Workplace violence and associations with health outcomes in public health administration agencies in Taiwan: a survey during the COVID-19 pandemic

Objectives: To investigate the prevalence of workplace violence in public health administration agencies and its effects on health outcomes. Methods: A survey was conducted in March 2022. Staff who had been working for at least one year in the Ministry of Health and Welfare or its subordinate agencies, the Department of Health, or in public health centers were recruited. Data were collected anonymously with a structured, online questionnaire. A total of 492 valid questionnaires were collected. Results: A total of 48.17% participants reported having experienced workplace violence (physical, psychological, verbal, or sexual). The most common type of violence was verbal (43.50%), followed by psychological (31.71%). Supervisors were the primary perpetrators of verbal and psychological violence, followed by clients and colleagues. Staff reported long working hours and high levels of psychological and physical stress. Furthermore, 22.97% of workers reported poor self-rated health, 60.57% had personal burnout levels higher than 50, and 63.41% reported poor mental health. Regression analyses showed that low workplace justice was most strongly associated with internal verbal and psychological violence, whereas routine work requiring interaction with the public was most strongly associated with external verbal violence. Staff who had experienced workplace violence in the past year had significantly higher risks of poor self-rated health, mental health, and personal burnout, and poor health was more strongly associated with workplace violence that originated inside the organization than with workplace violence that originated from outside the organization. Conclusions: This survey was conducted on-line anonymously, so the representativeness of our findings might be limited. However, heavy workloads and workplace violence in public health administration agencies during the COVID-19 pandemic are important issues deserving urgent attention. (Taiwan J Public Health. 2023;42(1) :42-61)

The handbook of security

The substantially revised third edition of The Handbook of Security provides the most comprehensive analysis of scholarly security debates and issues to date. It reflects the developments in security technology, the convergence of the cyber and security worlds, and the fact that security management has become even more business focused. It covers newer topics like terrorism, violence, and cybercrime through various offence types such as commercial robbery and bribery. This handbook comprises mostly brand new chapters and a few thoroughly revised chapters, with discussions of the impact of the pandemic. It includes contributions from some of the world's leading scholars from an even broader geographic scale to critique the way security is provided and managed. It speaks to professionals working in security and students studying security-related courses. Chapter 5 is available open access under a Creative Commons Attribution 4.0 International License via link.springer.com. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022. All rights reserved.

Workplace Bullying and Violence on Burnout Among Bangladeshi Registered Nurses: A Survey Following a Year of the COVID-19 Pandemic.

Objectives: To investigate burnout among Bangladeshi nurses and the factors that influence it, particularly the association of workplace bullying (WPB) and workplace violence (WPV) with burnout. Methods: This cross-sectional study collected data from 1,264 Bangladeshi nurses. Mixed-effects Poisson regression models were fitted to find the adjusted association between WPB, WPV, and burnout. Results: Burnout was found to be prevalent in 54.19% of 1,264 nurses. 61.79% of nurses reported that they had been bullied, and 16.3% of nurses reported experience of "intermediate and high" levels of workplace violence in the previous year. Nurses who were exposed to "high risk bullying" (RR = 2.29, CI: 1.53-3.41) and "targeted bullying" (RR = 4.86, CI: 3.32-7.11) had a higher risk of burnout than those who were not. Similarly, WPV exposed groups at "intermediate and high" levels had a higher risk of burnout (RR = 3.65, CI: 2.40-5.56) than WPV non-exposed groups. Conclusion: Nurses' burnout could be decreased if issues like violence and bullying were addressed in the workplace. Hospital administrators, policymakers, and the government must all promote and implement an acceptable working environment.

Workplace violence against healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis.

Workplace violence (WPV) is a prevalent phenomenon, especially in the healthcare setting. WPV against healthcare workers (HCWs) has increased during the COVID-19 epidemic. This meta-analysis determined the prevalence and risk factors of WPV. A database search was conducted across six databases in May 2022, which was updated in October 2022. WPV prevalence among HCWs was the main outcome. Data were stratified by WPV/HCW type, pandemic period (early, mid, late), and medical specialty. WPV risk factors were the secondary outcome. All analyses were conducted through STATA. Newcastle Ottawa Scale evaluated the quality. Sensitivity analysis identified effect estimate changes. A total of 38 studies (63,672 HCWs) were analyzed. The prevalence of WPV of any kind (43%), physical (9%), verbal (48%), and emotional (26%) was high. From mid-pandemic to late-pandemic, WPV (40-47%), physical violence (12-23%), and verbal violence (45-58%) increased. Nurses had more than double the rate of physical violence (13% vs. 5%) than physicians, while WPV and verbal violence were equal. Gender, profession, and COVID-19 timing did not affect WPV, physical, or verbal violence risk. COVID-19 HCWs were more likely to be physically assaulted (logOR = 0.54; 95% CI: 0.10: 0.97). Most healthcare employees suffer verbal violence, followed by emotional, bullying, sexual harassment, and physical assault. Pandemic-related workplace violence increased. Nurses were twice as violent as doctors. COVID-19 healthcare employees had a higher risk of physical and workplace violence.

