ARTICLE 7: “Assault rates and implementation of a workplace violence prevention program in the Veterans Health Care Administration” (7)
The goal of this research was to determine the impact that the implementation of a workplace violence presentation program had on violence rates in the VA health care system. Over the years, the Veterans Health Care Administration has implemented many strategies to make work environments safer, including a workplace violence prevention program. Using their previously set-up reporting system, researchers were able to determine the number of assaults in the past 6 fiscal years (2003-2009) as well as the current rates of assault in their facilities. Using an evaluation team of three members from each
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ARTICLE 8: “Patient and visitor violence in the general hospital, occurrence, staff interventions, and consequences: a cross-sectional survey.” (8)
The goal of this research was to quantitatively describe the occurrence of healthcare worker directed violence, describe how the violence is dealt with, and describe the consequences to the healthcare worker. This research was performed at a general hospital in Sweden using a cross-sectional survey that was dispersed to many types of healthcare workers ranging from physician to physical therapist to nursing assistant and midwife. The Survey of Violence Experience by Staff (SOVES-G-R) was given to 4,845 workers that had patient contact and 2,495 surveys were returned. Three categories are looked at using the SOVES-G-R including: individual characteristics, interactions, and organizational work environment. Results of these surveys showed that violence was seen by workers in all areas of patient care, often when medical or therapeutic interventions were taking place. The interventions used by the healthcare workers were also documented and found to be very inconsistent throughout the hospital, showing that the lack of education on avoidance of violence and de-escalation of violent patients was a problem that needs to be addressed throughout the healthcare
Indeed, Fudge (2006) describes this as vertical violence, which means that the act of violence is between senior and junior colleagues. Horizontal violence is across peer groups and similar levels of staff. The most common aggressors or bullies are nurse-managers and supervisors (Leiper, 2005). Certainly, education is very influential in terms of the respect seen among health care professionals, because it has been an ongoing issue as to understanding the hierarchy in the health care profession. The bridge between education and collaboration is still suffering today and it is an issue to address.
Safety is an important factor and is a high priority in healthcare. Kelly, Fenwick, Brekke, and Novaco (2015) shared that workplace violence impairs the staff perceptions of safety. However, both patients and staff are affected by workplace violence in many ways, from physical to emotional aspects. There are many reasons why violence occurs, that will be explained later in this paper. The purpose of this paper is to explain the reason and importance of the chosen phenomenon of interest. Moreover, primary and opposing philosophic viewpoints will be discussed, as well as ways of recognizing and utilizing them in nursing. The ways of knowing patterns in nursing and the utilization of these patterns will be explained, pertaining to nursing care.
One of the most critical factors which contribute to the number of preventable cases of healthcare harm is the culture of silence surrounding these cases. The fear of medical providers to report incidences is related to the possibility of punishment and liability due to a medical error (Discovery, 2010). The criminalization of some acts of medical error has resulted in job dismissal, criminal charges and jail time for some healthcare workers. This is despite the fact that the system they are working in helped to create the situation which led to the error in the first place. Human error, due to fatigue and system errors can result in deadly consequences, but by criminalizing the error it effectively shuts down the ability to correct the root problem. Healthcare workers, working at all levels within the medical system, can provide valuable input on how to improve the processes and prevent harm from occurring (Discovery, 2010).
Horizontal violence is a negative phenomenon that is increasing significantly in the hospital setting. It is defined as bullying, verbal and physical aggression that occurs to employees in the workforce. Horizontal violence has harmful effects on nurses as it lowers their self- esteem, and makes them feel as if they have no power in their career. This phenomenon also negatively impacts patient centered care and safety as nurses are more vulnerable to making medication errors and careless mistakes. Horizontal violence can be decreased in the hospital setting if interventions are implemented by members of the health care team. Education is key to decrease the occurrence of horizontal violence as it enables health care workers to
What is instead increasing at an alarming rate in hospitals is violence perpetrated by patients themselves – typically, mental health patients or the elderly.
The QSEN competences which are affected are the focus on patient safety and teamwork and collaboration. QSEN defines teamwork and collaboration as the “ability to function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision making to achieve quality patient care.” (Pre-Licensure KSA 's). QSEN defines patient safety as “Minimizes risk of harm to patients and providers through both system effectiveness and individual performance” (Pre-Licensure KSA’s). Failure to work with and collaborate with each other can break down morale and communication which in turn can negatively affect the patient. It is important to continue research and studying this topic, because the lasting effects of lateral violence can affect the health of the nurse and the patient long term and affect the revenue and budget of the hospital.
Your priority is the safety of yourself and the safety of the other residents. In settings where aggressive behaviour occures frequently, staff are trained in restraint techniques, which allows them to control the person without hurting them. You may witness this, if you see this you are not be expected to participate.
