This article describes the risk factors and protective strategies associated with workplace violence perpetrated by patients and visitors against healthcare workers. Perpetrator risk factors for patients and visitors in healthcare settings include mental health disorders, drug or alcohol use, inability to deal with situational crises, possession of weapons, and being a victim of violence. Worker risk factors are gender, age, years of experience, hours worked, marital status, and previous workplace violence training. Setting and environmental risk factors for experiencing workplace violence include time of day and presence of security cameras. Protective strategies for combating the negative consequences of workplace violence include carrying a telephone, practicing self-defense, instructing perpetrators to stop being violent, self- and social support, and limiting interactions with potential or known perpetrators of violence. Workplace violence is a serious and growing problem that affects all healthcare professionals. Strategies are needed to prevent workplace violence and manage the negative consequences experienced by healthcare workers following violent events.

Workplace violence in healthcare settings: risk factors and protective strategies.

Critical appraisal skills are believed to play a central role in an evidence-based approach to health practice. The aim of this study was to evaluate the effectiveness and costs of a critical appraisal skills educational intervention aimed at health care professionals. This prospective controlled trial randomized 145 self-selected general practitioners, hospital physicians, professions allied to medicine, and healthcare managers/administrators from the South West of England to a half-day critical appraisal skills training workshop (based on the model of problem-based small group learning) or waiting list control. The following outcomes were assessed at 6-months follow up: knowledge of the principles necessary for appraising evidence; attitudes towards the use of evidence about healthcare; evidence seeking behaviour; perceived confidence in appraising evidence; and ability to critically appraise a systematic review article. At follow up overall knowledge score [mean difference: 2.6 (95% CI: 0.6 to 4.6)] and ability to appraise the results of a systematic review [mean difference: 1.2 (95% CI: 0.01 to 2.4)] were higher in the critical skills training group compared to control. No statistical significant differences in overall attitude towards evidence, evidence seeking behaviour, perceived confidence, and other areas of critical appraisal skills ability (methodology or generalizability) were observed between groups. Taking into account the workshop provision costs and costs of participants time and expenses of participants, the average cost of providing the critical appraisal workshops was approximately £250 per person. The findings of this study challenge the policy of funding 'one-off' educational interventions aimed at enhancing the evidence-based practice of health care professionals. Future evaluations of evidence-based practice interventions need to take in account this trial's negative findings and methodological difficulties.

/pdf/critical-appraisal-skills-training-for-health-care-4jp45a2if0.pdf

Critical appraisal skills training for health care professionals: a randomized controlled trial [ISRCTN46272378]

This paper aims to assess consistent predictors through the use of a sample that includes different actors from the healthcare work force to identify certain key elements in a set of job-related organizational contexts. The utilized data were obtained from the 5th European Working Conditions Survey, conducted in 2010 by the European Foundation for the Improvement of Living and Working Conditions. In light of these objectives, we collected a subsample of 284 health professionals, some of them from the International Standard Classification of Occupations—subgroup 22—(ISCO-08). The results indicated that the chance of a healthcare worker referring to him/herself as bullied increases among those who work on a shift schedule, perform monotonous and rotating tasks, suffer from work stress, enjoy little satisfaction from their working conditions, and do not perceive opportunities for promotions in their organizations. The present work summarizes an array of outcomes and proposes within the usual course of events that workplace bullying could be reduced if job demands were limited and job resources were increased. The implications of these findings could assist human resource managers in facilitating, to some extent, good social relationships among healthcare workers.

https://www.mdpi.com/1660-4601/10/8/3121/pdf

Workplace Bullying among Healthcare Workers

Unlike the patient safety research network, no consensus document exists that outlines definitions and concepts that pertain to the workplace violence research environment in the health sector. There are no agreed definitions internationally for terms such as vertical and horizontal violence. This results in a challenging research environment where parallels and commonality are somewhat ambiguous. The objective of this study was to define six central actions of workplace violence for use in health sector research. This was a two-part study design, Part 1 was a literature search of medical related electronic databases from their beginning until the end of June 2014. Articles of any study type were included if their main purpose was to define the actions of workplace violence. Part 2 was a group discussion held during a workshop at an international conference to discuss and compile definitions for specific workplace violence acts. Part 1, a total of 91,681 articles were identified with 82 articles meeting the inclusion criteria with 50 articles excluded as they did not report on definitions relating to workplace violence. After discussion and debate the outcome of Part 2 concluded in a consensus where six definitions were proposed; Bullying, Verbal Abuse, Threat, Physical Abuse, Sexual Harassment, and Sexual Abuse.
 This study presents a set of definitions that serves as a starting point for defining workplace violence actions and as a foundation for future refinement and possible additions as the workplace and the way people work evolves over time in the health sector.

/pdf/working-towards-a-definition-for-workplace-violence-actions-41w43rl7vu.pdf

Working towards a definition for workplace violence actions in the health sector

Workplace violence (WPV) perpetrated by patients and visitors against nurses and physicians is a problem in adult emergency departments (EDs), but largely unrecognized and unreported in pediatric EDs. The purpose of this qualitative study was to describe the WPV that occurred in a pediatric ED and the negative effects on the workers. Data included transcribed interviews with 31 pediatric ED workers, nonparticipant observations, digital photographs, and archival records and were analyzed using a modified constant comparative analysis method. Participants perceived that both genders and all occupational groups were at risk for experiencing verbal and physical WPV. Common perpetrator characteristics were patients receiving a psychiatric evaluation and visitors exhibiting acute anxiety. Effects were experienced by workers, perpetrators, patient bystanders, and healthcare employers. It is concluded that WPV is a problem in this pediatric ED, and interventions need to be implemented to promote the safety of the workers and patients.

/pdf/violence-against-healthcare-workers-in-a-pediatric-emergency-1b3cglct4z.pdf

Violence against healthcare workers in a pediatric emergency department.

AIMS: To identify levels of Australian rural general practitioners' apprehension about violence, factors effecting apprehension and the effect of apprehension on service provision. METHOD: Six focus groups were held with rural GPs from Western Australia, New South Wales and Victoria. A questionnaire was developed on the basis of the focus group data and all GPs in these three areas were surveyed. RESULTS: The results indicated GPs were more apprehensive about providing after hours care than during business hours. Significant gender differences were found with women being more often apprehensive than men and more likely to withdraw after hours services. CONCLUSION: This study shows that that levels of apprehension about violence affect GPs' willingness to provide after hours services. Future provision of general practice after hours services and home visits in rural areas requires the availability of a safe working environment to reduce GPs' apprehension about workplace violence. Language: en

Rural general practitioner apprehension about work related violence in Australia

Alternative curricular options in rural networks - (ACORNS)

In 1998, the Department of General Practice (Faculty of Medicine and Dentistry, University of Western Australia) ran a pilot project to use computers in a sixth year rural general practice term. Students were provided with a laptop computer to take into rural and remote areas throughout Western Australia during their 4-week clinical attachment. An email mailing list was set up for course participants to share experiences and complete set learning activities specifically related to rural general practice. An evaluation of this pilot project found that students felt less isolated on rural attachments, course outcomes were improved and rural preceptors were more involved in the programme. The development of a teaching and learning programme that involves the use of computers in rural general practice for undergraduate students has the potential to improve the quality of their medical education.

Evaluation of a pilot project to use computers in a rural general practice term.

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Rural general practitioner apprehension about work related violence in Australia

Alternative curricular options in rural networks - (ACORNS)

Evaluation of a pilot project to use computers in a rural general practice term.