Workplace Violence in the Hospital: Strategies for Meaningful Change.

BACKGROUND: Workplace violence is not a unique problem to organizations. Evidence-based toolkits and strategies are available to help provide a guiding framework for the reduction of workplace violence events. As times and stressors (both personal and environmental) change, hospitals must keep constant attention on how to address and implement initiatives to keep staff safe. This manuscript addresses steps taken at 1 hospital to meet this challenge. PROCESS: Although a workplace violence committee had been in place for some time, it was identified that not all of the key players were included. Membership was evaluated, and executive-level support was provided. A review of literature was conducted and identified top priorities upon which to focus efforts. Subcommittees were formed to be responsible for these categories of work and to report back to the committee. EVALUATION: Data points and a dashboard were created to monitor trends and effectiveness, especially regarding combating the culture of underreporting. Processes and resources were formalized and made easily accessible to staff. Case studies and direct feedback from staff have been impactful and helped identify additional barriers. Evaluation will continue to occur using process-improvement methodology along with technological assistance. CONCLUSIONS: Workplace violence is not part of the job. Ongoing work is needed to continue to move the needle and make hospitals a safer place to work. Engagement from all levels of the organization is necessary to have a successful program.

Violence Risk Assessment in the Emergency Department.

INTRODUCTION: Workplace violence is a prevalent problem in health care, with mental health and emergency departments being the most at-risk settings. The aim of this evidence-based practice project was to pilot use of a violence risk assessment tool, the Broset Violence Checklist, to assess for risk of type II violence and record the interventions that nurses chose to implement to mitigate the situation. Additionally, reports made to the hospital reporting system were tracked and compared to previous reporting frequency. METHODS: Following staff education, nurses were instructed to complete checklists for all patients who have a score of 1 or higher, which indicates the presence of at least 1 high-risk behavior, and continue hourly scoring until the score returned to 0 or the patient was dispositioned. The number of incidents recorded, time of day, scores, interventions applied to mitigate violence, and change in scores after interventions were evaluated. The number of Broset Violence Checklist scoring sheets submitted and reports made via the hospital reporting system were compared. RESULTS: Incidents were most frequent from 11 am until 3 am. The highest scores occurred in the late evening and early morning hours. There were significantly more incidents captured with the use of the Broset Violence Checklist as compared to the hospital reporting system. Incidents significantly associated with higher scores included providing comfort measures, addressing concerns, and applying restraints. DISCUSSION: The Broset Violence Checklist was used successfully in the emergency department setting to identify behaviors associated with violence. Under-reporting to the hospital report system was identified in this project, consistent with reports in the literature. Specific interventions were not associated with a decrease in Broset Violence Checklist scores.

Workplace violence against Bangladeshi registered nurses: A survey following a year of the COVID-19 pandemic.

AIMS: To investigate the prevalence of workplace violence and its associated factors among Bangladeshi registered nurses. BACKGROUND: Workplace violence is prevalent among nurses, particularly in developing countries. However, the issue has never been examined in Bangladeshi nurses. METHODS: Between February 26 and July 10, 2021, this cross-sectional survey involving 1264 registered nurses was conducted. Workplace violence was determined by the Workplace Violence Scale (WVS). A multivariable logistic regression model was fitted to find the factors associated with workplace violence. This study complies with the EQUATOR (STROBE) checklist. RESULTS: Of the 1264 nurses, 885 (70%) nurses reported being exposed to workplace violence in the previous year. Three hundred twenty-four (324; 25.6%) nurses reported physical violence, whereas 902 (71.4%) nurses reported nonphysical violence. According to the multivariable logistic regression model, male nurses, nurses in the Sylhet division, emergency department nurses, nurses working extended hours, and non trained nurses to tackle workplace violence were prone to physical violence. Furthermore, public hospital nurses and non trained nurses to tackle workplace violence were more likely to be exposed to nonphysical violence. Nurses who had not been exposed to workplace violence were satisfied with their current job, but those who had been exposed to workplace violence were dissatisfied and intended to leave their current job. CONCLUSIONS AND IMPLICATIONS FOR NURSING AND HEALTH POLICY: High prevalence of workplace violence underscores nurses' current working conditions, which are particularly poor in public hospitals and emergency departments. Moreover, the COVID-19 pandemic put unprecedented pressure on the whole healthcare system and caused various difficulties for healthcare workers. To develop a zero-violence practice environment, health authorities should implement policy-level interventions. Healthcare staff should be guided to deal more successfully with patients and coworkers to create a positive working environment.

