Effectiveness of Chewing Gum on Nausea and Vomiting Following Postprocedure: A Systematic Review and Meta-Analysis.

PURPOSE: This study aimed to evaluate the effectiveness of chewing gum in reducing postprocedure nausea and vomiting. DESIGN: A systematic review and meta-analysis. METHODS: A systematic literature search was performed on MEDLINE Complete, EMBASE, CINAHL, PubMed, Web of Science, Academic Search Complete, and Cochrane Library databases from their inception to October 2, 2022. Methodological quality was assessed using the revised Cochrane Risk of Bias 2.0 tool for randomized trials. A meta-analysis was performed using a fixed-effects model to calculate pooled effects with Review Manager 5.4.1. FINDINGS: Twelve randomized trials encompassing 1,458 participants were pooled. The chewing gum intervention was effective in reducing vomiting (P = .007; risk ratio = 0.55; 95% Cl = 0.35-0.85), but not nausea (P = .14; risk ratio = 0.84; 95% Cl = 0.66-1.06). Thirty-minute sessions of gum chewing were significantly more effective in reducing vomiting than 15-minute sessions (P = .04; risk ratio = 0.31; 95% Cl = 0.1-0.93). CONCLUSIONS: The results indicate that repeated gum chewing sessions of at least 30 minutes may act as a nonpharmacological intervention for reducing vomiting. However, further studies are necessary to determine the outcomes of chewing gum interventions.

Effects of scar massage on burn scars: A systematic review and meta-analysis.

AIMS AND OBJECTIVES: This study explored the physical and psychological effects of scar massage on burn patients. BACKGROUND: Hypertrophic scar development is highly prevalent following burn injuries. Scar massage may have physical and psychological effects, although evidence of its effectiveness for burn scar improvement remains inconsistent. DESIGN: A systematic review and meta-analysis of randomised controlled trials and quasi-experimental trials. METHODS: This study was conducted following the Centre of Reviews and Dissemination guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Cochrane Library, Web of Science, Cumulative Index to Nursing and Allied Health Literature, PubMed, EMBASE, and Chinese Electronic Periodical Services were searched for studies published between January 1990 and February 2022. Quality was assessed using the Joanna Briggs Institute (JBI) Appraisal Checklist. The final recommendation strength was assessed according to the JBI recommendation rating. A meta-analysis was performed using Review Manager Version 5.4 software with a random-effect model. RESULTS: Seven studies (420 participants) investigating scar massage for burn patients were included. The scar massage sessions lasted 5-30 min and were delivered by massage therapists 1-3 times a week for 12 weeks. Overall, scar massage decreased pain levels (standardised mean difference [SMD]: -2.39; 95% confidence interval [CI]: -3.96 to -0.83), improved scar thickness (mean difference: -0.05; 95% CI: -0.1 to -0.0), reduced pruritus (SMD: -1.89; 95% CI: -2.95 to -0.82) and reduced anxiety (SMD: -1.52; 95% CI: -2.73 to -0.32), but no significant effect on depression(SMD: -0.92; 95% CI:-2.28 to 0.44). CONCLUSIONS: The meta-effects of scar massage among burn patients are significantly improved scar formation and reduced pruritus and anxiety. Providing scar massage is feasible and effective for burn patients. Future research should evaluate its long-term effects. RELEVANCE TO CLINICAL PRACTICE: Scar massage is relatively convenient and effective in preventing and alleviating hypertrophic burn scarring. Further research can provide detailed suggestions for effective scar massage implementation.

Effectiveness of integrated care for elderly patients with hip fractures: A systematic review and meta-analysis.

Hip fractures in the elderly often cause many complications after surgery. Although ample evidence shows that integrated care can effectively improve postoperative conditions, the effectiveness of specific interventions remains inconsistent across studies. This study was conducted following the Preferred Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The database was from November 1998 to July 2022. Twelve studies (3,010 participants) implemented integrated care for elderly patients with hip fractures. Overall, integrated care improved Activities of Daily Living (ADL) levels within 6 months, at 12 months, Quality of Life (QoL) at 6 months, and decreased Length of Stay (LOS) and mortality rate at 3 months. At least 3 months of integrated care intervention for hip fractures in the elderly to reduce patient complications and medical costs, can be used as a reference for future policies and clinical care.

[Precision Health in Nursing Practice].

