McCamon Teresa, Lowe Vicki, George Rinchu, Gordon Rachel, Watson Heather
Johns Hopkins Suburban Hospital, Bethesda, Maryland, USA.
Johns Hopkins Howard County General Hospital, Columbia, Maryland, USA.
J Clin Nurs. 2025 Apr;34(4):1187-1200. doi: 10.1111/jocn.17433. Epub 2024 Sep 30.
To identify best practices to prevent violence against healthcare workers by patients at risk for aggression in the adult inpatient setting.
An integrative review.
Conducted using the Johns Hopkins Evidence-based Practice for Nurses and Healthcare Professionals Model. Title and abstract screening on 4186 articles resulted in 156 for full text review. Full text screening yielded 14 articles that met inclusion criteria.
A search of the databases PubMed, CINAHL, Embase, and JBI from January 2019 to February 2023.
The review revealed behavioural intervention teams, environmental changes, and coordinated communication plans were the most used strategies, however none demonstrated significant decreases in violence.
Health systems can implement strategies shown to decrease the incidence of violence in healthcare settings globally. Lack of consistency in the evidence suggests the need for further research to assess mitigating strategies for violence against healthcare workers in inpatient hospital settings.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Patient safety is a cornerstone of nursing practice; however, healthcare workers need to feel safe in their work environment. Violent events are chronically underreported, ill defined, and when reported, do not address change in the practice setting. Identifying strategies to address escalating behaviour before it results in violence is crucial for everyone's safety.
This integrative review exposes the scarcity of evidence available to address rising concerns about patients on healthcare provider violence (Type II) in the workplace. Although several assessment tools for identifying violent patients exist, evidence regarding prevention is woefully absent. The review highlights potential interventions for further study to equip healthcare workers to manage patients safely and effectively before an escalation occurs.
PRISMA checklist for integrative reviews.
No patient or public contribution was part of this review.
确定在成人住院环境中，针对有攻击风险的患者预防其对医护人员实施暴力的最佳做法。
综合综述。
采用约翰霍普金斯护士及医护专业人员循证实践模型进行。对4186篇文章进行标题和摘要筛选，筛选出156篇进行全文审查。全文筛选后得到14篇符合纳入标准的文章。
检索2019年1月至2023年2月期间的PubMed、CINAHL、Embase和JBI数据库。
综述显示，行为干预团队、环境改变和协调沟通计划是最常用的策略，但均未显示出暴力行为有显著减少。
卫生系统可实施已证明能在全球范围内降低医疗环境中暴力发生率的策略。证据缺乏一致性表明，需要进一步研究以评估住院医院环境中针对医护人员暴力行为的缓解策略。
对专业和/或患者护理的启示：患者安全是护理实践的基石；然而，医护人员需要在工作环境中感到安全。暴力事件长期以来报告不足、定义不明确，而且报告时也未涉及实践环境中的变化。在暴力行为发生之前确定应对行为升级的策略对每个人的安全至关重要。
本综合综述揭示了可用于解决职场中对医护人员暴力（第二类）日益增加的担忧的证据稀缺。虽然存在几种识别暴力患者的评估工具，但关于预防的证据却严重缺乏。该综述强调了潜在的干预措施以供进一步研究，使医护人员能够在情况升级之前安全有效地管理患者。
综合综述的PRISMA清单。
本综述未纳入患者或公众参与。
