Mundey Natasha, Terry Victoria, Gow Jeff, Duff Jed, Ralph Nicholas
School of Nursing and Midwifery, University of Southern Queensland, Toowoomba, Australia.
Centre for Health Research, University of Southern Queensland, Ipswich, Australia.
J Nurs Manag. 2023 Dec 6;2023:3239640. doi: 10.1155/2023/3239640. eCollection 2023.
Up to 92% of health workers experience some form of patient-perpetrated violence. The highest risk environments include emergency departments, acute care settings, and mental health units. Given such elevated rates of violence, current interventions have questionable efficacy or implementation challenges.
We conducted a systematic review conforming to PRISMA reporting requirements. We searched PubMed, CINAHL, PsycINFO, Scopus, and the Cochrane Library. Studies reporting interventions to prevent patient-initiated violence against healthcare workers in hospitals were included, and findings were synthesised.
Based on meeting eligibility criteria, twelve studies were included in the review. Most interventions reported an effect with eleven of the twelve studies describing changes in the incidence of violence postintervention. Most studies were evaluations of education and training programs ( = 7), followed by action plans ( = 2), and a reporting instrument, risk assessment tool, and legislation ( = 1).
Insights into effective strategies to prevent hospital patient and visitor-initiated violence are necessary to develop guidelines for better aggression/violence deterrence. Violence prevention requires strong, evidence-based, and clinically applicable interventions that promote the safety and satisfaction of all healthcare workers. . Formulating effective and appropriate strategies that aid in early recognition, prevention, and management of aggression/violence will benefit all health workers. Patient and staff satisfaction will rise; healthcare workers will regain a sense of preparedness, and higher levels of safety will be achieved. Without these effective interventions being established, the magnitude of adverse outcomes from patient-perpetrated violence will continue in healthcare.
高达92%的医护人员曾遭遇某种形式的患者实施的暴力行为。风险最高的环境包括急诊科、急症护理机构和精神卫生科。鉴于暴力发生率如此之高，当前的干预措施疗效存疑或在实施方面存在挑战。
我们进行了一项符合PRISMA报告要求的系统评价。我们检索了PubMed、CINAHL、PsycINFO、Scopus和Cochrane图书馆。纳入了报告在医院预防患者对医护人员实施暴力的干预措施的研究，并对研究结果进行了综合分析。
根据纳入标准，本评价纳入了12项研究。大多数干预措施报告有效果，12项研究中的11项描述了干预后暴力发生率的变化。大多数研究是对教育和培训项目的评估（n = 7），其次是行动计划（n = 2），以及一种报告工具、风险评估工具和立法（n = 1）。
有必要深入了解预防医院患者和访客实施暴力的有效策略，以制定更好的攻击/暴力威慑指南。预防暴力需要强有力的、基于证据的且临床适用的干预措施，以促进所有医护人员的安全和满意度。制定有助于早期识别、预防和管理攻击/暴力的有效且适当的策略将使所有医护人员受益。患者和工作人员的满意度将会提高；医护人员将重新获得准备充分的感觉，并实现更高水平的安全。如果不建立这些有效的干预措施，患者实施暴力所导致的不良后果的严重程度在医疗保健领域将持续存在。