Precision health is a new trend in medical care that follows in the footsteps of precision medicine. While precision medicine focuses on treating diseases after occurrence, precision health places greater emphasis on preventative healthcare and health empowerment to prevent and predict disease. Precision health aims to assess the social, economic, cultural, and environmental factors of individuals based on their unique biology, genomics, and other factors and to provide personalized healthcare, preventive medicine, and health promotion through disease prediction to empower people to lead the best possible healthy life. Precision healthcare is the focus of development in advanced countries. Disease diagnosis, treatment, and the successful implementation of precision health needs are optimized using technology such as genomic testing in combination with individual clinical and health information. Precision health focuses on the early identification of risks and prevention. Nursing staff should integrate evidence-based precision health and provide the best medical services and personalized care to each individual to achieve the best quality of life.

[Concept Analysis of Fusion Leadership].

Important concepts in leadership management related to the field of medical care management include servant leadership, charismatic leadership, and transformational leadership. Since the 2020 emergence of the coronavirus pandemic, the world has faced the immediate challenges of epidemic prevention and control. Although national government and medical system officials as well as scholars have weighed in on this issue, their leadership does not appear to line up the core ideas of leadership. Daft and Lengel (2000) examined the influence of fusion leadership on individuals and organizations. The fusion of many nuclei of leadership intentions will produce great power and influence. To elucidate the concept of integrated leadership for individuals and organizations in the post-pandemic healthcare system, this paper summarizes the defining characteristics of fusion leadership based on the conceptual analysis method of Walker and Avant (2019). Concurrently, we confirm the antecedents and consequences of fusion leadership, use different cases to illustrate the analysis, and share the reference indicators and measurements of fusion leadership to provide a reference for healthcare system administrators.

Demoralization level fluctuated at various time frame of radiotherapy for patients with different cancers: a longitudinal observational study.

BACKGROUND: Demoralization is a psychological response that is frequently observed in patients with cancer or advanced diseases. It is affected by national characteristics, culture, disease characteristics and general conditions of the patient such as individual cultural features, nature of stress, personal expression preferences and social behavior. Compared with the results of previous studies on demoralization syndrome, patients with cancer in Taiwan exhibit a higher prevalence of demoralization. We aimed to investigate the prevalence of high demoralization and the changes in the level of demoralization in cancer patients during radiotherapy to explore the associated factors and the contributing factors to the high level of demoralization. METHODS: We used the Demoralization Scale-Mandarin Version to evaluate the demoralization level at six-time points in patients admitted for radiotherapy in a 3-month observational period. 101 patients allocated to three groups by cancer region completed the study. We applied the generalized estimating equation (GEE) to analyze the changes in the demoralization level among the three groups. The variables associated with the changes in the demoralization level were also investigated. RESULTS: In the analysis using univariate GEE, only patients in the chest and breast group exhibited significant changes at two different time points. The results obtained using multivariate GEE revealed that sociodemographic variables, stage of disease and use of surgery or chemotherapy had no impact on the changes in demoralization across three months. CONCLUSION: The demoralization level certainly fluctuated in an extremely high range. The higher prevalence of demoralized patients may indicate that if medical staff neglect the importance of demoralization, demoralized patients with cancer may not receive appropriate care.

[Effectiveness of Nursing Leadership Training Programs: Mixed-Methods Research].

BACKGROUND: Taiwan Nurses Association (TWNA) has recommended nursing leader applicants to the International Council of Nurses (ICN) Global Nursing Leadership Institute since 2009, held the Nightingale Nursing Leadership Institute Training Program since 2011, and co-hosted the ICN Leadership for Change Program with ICN since 2015. The TWNA actively cultivates nursing leaders with vision and an international perspective. PURPOSE: To investigate the professional efficacy of nursing leaders who had attended these leadership training programs. METHODS: A mixed-methods research design was adopted. One hundred and sixty-seven nursing leaders who had attended at least one of the three leadership training programs were enrolled as participants. Data collected from online surveys were used in the quantitative analysis. Data collected from the content analysis of achievement reports and focus groups were used in the qualitative analysis. RESULTS: Diligence in work and listening were the highest-scoring items in the leadership and communication skills categories for the three leadership training programs. The results of the content analysis found that the achievement reports of the Nightingale Nursing Leadership Institute and Leadership for Change programs were mostly concerned with the professional issues in organizations. The impact of leadership training and suggestions for future program planning were discussed in the focus groups. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The results of this study support that these training programs have been successful in promoting a commitment to organizational improvement among program participants and have increased the professional impact of nursing on society.

