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2.
Br J Nurs ; 28(19): 1273, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31680576

RESUMO

Sam Foster, Chief Nurse, Oxford University Hospitals, discusses what a health organisation's response should be to a report of a sexual assault on a member of staff.


Assuntos
Política Organizacional , Delitos Sexuais/prevenção & controle , Medicina Estatal/organização & administração , Violência no Trabalho/prevenção & controle , Humanos , Reino Unido
3.
J Nurs Adm ; 49(11): 525-530, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31651611

RESUMO

Healthcare workplace violence is a growing concern among nurses; however, nurse administrators and managers may not be fully aware of the level, frequency, or extent of the trauma that staff nurses experience. This information gap is influenced by nurses' failure to report violent incidents, their belief that they are expected to care for violent/assaultive patients, time required for extensive documentation about these incidents, and perceptions that minimal follow-up to mitigate future episodes will occur. This article describes the evidence-based structures, processes, and practices supported to minimize organizational risk and protect nurses and other staff from being physically or emotionally injured and/or traumatized in the workplace.


Assuntos
Guias como Assunto , Recursos Humanos de Enfermagem no Hospital/psicologia , Gestão da Segurança/métodos , Gestão da Segurança/normas , Violência no Trabalho/prevenção & controle , Violência no Trabalho/psicologia , Local de Trabalho/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
4.
Br J Nurs ; 28(19): 1173, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31647731

RESUMO

Sam Foster, Chief Nurse, Oxford University Hospitals, discusses what a health organisation's response should be to a report of a sexual assault on a member of staff.


Assuntos
Política Organizacional , Delitos Sexuais/prevenção & controle , Medicina Estatal/organização & administração , Violência no Trabalho/prevenção & controle , Humanos , Reino Unido
7.
Nurs Leadersh (Tor Ont) ; 32(SP): 58-70, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31099747

RESUMO

Background: Nurses are disproportionately prone to experience incidents of violent victimization. Despite the vast literature on violence in healthcare settings, few studies have identified effective violence prevention interventions. Aim: The aim of the study was to explore the experiences of nurses regarding the implementation of technology-based violence prevention interventions. Methods: Qualitative data were collected through semi-structured focus groups and interviews with 11 nurses at Humber River Hospital. Interviews were audiotaped, transcribed and subjected to a content analysis to identify core themes from the data. Results: Three themes were identified: reassurance of safety, an increase in proactive measures and limitations of technology. Nurses held positive perceptions of the impact of technology-based interventions on violent incidents. The interventions were regarded as effective for the detection of potentially violent patients as well as for providing assistance from security staff when a violent incident occurs or appears imminent. However, nurses also acknowledged that patient-related violence was "unavoidable" and that technology cannot fully prevent violence from occurring. Conclusion: The findings from this study support the replication of these interventions in other healthcare facilities. Engaging staff, patients and families in this unique digital and technology-enriched environment has been critical for the successful implementation of the violence prevention electronic flagging system. Patient and family education and communication were essential for addressing concerns related to "labelling."


Assuntos
Comportamento de Busca de Ajuda , Violência no Trabalho/prevenção & controle , Adulto , Atitude do Pessoal de Saúde , Feminino , Humanos , Entrevistas como Assunto/métodos , Masculino , Pesquisa Qualitativa , Medidas de Segurança/normas , Local de Trabalho/psicologia , Local de Trabalho/normas
8.
Work ; 62(4): 525-541, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31104039

RESUMO

BACKGROUND: Violence and threats of violence against personnel at psychiatric wards as well as in the prison service is a major work environment problem. To date results from interventions to prevent violence and threats in these sectors have been inconclusive or of small effect. One of the reasons may be that violence and threats of violence occur as a consequence of a complex interaction between employee-level and management-level factors. OBJECTIVE: To design a tailored and theory-based intervention program directed at violence prevention in psychiatric wards and prisons that integrates the employee-level and management-level, and development of an evaluation design building on the Context, Process, and Outcome Evaluation Model. METHODS: The study follows a stepped-wedged design with 16 work units entering the intervention in four groups with differing start dates from September 2017 to January 2019. The context and process evaluation includes: calculating the implementation degree; mapping of contextual factors; interviews with unit-leaders and employees before and after the intervention. The outcome evaluation includes performing multi-level statistical analysis on data from a three-monthly questionnaire to employees at the participating workplaces. RESULTS: The first results will be available in 2020. CONCLUSIONS: The comprehensive evaluation of the intervention will give insight into the processes and effects of the intervention.