Exploring workplace violence on surgical wards in Sweden: a cross-sectional study.

BACKGROUND: Workplace violence is a global threat to healthcare professionals' occupational health and safety and the situation has worsened during the COVID-19 pandemic. This study aimed to explore workplace violence directed against assistant and registered nurses working on surgical wards in Sweden. METHODS: This cross-sectional study was conducted in April 2022. Using a convenience sampling procedure, 198 assistant and registered nurses responded to an online questionnaire developed for this specific study. The questionnaire comprised 52 items and included, among other items, subscales from validated and previously used instruments. Data analysis included descriptive statistics, the chi-square test, and independent-samples t-test. RESULTS: The most frequently reported type of workplace violence was humiliation (28.8%), followed by physical violence (24.2%), threats (17.7%), and unwanted sexual attention (12.1%). Patients and patients' visitors were reported as the main perpetrators of all kinds of exposure. Additionally, one third of the respondents had experienced humiliation from colleagues. Both threats and humiliation showed negative associations with work motivation and health (p < 0.05). Respondents classified as working in a high- or moderate-risk environment were more frequently exposed to threats (p = 0.025) and humiliation (p = 0.003). Meanwhile, half of the respondents were unaware of any action plans or training regarding workplace violence. However, of those who indicated that they had been exposed to workplace violence, the majority had received quite a lot or a lot of support, mainly from colleagues (range 70.8-80.8%). CONCLUSION: Despite a high prevalence of workplace violence, and especially of humiliating acts, there appeared to be low preparedness within the hospital organizations to prevent and/or handle such incidents. To improve these conditions, hospital organizations should place more emphasis on preventive measures as part of their systematic work environment management. To help inform such initiatives, it is suggested that future research should focus on the identification of suitable measures regarding different types of incidents, perpetrators, and settings.

Violence Against Healthcare Workers During COVID-19 Pandemic In India

Purpose: The violence against healthcare workers is one of the world's serious public health and patient care challenges. This is often exacerbated during emergencies, and the same has been observed during COVID-19. Method(s): The study reported an analysis of media reports during the first and second waves of the COVID-19 pandemic from India. We searched and analysed violent incidents against healthcare workers reported in English & Hindi online media. Our media analysis also reported perpetrators and triggers to mitigate violence against healthcare workers. Finding(s): We studied 51 incidents of violence, during March 2020-August 2021, as per our inclusion criteria. The majority of this reported violence occurred from the government hospitals (45.1%), followed by the community (29.4%), private hospitals (19.6%), quarantine facilities (4.0%), and burial grounds (1.9%). Doctors were targeted in the majority (82.3%), followed by other hospital staff (security and support) (33.3%), nurses (9.8%), ANMs (3.9%), and ASHA (2.0%). The majority of reported incidents were related to physical violence (58.9%), followed by verbal and physical combined (23.5%), sexual harassment (9.8%), and verbal (7.8%). The preparators of violence were family members (53.0%), community (31.4%), police officials (7.8%), and patients (7.8%). Conclusion(s): The actions required to mitigate the violence against healthcare workers require a multipronged approach with the introduction of strict policy measures and their implementation. The mandatory training of healthcare workers in soft and communication skills, protection, and coping mechanisms to prevent and de-escalate such incidents.Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Nurses with workplace violence in pneumology settings during Covid-19

Background: Workplace violence (WPV) has consequences both for healthcare workers and healthcare organizations. Nurses are the most exposed healthcare workers to vertical WPV. Aims and Objectives: Describe the Italian WPV and identify its predictive factors. Method(s): This is a secondary analysis conducted in hospital pneumology settings from a larger study between January and April 2021. Data were collected through the Practice Environment Scale of the Nursing Work Index (PES-NWI;Likert scale 1 to 4) and the Violence in Emergency Nursing and Triage (VENT) Questionnaire. Result(s): The analysis was conducted on 484 pulmonary nurses (72.9% female;mean age 38.9 years, SD 9.8). Thirty-four per cent (n=164) of them have had an experience of WPV in last year and/or their last week and 16.7% (n=81) only in their last week. Comparing main results between nurses with WPV vs no WPV the number of patients was higher for nurses with WPV (MD +4.8;p<.001). The PES-NWI results were significantly worse for nurses with WPV: global mean scores (MD +0.2;p<.001);nurse participation in hospital affairs (MD +0.3;p<.001);nurse manager ability leadership, and support of nurses (MD +0.2;p<.001);physician-nurse relationship (MD +0.2;p<.001). Conclusion(s): Public health companies should reduce WPV by investing in resources for the management and prevention of the phenomenon. Integrated and multimodal programs of prevention and management of WPV are useful to combat it. Improving the work environment and job satisfaction should reduce WPV.