[Reflections on the Prospective Professional Competency of Taiwan Public Health Nurses].

Societal ageing, the rising prevalence of chronic diseases, and the COVID-19 pandemic have changed the global healthcare environment dramatically. These challenges have significantly burdened community medical and healthcare systems and complicated the work of public health nursing. As an important care provider on the frontlines of primary care, public health nurses (PHNs) must keep up with the current state of the medical environment and statistical data interpretation, scientific data translation, community resource sharing, and telehealth applications. These demands have greatly impacted the traditional routines and existing professional core competencies of PHNs. Discussions among 12 Taiwanese public healthcare experts and the definition of public health nursing capacity from World Health Organization were considered in this review. In addition to reflecting on social changes and the professional development of public health nursing, eight prospective recommendations were provided in this review to enhance the professional competence of PHNs and better prepare them for future changes in the health environment and primary healthcare. The suggestions provide a reference for updating the position statement of PHNs.

The effects of exercise on chemotherapy-induced peripheral neuropathy symptoms in cancer patients: a systematic review and meta-analysis.

PURPOSE: To conduct a systematic review and meta-analysis of current studies to determine whether exercise affects chemotherapy-induced peripheral neuropathy (CIPN) symptoms in cancer patients. DESIGN: The Medline, Embase, Cochrane Library, CINAHL, PubMed, and National Central Library databases, and the reference lists of the included studies were surveyed. The Consolidated Standards of Reporting Trials (CONSORT) extension checklist for non-pharmacologic treatment was used to evaluate the literature. SETTING AND PARTICIPANTS: Exercise interventions offered in hospitals or at home. A total of 178 participants from 5 studies were assessed in the meta-analysis, with their mean age ranging from 48.56 to 71.82 years. METHODS: The randomized control trials were summarized in a systematic review. The effects of the exercise interventions were compiled for meta-analysis. A forest plot was constructed using a fixed effect model to obtain a pooled mean difference. RESULTS: The pooled results indicated that exercise interventions significantly improved the CIPN symptoms of the participants (mean difference: 0.5319; 95% confidence interval: 0.2295 to 0.8344; Z = 3.45; P = 0.0006). A combination of exercise protocols including a nerve gliding exercise intervention was found to have improved CIPN symptoms. In addition, a sensorimotor-based exercise intervention was found to have reduced CIPN-induced loss of postural stability. CONCLUSIONS AND IMPLICATIONS: The findings indicated that the effects of exercise could improve CIPN symptoms in cancer patients. Nevertheless, further investigations of different exercise protocols and intensity of intervention utilizing larger sample sizes and more specific outcome measures will further inform the best practices for cancer patients.

Effect of earplugs and eye masks on the sleep quality of intensive care unit patients: A systematic review and meta-analysis.

AIMS: To evaluate the effect of earplugs and eye masks on the sleep quality of patients in intensive care unit (ICU). DESIGN: Systematic review and meta-analysis. DATA SOURCES: Randomized controlled trial studies conducted before May 5, 2020 were searched for in Embase, MEDLINE, Cochrane Library, CINAHL and Index to Taiwan Periodical Literature System databases. REVIEW METHODS: Analyses in this study were according to the PRISMA statement. The heterogeneity of the data was investigated through sub-group analysis while a meta-analysis was performed using the Review Manager 5.3 software. RESULTS: A total of 797 patients from 13 studies were included in this study. Without considering alone or combined use of earplugs and eye masks, the meta-analysis supported that there was a significant effect on self-reported sleep quality. The overall standardized mean difference of the effect size was 1.44 (95% confidence interval [CI]: [0.80, 2.09]). Sub-group analysis indicated that the use of earplugs alone had no significant effect on sleep quality (effect size: 0.07, 95% [CI]: [-0.50, 0.64]). The use of eye masks alone had a significant effect on sleep quality (effect size: 1.56, 95% [CI]: [1.08, 2.05]). The use of both earplugs and eye masks proved to have the largest effect size on sleep quality (effect size: 2.08, 95% [CI]: [0.95, 3.21]). CONCLUSION: The combined use of earplugs and eye masks or the standalone use of eye masks is a non-invasive, economical and effective way to promote sleep quality in adult ICU patients. IMPACT: Clinical nurses could use this meta-analysis as it recommends that nurses provide adult ICU patients with either one or both earplugs and eye masks to improve the patients' sleep quality. STUDY REGISTRATION: The review protocol was registered a priori and published online in the PROSPERO database of systematic reviews (www.crd.York.ac.uk/Prospero with the registration number # CRD42021221185).