Assuntos
Hospitais Psiquiátricos/normas , Prisões/normas , Violência no Trabalho/prevenção & controle , Grupos Focais/métodos , Hospitais Psiquiátricos/tendências , Humanos , Entrevistas como Assunto/métodos , Prisões/tendências , Avaliação de Programas e Projetos de Saúde/métodos , Inquéritos e Questionários , Local de Trabalho/psicologia , Local de Trabalho/normas
10.
J Nurs Adm ; 49(3): 116-117, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30789553

RESUMO

Despite deeper investment in security measures, the rate of violence and point-of-care safety threats in healthcare settings is rising. As a result, nurses do not always feel safe while delivering care. In this article, the authors describe strategies for addressing point-of-care violence. This is the 2nd article of a series. The 1st article of this series, Cracks in the Foundation of the Care Environment Undermine Nurse Resilience, in the December 2018 issue (volume 48, issue 12) of The Journal of Nursing Administration, the authors explained how nursing leaders can reduce frontline nurse stress and burnout by addressing 4 "cracks in the foundation" of the care environment that can undermine nurse resilience. This article aims to help leaders address 1 of the foundational cracks: that violence and point-of-care safety threats are now commonplace in healthcare settings.


Assuntos
Esgotamento Profissional/prevenção & controle , Recursos Humanos de Enfermagem no Hospital/psicologia , Sistemas Automatizados de Assistência Junto ao Leito , Resiliência Psicológica , Violência no Trabalho/prevenção & controle , Local de Trabalho/psicologia , Agressão , Humanos , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Gestão da Segurança , Estados Unidos , Violência no Trabalho/psicologia
11.
Ind Health ; 57(2): 175-183, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30700668

RESUMO

This consensus report summarizes the negative impact of work-related psychosocial factors and job stressors on the health and wellbeing of shift workers. Psychosocial factors may (a) directly affect work schedules or (b) mediate or moderate relationships between work schedules, circadian factors, and health. In this paper, prominent psychosocial models (e.g. Job Strain and Effort-Reward Imbalance) are used to help assess detrimental effects, including pathophysiologic outcomes. Several studies indicate the psychosocial environment can be more problematic for shift workers compared to regular day workers. This is likely due to shift worker's experiencing greater risks of low job control, high physical work demands, lower support from supervisors, and greater levels of over-commitment. Workplace violence is another frequently encountered psychosocial stressor for shift workers more likely to be in regular contact with the general public, such as police officers, security personnel, professional drivers, and other service employees being at elevated risk. A large body of literature confirms night and irregular shift schedules increase risk for injury. Non-diurnal schedules can trigger and worsen such incidents, especially under unsafe conditions. The problem of workplace violence for shift workers, in terms of severity and consequences, is probably underestimated, especially when present among other occupational stressors. Practical considerations and recommendations for action to mitigate the detrimental effects of psychosocial stressors on night and shift workers are presented.