At the same time, workplace incivility happens between colleagues and between manager and subordinates, it is happening almost every day in healthcare settings such as in hospital and clinics where workers are directly uncivil to disrespect each other. For instance, when a nurse is deviant or does not follow the supervisor intensely because of differences in opinion or an act of retaliation when the manager is being rude, treating their staff with rough words, discourtesy, and lack respect to his staff, there are also times when the uncivil behavior is not intentional or
According to Purpora and Blegen, approximately 60% of actual errors in patient care result from poor and ineffective communication (para. 3). Horizontal violence causes a decrease in effective communication between caregivers which places the patient’s safety in jeopardy. Horizontal violence decreases staff morale which leaves room for error in the workplace (Longo & Smith, 2011).
A practice that has been put in place is the use of call buttons that are installed and easily available for the staff to use when dealing with escalating patients. Within this Veterans Affairs Hospital, the inpatient geriatric unit has at least 2-3 cases of patient-on-patient assault each month. For those that are very aggressive, this is currently being addressed by the use of one-on-one staff and antipsychotic medications. Clinicians are expected to be able to assess whether intervention is needed to protect other patients and staff from patients’ violence, to assess when patients pose a sufficient level of risk, and to assess when patients who have been hospitalized can be safely discharged to the community. However, surveys of practitioners suggest that many receive little formal training in violence risk assessment. (McNeil, et al. 2009) The limitations of formal training in risk assessment for violence suggested by such surveys underscore the need for education in this topic, hence the relevance of this educational training. Nurses on the front lines of care are ill-prepared to deal with this, hence the need for training. (Peek-Asa, et al.
Workplace violence is the main issue in the United States expressed influencing a large number of American consistently. Working environment violence is any demonstration or danger of physical savagery, provocation, terrorizing, or other undermining problematic conduct that happens at the work site. It ranges from dangers and verbal mishandle to physical ambushes and even murder. It can influence and include workers, customers, nurses, patient, clients, and guests. Workplace violence can be discovered anywhere in every field we may accept the fact that it can happen in our workplace too, but the fewer people speak which is encouraging these criminals to prepare of making more atrocity. The occupational safety and health organization (OSHA) have created rules and suggestions to decrease laborer presentation to this deplorable scourge but still many people are being victimized their hands are tied up mouths are taped out to face the reality of what they are living through (OSHA 2015). OSHA’s paradigm incorporates the following elements: management commitment and employee involvement, hazard analysis or assessment, hazard controls, employee training, and recordkeeping and evaluation (McPhaul, London, & Lipscomb, 2013). As mentioned, these elements are basic guidelines in constructing a program, but more specific measures are needed to address specific precursors that contribute to the occurrence of violence and bullying. This would assist in forming the best strategies to remedy workplace violence and incivility.
In reality, there are limited places that violence cannot happen, however, we are often surprised by some of the places violence does take place. One of the places many don’t expect violence to take place is in the hospital. Hospitals are designed to promote safety and provide medical care and nursing treatment for sick or injured people. Unfortunately, on January 12, 2016 a hospital security guard and a police officer endured near-fatal shootings by a drug-affected patient in Nepal. Rachel Olding, the author of an article written February 4, 2016 points out some concerns, thoughts, and ideas for improvement taken from hospital workers who have seen and experienced hospital violence firsthand. Hospitals need to be a place of safety for their patients, staff, and visitors.
This is relevant for me as it is for everyone in the healthcare industry. We all want to work in an environment that is free from violence especially in an environment that is already full of stress. It is good to know that there are governmental sanctions for those that violate harassment or violence regulations in the workplace. We still need management to be accountable with those under their direction, disciplining and counseling problem employees as necessary. Because of this threat that constantly hangs over our heads we as nurses should develop a process or plan
The Bureau of Labor Statistics (2000) shows that 48% of all non-fatal work related assaults and acts of violence have occurred in health care and social service settings. Violence against mental health and health care workers has the potential to cause major physical injuries and psychological trauma. In return this poses serious consequences on employers such as increased turnover, medical and psychological care, increased absenteeism, decreased morale, job dissatisfaction, legal issues, and worker burn-out. Agencies and clinicians are encouraged to evaluate and identify the risks that are potential barriers in their agencies. Safety plans need to be implemented and strategized along with re-evaluations on a continuous basis (Taylor, H. 2013).
Several models and concepts arose in preventative measures to workplace violence in nursing. One conceptual model, according to Covert Crime at Work, is “a conceptual model derived from 370 surveys show working conditions conducive to bullying, thus helping to identify risks early and to prevent unhealthy environments from developing.” After recognition of these research and studies, organizations such as Occupations Safety and Hazard Association, American Nurses Associations, and etc, have implemented guidelines to prevent workplace violence in nursing.