Nurses' Workplace Violence: Causes, Interventions, and Barriers to These Interventions

Introduction

Most of the nurses have had instances of workplace violence, especially those who work in psychiatric settings. Abuse happens in various forms, the worst being physical violence. With the reports showing 33% of nurses in psychiatric settings have reported an incident of violence, there need to be mechanisms to curb violence in psychiatric settings. In this research, the mechanisms compared are the formulation and implementation of security policies with workplace education. This paper focuses on analysis and comparison between eight articles, all addressing workplace violence.

Comparison of research questions

The research by Itzhaki et al. majorly focuses on the techniques used to reduce workplace violence in psychiatric settings. Workplace violence is rampant in psychiatric centers, and the authors choose to focus on the methods being applied to minimize these cases. Hamblin focused on workplace violence in psychiatric settings, and focus on finding out the effectiveness of worksite walkthrough policy implementation in addressing workplace violence. This will help determine how useful a worksite walkthrough is in minimizing workplace violence.

Blando, Ridenour, Hartley, & Casteel researched explicitly on barriers to effective implementation of programs in preventing workplace violence, specifically in hospitals. The researchers claim that implementing violence prevention programs is of great importance but again finding out why the implementation of these programs is too hard. For Pekurinen et al., the research question addresses the impact of patient behaviors and aggressions on the security and well-being of nurses. Some patients behave badly and are excessively aggressive, and the authors focused on the effect that increases the risk of violence against nurses.

The fifth article by Gillespie, Farra, & Gates focuses on research on the effectiveness of workplace education programs in reducing workplace violence. The research question for the sixth article by Copeland & Henry is to investigate the expectations, experiences, and recommendations of nurses about workplace violence. The seventh article researches the effectiveness of current prevention intervention mechanisms on workplace violence and threats. The last article by Ridenour et al. researches the risks associated with workplace nursing staff in the psychiatric department.

Comparison of sample populations

The research by Itzhaki et al. in their study sampled enrolled and registered nurses in the Finnish hospital District. The focus group was 22, and the research was conducted through interviews and questionnaires. Hamblin sampled supervisors in 21 hospital units in 7 metropolitan hospitals in the United States. Data was collected through the collection of data reports, interviews, and questionnaires in randomized study units.

Blando, Ridenour, Hartley, & Casteel sampled 30 nurses in the hospital setting, and research was conducted through interviews, which were film recorded and later translated into transcripts. Pekurinen et al. sampled 42 nurses in psychiatric and non-psychiatric settings. The research implemented a cross-sectional study through interviews, questionnaires, and surveys, which were later evaluated.

The article by Gillespie, Farra, & Gates sampled 120 nurses who work in the emergency department, and data was collected through interviews, questionnaires, and surveys.

Copeland & Henry sampled 147 nurses in the emergency department, and research was done through Interviews filmed recorded, and translated into transcripts. In the article by Gadegaard, Andersen & Hogh, 360 nursing staff working in prison, probation services, elderly care, and psychiatry were sampled, and research was done through controlled trials. Ridenour et al., in their study, sampled 284 nurses in 8 acute psychiatric units, and analysis was done through surveys and interviews.

A comparison of limitations

The first article by Itzhaki et al. had several limitations, including the choice of using nurse managers as contact people for recruiting participants, posed a challenge of selective sampling, nurses working in the same hospital, and finally influence of data interpretation by authors’ occupational histories. Limitations of the research by Hamblin et al. included a lack of cost estimations of the intervention, and therefore all future researchers must assess their costs, the modest number of intervention units that returned the walkthrough questionnaires, the moderate response rate from unit supervisors on the follow-up questionnaire and organizational changes at the hospital system during the study period.

Blando, Ridenour, Hartley, & Casteel had limitations such as lack of randomization among the focus group participants that could have resulted in reporting bias and also that focus group participants were members of workers union and therefore some of their comments may not have represented all nurses. The limitations of the research by Pekurinen et al. included the cross-sectional nature of the study did not allow researchers to make definite causal conclusions about the results, the study relied on self-reported questionnaires, which created the possibility of standard method variance, and misunderstanding or modifying answers in order to give a more socially desirable response and lastly, the differences between the groups might have been affected by the large sample size.

Gillespie, Farra, & Gates had no limitations and conflicts during the study. A study by Copeland & Henry had some limitations. The first was a small sample size and inclusion of only one facility which limited the generalizability of the study. The study only addressed two types of workplace violence, while there are various types. Finally, the nurse who responded to the surveys must have heard different experiences from those who did not, therefore generalization was limited.

Ridenour et al. also had limitations in their research which included, some of the associations found in the study were not statistically significant despite the large sample size, due to privacy restrictions and HIPAA restrictions researchers were not able to link assault information to an individual nurse, lack of statistical power and there were also restrictions on data collection on patients.

Conclusion

All eight studies focused on workplace violence but from a different angle. Each of the research questions studied by each study is relevant in finding information about the prevalence of workplace violence against nurses, causes, interventions, and barriers to these interventions. The studies were done for different settings and samples, which was great since it is from various locations helping in getting a good picture of workplace violence. All the studies also had limitations due to the nature of the research, but still, the findings create a real description of the issue. The articles help form a foundation for further study. Further research should be done on various energy transfer mechanisms for psychiatric patients.

References

1. Blando, J. D., Ridenour, M., Hartley, D., & Casteel, C. (2014). Barriers to effective implementation of programs for workplace violence prevention in hospitals. OJIN: The Online Journal of Issues in Nursing (American Nurses Association), 20(1), 1-11.
2. Copeland, D., & Henry, M. (2017). Workplace violence and perceptions of safety among emergency department staff members: Experiences, expectations, tolerance, reporting, and recommendations. Journal of trauma nursing, 24(2), 65-77.
3. Gadegaard, C. A., Andersen, L. P., & Hogh, A. (2018). Effects of violence prevention behavior on exposure to workplace violence and threats: a follow-up study. Journal of interpersonal violence, 33(7), 1096-1117.
4. Gillespie, G. L., Farra, S. L., & Gates, D. M. (2014). A workplace violence educational program: A repeated measures study. Nurse education in practice, 14(5), 468-472.
5. Hamblin, L. E., Essenmacher, L., Luborsky, M., Russell, J., Janisse, J., Upfal, M., & Arnetz, J. (2017). Worksite Walkthrough Intervention: Data-driven Prevention of Workplace Violence on Hospital Units. Journal of occupational and environmental medicine, 59(9), 875-884.
6. Itzhaki, M., Bluvstein, I., Peles Bortz, A., Kostistky, H., Bar Noy, D., Filshtinsky, V., & Theilla, M. (2018). Mental health nurse's exposure to workplace violence leads to job stress, which leads to reduced professional quality of life International Journal of Mental Health Systems
7. Pekurinen, V., Willman, L., Virtanen, M., Kivimäki, M., Vahtera, J., & Välimäki, M. (2017). Patient aggression and the wellbeing of nurses: a cross-sectional survey study in psychiatric and non-psychiatric settings. International journal of environmental research and public health, 14(10), 1245.
8. Ridenour, M., Lanza, M., Hendricks, S., Rierdan, J., Zeiss, R., Schmidt, S., ... & Amandus, H. (2016). The violence prevention community meeting: a multi-site study. Archives of psychiatric nursing, 30(3), 382-386.