Factors influencing the mobile instant messaging application usage behaviours among home healthcare providers.

AIMS AND OBJECTIVES: To explore the practice related to mobile instant messaging applications usage among home healthcare providers in Taiwan; and based on the unified theory of acceptance and usage of technology and perceived risk theory to examine the influencing factors. BACKGROUND: Previous work has indicated the potential for using mobile instant messaging applications in chronic disease, disasters and public health emergencies. However, few studies have conducted to understand how healthcare professionals use them. DESIGN: A cross-sectional design was used in the study. METHODS: A wide-ranging empirical investigation was conducted in Taiwan. A total of 102 home agencies participated in this study, and 331 valid data were collected. The ODS guideline was followed. RESULTS: 69% of the participants had used mobile instant messaging applications, with high functionality and interesting value can integrate various messages and contribute to adoption. Performance expectancy, effort expectancy, and social influence were significantly positively correlated with behavioral intention. The perceived risk had a significant negative correlation with performance expectancy and use behavior. Among the relevant influencing factors, different types of organization, job position, and institutional policy were related to significant differences in use behaviors. CONCLUSIONS: Our research reported on mobile instant messaging applications usage and behavioral intention among home healthcare providers. This study also highlighted the need to establish regulations within the applications and improve safety and security guidelines. Further research may extend the understanding of the organizations' influencing factors. RELEVANCE TO CLINICAL PRACTICE: This study may help programmers, managers and policymakers improve their strategies for expanding usage of mobile instant messaging applications.

[Workplace Fatigue, Metabolic Syndrome, and Cardiovascular Disease Risks: A Study of Long-Term Night Shift Nurses].

BACKGROUND: Night-shift work affects the physical and mental health of employees. Early identification of relevant high-risk groups may be referenced in health promotion, job analysis, and job design. PURPOSE: To explore the differences in workplace fatigue, physiological index of metabolic syndrome, and risk of cardiovascular disease between long-term and non-long-term night-time working nursing staff. METHODS: The health examination data of 91 long-term and 119 non-long-term night-shift nurses were collected. A sub-data analysis approach was used and t-test, chi-square, Pearson`s correlation, and hierarchical multiple regression were used to conduct statistical analysis. RESULTS: A positive correlation between cardiovascular risk and workplace fatigue was found in the long-term night-shift working group. Moreover, a lower average duration of sleep was found in the non-long-term night-shift working group. Finally, the participants with workplace fatigue and metabolic syndrome were found to have higher levels of cardiovascular risk. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Nursing staff who work night shifts for long-term and non-long-term periods should all receive regular health check-ups and practice healthy eating, exercise, and sleep habits. Employers should provide regular health checkups to their nursing staff and implement measures to identify health hazards in accordance with laws on labor standards, occupational safety, and health and labor health protection regulations, and then adopt appropriate plans and necessary safety and health measures to achieve a mutually beneficial result for both employers and employees in the healthcare industry.

Effects of different reminder strategies on first-time mammography screening among women in Taiwan.

BACKGROUND: The study's purpose was to examine the effectiveness of different reminder strategies on first-time free mammography screening among middle-aged women in Taiwan. METHODS: A quasi-experimental design with random assignment was adopted to divide the participants into three Reminder Strategies groups (mail reminder, telephone reminder, and combined mail and telephone reminders) and one control group. This study recruited 240 eligible middle-aged women, and 205 of them completed the study. Upon the completion of data collection, mail reminders were provided to women of the first group; telephone reminders were provided to the second group; mail followed by telephone reminders were provided to the third group, and the usual postcards were provided to the control group 1 month after the interventions. Two follow-up assessments were conducted 1 and 3 months after the intervention to collect mammography-screening behaviors from all groups. RESULTS: The findings showed that, compared to the control group, more participants in the intervention groups underwent mammography screening after receiving reminder interventions. Telephone contact as reminder was found to have the most significant influence among the interventions (OR = 5.0556; 95% CI = 2.0422-13.5722). CONCLUSIONS: Government and healthcare providers are recommended to consider adopting the telephone reminder strategy to encourage women to undergo their first-time mammography screening.