Workplace violence, trauma, and the lived experience of corrections officers: A phenomenological study

Corrections officers are required to ensure compliance from inmates, and sometimes they have to use force, resulting in violent encounters. Such incidents can be traumatic for those directly and indirectly involved. Previous studies examined the working conditions of jail staff, but their focus was not primarily directed toward corrections officers. The purpose of this qualitative phenomenological study was to explore how everyday occurrences of violence associated with working in jails influence corrections officers' physiological well-being. The theory of constructed emotions framed this study. Recruiting was conducted using a demographic and interest survey distributed through Facebook. Using purposive sampling, semi structured interviews were conducted using the Zoom platform (due to the COVID-19 pandemic) and face-to-face with 11 active-duty corrections officers working in a complex jail system in a northeastern metropolitan region. The study addressed the lived experiences of corrections officers who experienced or witnessed workplace violence by inmates and how inmates cope with trauma. Interview responses were coded and analyzed to identify common themes. The corrections officers' most common concerns were lack of follow-up after a use-of-force encounter and workplace policies about the use of force that are ineffective and detrimental. Other findings indicated fear, helplessness, stress, anxiety, and anger. Policymakers, key stakeholders, and others may lead to positive social change by using these findings in developing effective and competent strategic planning, management, and policy implementation to support corrections officers and offer them better ways to process the trauma that they experience throughout their careers. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Meet Lynda Enos: The Occupational Health Master

The article focuses on Lynda Enos a certified professional ergonomist who has worked in various healthcare and occupational health settings. Topics include discussing her background and how she became interested in occupational health, preventing violence in healthcare settings, and her work for a nursing union.

[Attacks on personnel assigned to the Primary Care Management of Tenerife and the SARS-CoV2 pandemic]. / Agresiones a personal adscrito a la Gerencia de Atención Primaria de Tenerife y pandemia por SARS-CoV2.

OBJECTIVE: To measure and characterize the aggressions suffered by health professionals in the field of primary care in Tenerife between 2018-2019 (pre-pandemic) and 2020-2021 (pandemic). Secondly, to analyze the degree of knowledge of the professionals in relation to the procedure for action against aggressions as well as the existing security measures and aspects that could be improved for their protection. MATERIALS AND METHODS: Observational, descriptive and cross-sectional study using a self-completed form electronically. It was disseminated through the different communication channels with health professionals, being available between March and April 2022. The quantitative variables were analyzed using measures of central tendency and dispersion, and the qualitative variables in percentage, also performing a bivariate analysis using the Chi square and Student's T. RESULTS: 72.50% of the participants have suffered some type of aggression in the workplace and they are more frequent causes in the metropolitan area of Tenerife, which are produced fundamentally by the patient and their relatives. These aggressions are mostly verbal and occur in greater quantity towards women with the category of nurse. CONCLUSIONS: Nursing is the category that suffers the most aggressions in primary care in Tenerife, regardless of the area of the island where they carry out their work.

Are America's Caregivers on the Brink of Extinction? The Pandemic Straw that Broke the Nurses' Back.

The coronavirus disease 2019 pandemic has drawn attention to many of the inadequacies of the US health-care system. Perhaps, no profession has felt these shortcomings more than nurses. This female-dominated profession has the potential to suffer a high attrition rate for several reasons, including declining mental health and increasing workplace violence. Nurses have already begun to leave the bedside. Unless significant changes can be made quickly to prevent more of these caregivers from leaving the profession, the health and safety of the US population are at risk.

Aggression and burnout in nurses during COVID-19: A cross-sectional study.