Assuntos
Doenças Profissionais/psicologia , Estresse Ocupacional/psicologia , Jornada de Trabalho em Turnos/psicologia , Feminino , Humanos , Masculino , Estresse Ocupacional/fisiopatologia , Fatores Socioeconômicos , Estresse Psicológico , Violência no Trabalho/prevenção & controle , Violência no Trabalho/psicologia
12.
J Nurs Manag ; 27(4): 781-791, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30784135

RESUMO

AIM: To examine health care managers' and health and safety staff experiences of prevention and management of workplace violence against staff. BACKGROUND: Employers have a responsibility to protect employees from workplace violence. The varied care settings present challenges for those responsible for ensuring safety. METHOD: Descriptive exploratory study using semi-structured interviews with 99 participants responsible for workplace safety, from 29 health services across metropolitan and regional Victoria, Australia. Interviews were audio-recorded, transcribed and thematically analysed. RESULTS: Five themes were identified: Workplace violence was accepted as "part of the job"; Participants relied on government resources and networking to guide them; Working alone and home visiting was a risk factor; Participants demanded a single, state-wide training programme; Sharing information is vital. CONCLUSIONS: Participants were acutely aware of the risks of violence towards staff, and of their responsibility in managing risks. Knowledge sharing and consistent, regular education can reduce the risks. Additional resources were required, particularly during home visits, or when working alone. IMPLICATIONS FOR NURSING MANAGEMENT: Managers need to prioritize resources such as reliable rapid response systems to prevent and manage violence, particularly against staff working alone or home visiting. Information sharing between health services and other agencies is important to reducing risk.


Assuntos
Pessoal de Saúde/estatística & dados numéricos , Enfermeiras Administradoras/psicologia , Gestão de Riscos/métodos , Violência no Trabalho/prevenção & controle , Atitude do Pessoal de Saúde , Humanos , Entrevistas como Assunto/métodos , Pesquisa Qualitativa , Vitória , Violência no Trabalho/psicologia
13.
Nursing ; 49(3): 61-63, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30801410

RESUMO

As caregivers, nurses often dismiss violent patient interactions as "just part of the job." This article addresses this misconception, differentiates between two types of violence present in healthcare settings, and stresses the importance of reporting and evaluating violent acts to plan mitigation strategies.


Assuntos
Relações Enfermeiro-Paciente , Recursos Humanos de Enfermagem no Hospital/psicologia , Violência no Trabalho/prevenção & controle , Humanos , Gestão de Riscos , Violência no Trabalho/classificação , Violência no Trabalho/estatística & dados numéricos
14.
J Nurs Adm ; 49(2): 73-78, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30633062

RESUMO

OBJECTIVE: The aim of this study was to evaluate the impact of behavior management training on nurses' confidence in managing aggressive patients. BACKGROUND: Nurses are at a high risk of experiencing violence directed toward them by patients. METHODS: This quality improvement project used a pre-and-post study design. A survey was administered within 1 month before behavior management training and 1 month after training, capturing participants' demographic and work characteristics, as well as their experiences with patient/visitor-perpetrated violence. Confidence was measured using the Confidence in Coping with Patient Aggression Instrument. Open-ended questions sought participants' thoughts on workplace violence prevention initiatives. RESULTS: Thirty-eight confidence scores were assessed. Nurses' confidence in coping with patient aggression was significantly higher after behavior management training. Nurse participants described the training as "timely," "helpful," and "beneficial." CONCLUSION: With an increased understanding of violent behavior stages and warning signs, a nurse is better able to manage a potentially violent situation.


Assuntos
Agressão/psicologia , Controle Comportamental , Capacitação em Serviço/organização & administração , Relações Enfermeiro-Paciente , Recursos Humanos de Enfermagem no Hospital/educação , Violência no Trabalho/prevenção & controle , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Papel do Profissional de Enfermagem , Recursos Humanos de Enfermagem no Hospital/psicologia , Violência no Trabalho/psicologia , Adulto Jovem
16.
West J Emerg Med ; 20(1): 170-176, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30643621

