaths in the U.S. and Georgia. Results: We identified an overall mortality rate of 27% for all-types of firearm injuries. The estimated average annual age-adjusted firearm injury rate was 31.5 per 100,000 people. The case fatality rate for suicide due to firearm injury notably had the highest gun-related mortality rate by greater than 6-fold. Furthermore, from 2015 to 2016, the national mean annual case fatality rate was 84% for firearm-related suicide according to 2017 CDC report. Conclusion: Greater investment into research, education and prevention of gun-related violence among citizens in the state of Georgia is necessary. Although firearm-related aggravated assault due to interpersonal violence is common, the case fatality rate due to suicide has a greater than 6-fold higher rate of death

Emergency Medical Service Providers’ Perception of Health- Threatening Stressors in Emergency Missions: A qualitative Study

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