[Toward 2020 the International Year of the Nurse and the Midwife: Linking Taiwan Nursing With the World].

To commemorate the 200th birthday of Florence Nightingale, the World Health Organization announced 2020 as the "International Year of the Nurse and the Midwife." Nursing is in the frontline of transformational care. The actions of nurses help bring positive changes to the world. Taiwan cannot stand outside of the global community. The Taiwan Nurses Association is also involved actively in international affairs. The expertise and enthusiasm of Taiwan's nurses may be highlighted by attending and responding to various meetings, conferences, and global nursing events organized by the International Council of Nurses (ICN) such as the Council of National Nursing Association Representatives (CNR), ICN Congress, and Nursing Now campaign. This article shares important information and insights on the 2019 ICN CNR meeting and the ICN Congress to expand the international perspective of nurses and to inspire and explore the future development of the nursing profession in Taiwan.

[The Key Role of Taiwanese Nurses in Combating COVID-19 Pandemic].

As the COVID-19 pandemic continues to rage worldwide, Taiwan has achieved outstanding performance in controlling the spread of the outbreak domestically, earning global appreciation. Nurses on the frontlines deserve much of the credit for the ongoing success in fighting against this outbreak in Taiwan. Taiwan's success to date is grounded in proactive preparedness and deployment by the government and effective teamwork among government agencies, medical institutions, enterprises, and the public. Comprehensive containment strategies and preparedness have allowed nurses to effectively perform their duties and combat the pandemic. Nurses safeguard the public's health a myriad of ways, including implementing quarantine measures at air and seaports, conducting fever screenings, delivering inpatient isolation treatments, performing case contact tracing, providing community care services, and operating special chartered-flight services. The Taiwan Nurses Association (TWNA) provides vital lead in this pandemic response, advocating for the safety, health and wellbeing of nurses; highlighting the contributions and value of nurses; and enhancing the professional image and status of nurses. Furthermore, through its global platform, TWNA shares with peer organizations worldwide the content and efficacy of actions taken by the national government, the contributions of healthcare workers, and the support and encouragement received from the public in COVID-19 containment to demonstrate values of Taiwan and nursing.

Influence of work excitement and workplace violence on professional commitment and turnover intention among hospital nurses.

AIM AND OBJECTIVES: This study aimed to determine the influence of work excitement, workplace violence and the violence prevention climate on professional commitment and turnover intention. BACKGROUND: Workplace violence can easily cause the quality of nursing care to decline. Improvements in the working environment and working conditions can improve nurses' professional commitment and satisfaction. DESIGN: A cross-sectional multicentre study with convenience sampling was conducted. We have complied with the guidelines of STROBE Checklist in presenting this research. METHODS: Out of 900 questionnaires, 696 were deemed valid for analysis (77.33%). This study collected data on sociodemographic information, experiences of workplace violence, professional commitment, work excitement, violence prevention climate and turnover intention. RESULTS: The results show that professional commitment has a significant effect on turnover intention. Professional commitment positively influences work excitement, especially when the work is challenging and varied. It also indirectly influences turnover intention by generating work excitement. Workplace violence introduces an interactive moderating effect on the relationship between professional commitment and work excitement. A violence prevention climate changes the interactive moderating effect of workplace violence on professional commitment, which in turn influences turnover intention. CONCLUSIONS: Positive work experience, institutional organisational policies and support systems are the mediating and moderating factors in the relationship between professional commitment and turnover intention. Nurses expect organisations to maintain good staff relations, provide a positive working environment and learning opportunities and strengthen communication channels, all of which affect nurse retention. RELEVANCE TO CLINICAL PRACTICE: Workplace violence is a serious crisis that can lead to turnover intention among hospital nurses. To enhance interpersonal relationships in the workplace and improve nurse retention, hospitals should schedule an adequate amount of staff and provide sufficient equipment and supplies to create a safe and positive work environment.

The effect of music therapy on reducing depression in people with dementia: A systematic review and meta-analysis.