RESUMO

Introduction: Emergency physicians (EP) experience high rates of workplace violence, the risks of which increase with the presence of weapons. Up to 25% of trauma patients brought to the emergency department (ED) have been found to carry weapons. Given these risks, we conducted an educational needs assessment to characterize EPs' knowledge of firearms, frequency of encountering firearms in the ED, and level of confidence with safely removing firearms from patient care settings. Methods: This was a survey study of attending and resident EPs at two academic and four community hospitals in the Midwest and Northeast. A 26-item questionnaire was emailed to all EPs at the six institutions. Questions pertained to EPs' knowledge of firearms, experience with handling firearms, and exposure to firearms while at work. We calculated response proportions and p-values. Results: Of 243 recipients who received the survey, 149 (61.3%) completed it. Thirty-three respondents (22.0%) reported encountering firearms in the workplace, 91 (60.7%) reported never handling firearms, and 25 (16.7%) reported handling firearms at least once per year. Thirty-six respondents (24.0%) reported formal firearms training, and 63 (42.3%) reported no firearms training. There were no significant regional differences regarding firearms training or exposure. Residents from the Northeast were more likely to be moderately confident that they could safely handle a firearm prior to law enforcement involvement (p=0.043), while residents from the Midwest were more likely to be not at all confident (p=0.018). Conclusion: The majority of surveyed attending and resident EPs reported little experience with handling firearms. Among resident EPs, there was a regional difference in confidence in handling firearms prior to law enforcement involvement. Given the realities of workplace violence and the frequency with which firearms are encountered in the ED, further investigation is needed to evaluate provider competence in safely handling them. EPs may benefit from training on this topic.


Assuntos
Armas de Fogo , Determinação de Necessidades de Cuidados de Saúde , Médicos/estatística & dados numéricos , Violência no Trabalho/prevenção & controle , Serviço Hospitalar de Emergência/organização & administração , Feminino , Humanos , Conhecimento , Masculino , Segurança , Estados Unidos
17.
J Adv Nurs ; 75(8): 1657-1666, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30644125

RESUMO

AIMS: To explore associations between specific violence prevention strategies and nurses' perceptions of workplace safety in medical-surgical and mental health settings. BACKGROUND: Workplace violence is on the rise globally. Nurses have the highest risk of violence due to the nature of their work. Violence rates are particularly high among USA and Canadian nurses. Although multiple violence prevention strategies are currently in place in public healthcare organizations in British Columbia, Canada, it is unknown whether these approaches are associated with nurses' perceptions of workplace safety. DESIGN: This is an exploratory correlational design using secondary data. METHODS: Using data obtained from a province-wide survey of nurses between March 2017 - January 2018, this study included 771 nurses from medical-surgical and 189 nurses from mental health settings. Data were analysed using ordinal logistic regressions. RESULTS: For medical-surgical and mental health nurses, greater perceptions of workplace safety were related to employers listening to them with respect to violence prevention strategies. Nurses in both settings were more likely to feel safe when they were not expected to physically intervene during a code white situation. Medical-surgical nurses were more likely to feel safe when code white incident reviews were conducted and fixed alarms were used. Mental health nurses were more likely to report feeling safe when they had enough properly trained code white responders on their unit. CONCLUSION: Nurse-employer engagement is critical to nurses' perceptions of feeling safe at work. Engagement opportunities include nurses' involvement in discussions about appropriate violence prevention strategies, collaborative debriefing after violent incidents and co-development and updates of patients' behavioural care plans.


Assuntos
Atitude do Pessoal de Saúde , Recursos Humanos de Enfermagem no Hospital/psicologia , Saúde do Trabalhador/estatística & dados numéricos , Enfermagem Perioperatória , Enfermagem Psiquiátrica , Violência no Trabalho/prevenção & controle , Violência no Trabalho/psicologia , Adulto , Canadá , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Violência no Trabalho/estatística & dados numéricos
18.
Workplace Health Saf ; 67(2): 96, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30526414

RESUMO

Workplace violence is common in health care settings. Occupational and environmental health nurses should educate employees about measures to prevent violence in the workplace.