Workplace violence against nurses, an ever-present problem in the healthcare workplace, has been increasing with COVID-19 and affects occupational health. This study analyzed the consequences of COVID-19 on violence against nurses, identifying its association with burnout, emphasizing the importance of work-related variables. A total of 1013 actively employed nurses in Spain with a mean age of 34.71 years filled out a computer-assisted web interviewing survey. Aggression as a consequence of their work was reported by 73.44% of the nurses. Those most affected were in primary care, and verbal aggression by patients and their families was the most frequent. Nurses who were attacked scored significantly higher in emotional exhaustion and depersonalization. Furthermore, 83.22% said that COVID-19 was an important factor in the increase in violence toward healthcare workers. Analysis showed that a perceived secure environment was a mediator between the belief that COVID-19 was an influential factor in the increase of violence and the depersonalization dimension of burnout. Increasing perceived security in the work environment among nurses can be effective in promoting well-being, work performance, and commitment to the profession.

Development and Validation of a Questionnaire Assessing the Perception and Practice of Workplace Violence Prevention Among Employers at Healthcare Facilities in North-Eastern Malaysia.

Introduction Healthcare workers have been suffering from workplace violence in alarming numbers, showing the importance of its prevention initiative. This study aims to develop and validate a new questionnaire to assess the perception and practice scores of workplace violence prevention among employers at healthcare facilities. Methods Existing literature has been reviewed to establish the domains and refine the items. The first drafted domain was the perception constructed by six components and 59 items. The second drafted domain was practice, consisting of six components and 41 items. Content validation was measured by a panel of experts using the item-level content validity index (I-CVI). Then, face validation analysis was carried out among 10 healthcare employers and presented as the item-level face validity index (I-FVI). Lastly, 222 participants were recruited to determine the validity and reliability of the questionnaire by using an exploratory factor analysis (EFA) and internal consistency reliability. Results Following content validation, two items in the practice domain were removed because of the I-CVI below 0.78. The I-CVI values of the remaining items for both domains were above 0.78, indicating good relevancy of 59 items to assess the perception and 39 items to evaluate the practice domains. The I-FVI values for both domains were above 0.80, suggesting that the participants easily understood the questionnaire. Bartlett's test of sphericity was significant for both domains (p<0.001). The Kaiser-Meyer-Olkin measure was 0.879 for the perception domain and 0.941 for the practice domain. All items load above 0.6 in their respective factor. In addition, Cronbach's alpha coefficient of reliability test ranged from 0.71 to 0.92 and from 0.82 to 0.97 for the perception and practice domains, respectively. The final revised questionnaire consisted of nine components (35 items) for perception and four components (27 items) for practice. Conclusion The newly developed set of questionnaires is a valid and reliable tool to assess the perception and practice of workplace violence prevention among employers at healthcare facilities.

The effect of COVID-19 on workplace violence in California's hospitals: An interrupted time series analysis.

AIM: This study used California's unique Workplace Violent Incident Reporting System (WVIRS) to describe changes in workplace violence (WV) exposure for hospital-based healthcare workers during the pandemic. DESIGN: Interrupted time series analysis. METHODS: We compared the linear trends in weekly WV incidents reported during the period before the COVID-19 pandemic (7/1/2017-3/20/2020) to the period following California's shutdown (3/21/2020-6/30/2021). We created mixed effects models for incidents reported in emergency departments (EDs) and in other hospital units. We used hospital volume data from the California Department of Health Care Access and Information. RESULTS: A total of 418 hospitals reported 37,561 incidents during the study period. For EDs, the number of reported incidents remained essentially constant, despite a 26% drop in outpatient visits between the first and second quarters of 2020. For other hospital units, weekly incidents initially dropped-parallel to a 13% decrease in inpatient days between the first and second quarters of 2020-but then continued parallel to the trend seen in the pre-COVID period. CONCLUSION: WV persists steadily in California's hospitals. Despite major reductions in patient volume due to COVID-19, weekly reported ED incidents remained essentially unchanged. IMPACT: Surveys and media reported that WV increased during the pandemic, but it has been difficult to measure these changes using a large-scale database. The absolute number of WV incidents did not increase during the pandemic; however, the trend in reported incidents remained constant in the context of dramatic decreases in patient volume. New federal WV prevention legislation is being considered in the U.S. California's experience of implementation should be considered to improve WV reporting and prevention. PUBLIC CONTRIBUTION: There was no public contribution to this study. The goal of this analysis was to summarize findings from administrative data. The findings presented can inform future discussion of public policy and action.

OSHA COVID-19 Draft Rule in Healthcare Expected Soon

The article offers information on rules drafted by Occupational Safety and Health Administration (OSHA) for protecting healthcare workers in COVID-19 standard. Topics include information on emergency temporary standards;consideration of less restrictive policies for healthcare workers who have been vaccinated;and comments of Deborah Burger, president of National Nurses United (NNU).