The aim of this study was to determine the effectiveness of music therapy on reducing depression for people with dementia during different intervention intervals. A systematic review with a meta-analysis of randomized controlled trials. The databases surveyed include AgeLine, CINAHL, MEDLINE, PsycINFO, PubMed, and Cochrane. Seven studies were included in this review. The result revealed that music therapy significantly reduced depression at six, eight, and 16 weeks. This study also supported that music therapy significantly improved depression when the results of six studies with medium-term interventions were pooled. However, no evidence of effect of music therapy on depression was observed at three, four, 12 weeks, and five months during intervention, and one and two months after the cease of music therapy. Music therapy without a music therapist involved did not significantly reduce depression at any time. Medium-term of music therapy might be appropriate in reducing depression for people with dementia.

Meta-analysis of randomized controlled trials of the efficacy of propolis mouthwash in cancer therapy-induced oral mucositis.

PURPOSE: This meta-analysis aimed to evaluate the efficacy and safety of propolis mouthwash in cancer patients with therapy-induced oral mucositis. METHODS: This was a systematic review of randomized control trails (RCTs). We searched ten electronic databases for studies published prior to April 06, 2017. The included RCTs were published in English and Chinese. The Jadad score was used to evaluate the quality of the articles identified. Two reviewers independently evaluated each of the studies. The data were entered into Review Manager (RevMan) 5.3 software and checked for accuracy. Outcome incidence analysis was performed using odds ratios (ORs). RESULTS: Of the 352 articles identified, five potentially relevant articles met our inclusion criteria. These 5 RCTs included a total of 209 participants. The Jadad score for methodological quality was 3.60 ± 0.55. No obvious publication bias was noted. The incidence of severe oral mucositis was significantly lower in the propolis group than in the control group (OR = 0.35, p = 0. 003). The corresponding 95% confidence interval (CI) was 0.18 to 0.70. Between-study heterogeneity was low (I2 = 0.000, p = 0.45). No side effects were reported. CONCLUSIONS: Propolis mouthwash is effective and safe in the treatment of severe oral mucositis. To maintain propolis safety, propolis usage should occur under the supervision of medical staff and health professionals. Future multi-center studies and a clinical protocol are needed to confirm the current findings regarding the efficacy and safety of propolis mouthwash.

Predictors of depressive symptoms among psychiatric nurses who suffered from workplace violence.

AIMS: We examined the possible factors that contributed to or prevented developing depressive symptoms among psychiatric nurses who suffered from workplace violence under Hill's ABC-X Model. BACKGROUND: Workplace violence-related depressive symptoms are some of the major causes leading to impaired quality of life of victims and a heavy burden on society. DESIGN: This is a cross-sectional and correlational study. METHOD: All participants were recruited from psychiatric wards of six hospitals in Taiwan. The data were collected through structured questionnaires from October 2013-March 2014 and a total of 278 psychiatric wards nurses participated in this study and completed all questionnaires. Logistic regression was used to examine the relationships among types and severity of violence, social support and depressive symptoms. RESULTS: Of assaulted psychiatric ward nurses, 75.9% had depressive symptoms and those with higher family support had significantly lower depressive symptoms. CONCLUSIONS: Family support plays the most important role among assaulted psychiatric ward nurses as a protective factor against developing depressive symptoms in this study.

Violence-prevention climate in the turnover intention of nurses experiencing workplace violence and work frustration.

AIMS: To determine the moderating effect of a violence-prevention climate and the mediating effect of work frustration on the relationship between workplace violence (WPV) and the turnover intention of nurses. BACKGROUND: To maintain the stability and work quality of nurses, WPV should be studied to provide effective prevention measures. METHODS: A cross-sectional study with a convenience sample was adopted. Participants were nurses from three hospitals in Taiwan. Of 1,531 questionnaires, 973 were valid for analysis (63.6%). RESULTS: A total mediating effect of work frustration on nurses' own experiences of WPV increased turnover intention. Witnessing WPV toward coworkers caused a significant partial mediating effect on work frustration that further increased turnover intention. A violence-prevention climate had a significant moderating effect on the work frustration and turnover intention of nurses after they had witnessed violence against others. CONCLUSION: Effective policies and an incentivized reporting system can foster a safe and friendly work environment not only for nurses who experience violence but also for those who witness violence. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers and leaders must create a positive consultative pipeline to ensure a safe climate and environment for both the victims of WPV and the nurses who witness violence against others.