Assuntos
Pessoal de Saúde/educação , Violência no Trabalho/prevenção & controle , Humanos , Enfermagem do Trabalho
19.
J Nurs Manag ; 27(3): 592-598, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30223311

RESUMO

AIM: The study aimed to evaluate the reporting, monitoring and use of workplace violence data in Victorian health services. BACKGROUND: Surveillance of workplace violence is important in understanding the circumstances in which workplace violence occurs and development of relevant and appropriate prevention and intervention strategies. METHOD: A descriptive exploratory approach was used. Fifteen staff from occupational health and safety, quality and safety, and nurse unit managers, from five major metropolitan health services were interviewed. Recorded interviews were transcribed verbatim and thematically analysed. RESULTS: Three themes were identified: (a) "under-reporting of workplace violence," (b) "inconsistent guidance" caused subjective and variable data coding and (c) "application of data" described how health services used the data available to them, to inform the development and implementation of systems designed to prevent workplace violence. CONCLUSIONS: Improved reporting systems may increase consistency in reporting, enable data sharing across organisations and assist in planning of prevention strategies. IMPLICATIONS FOR NURSING MANAGEMENT: Staff should be encouraged to complete incident reports for each episode of workplace violence. Incident reporting systems must be simplified to reduce the burden of reporting. Nurse managers should advocate for the sharing of health service workplace violence data, to enable improved prevention across all services.


Assuntos
Gestão de Riscos/normas , Violência no Trabalho/estatística & dados numéricos , Adulto , Atitude do Pessoal de Saúde , Feminino , Humanos , Entrevistas como Assunto/métodos , Masculino , Pesquisa Qualitativa , Gestão de Riscos/estatística & dados numéricos , Inquéritos e Questionários , Vitória , Local de Trabalho/psicologia , Local de Trabalho/normas , Local de Trabalho/estatística & dados numéricos , Violência no Trabalho/prevenção & controle
20.
J Clin Nurs ; 28(1-2): 116-124, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30300949

RESUMO

AIMS: To examine the relationship between workplace violence perpetrated by clients, their innate neurophysiological response to dis-ease and the resulting interactions with healthcare providers. BACKGROUND: Client-on-worker violence remains a problem globally. Workplace violence risk factors have been documented. A gap remains in understanding what has happened to clients that perpetrate violence, and the link between adverse childhood experiences (ACE), the neuroscience of threat and trauma-informed care. DESIGN: This explanatory study was part of a larger descriptive study. METHODS: Managers, directors, health/safety staff, nurses and educators (n = 99) from Australian rural and metropolitan health services participated in individual and group interviews. Following inductive thematic analysis, a secondary analysis, informed by understandings of ACE, polyvagal theory and trauma-informed care, was conducted. Analysis was guided by the question: What happens to clients that causes them to instigate violence against healthcare workers? Reporting of this research adheres to the COREQ guidelines. RESULTS: Clients can react aggressively when under perceived threat. Themes included are as follows: client stress and trauma, previous client trauma, impact of care provision on client and trauma-informed care. CONCLUSION: Healthcare services can be experienced as stressful environments. Coupled with high incidences of past trauma, clients' assessment of risk and safety can be compromised resulting in inappropriate reactivity when staff are trying to provide care. Care provision can be perceived as a threat to clients' physical and psychological safety, activating the fight protective response resulting in aggression. Understanding and applying neuroscience and implementing a cultural change of trauma-informed care have the potential to reduce workplace violence. Even with these understandings, it is imperative that healthcare staff are protected and feel safe at work. RELEVANCE TO CLINICAL PRACTICE: Understanding trauma and the neuroscience of threat and safety can assist staff to understand what happens to clients that causes them to instigate violence against healthcare providers and implement systems and strategies to respond to such threat.


Assuntos
Pessoal de Saúde/organização & administração , Gestão da Segurança/organização & administração , Violência no Trabalho/prevenção & controle , Local de Trabalho/normas , Adulto , Agressão/psicologia , Austrália , Feminino , Pessoal de Saúde/psicologia , Humanos , Masculino , Relações Profissional-Paciente , Desenvolvimento de Pessoal/organização & administração , Local de Trabalho/psicologia
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