- Sample: Nurses working on 4N medical surgical Neuro/stroke unit
- Independent Variables: Implementation of an evidence-based workplace violence prevention strategy
- Dependent Variables: Number of reported WPV incidents and nurses’ well-being
- Instrument A pre/post-test of nurse safety perception survey and knowledge gained from education
- Intervention: De-escalation training session for nursing staff, de-escalation pocket card, and re-education on violence risk alert notice on the patient’s door.
- Keywords: Nurse safety, acute care settings, nurse violence, verbal aggression, improve nurse safety, de-escalation training
Protecting Those Who Care: Nurse Safety in Acute Care
Rosalia Agrusa | Nursing, Rochester Christian University
Sponsor: Professor Amy Guitar
Workplace violence (WPV) is a growing concern in acute care settings worldwide.
Nurses are at increased risk due to:
- Altered mental status
- Behavioral disturbances
- High-acuity patients
- Psychiatric comorbidities
WPV leads to:
- Burnout
- Post-traumatic stress disorder
- Decreased job satisfaction
- Poor patient outcomes
- Increase in turnover
- WPV incident reports will be collected and compared before and after implementation to analyze changes and the severity of incidents.
- A pre- and post- test survey will be used to evaluate changes in nurses’ confidence, awareness, and perceived safety in managing aggressive behaviors
- Reporting rates of workplace violence incidents will be evaluated to assess improvement in documentation and reporting practices.
- The educational PowerPoint will consist of:
- Overview of workplace violence in acute care settings
- Risk factors for aggressive behavior
- Recognition of early warning signs of aggression/violence
- De-escalation techniques
- Proper workplace violence reporting
- supports risk identification and communication (use of behavioral risk alert signage)
- Strategies to promote nurse safety and teamwork during high-risk situations
In nurses working in acute care settings, how do evidence-based workplace violence prevention strategies, compared with current practices, affect nurse safety outcomes and well-being?
�P: Nurses working in an acute care facility
I: Evidence-based workplace violence prevention strategies
C: Current practices
O: Improve nurse safety outcomes and well-being
T: Over 12 weeks acute
Intended Outcomes and Results
- Workplace violence (WPV) is common and impacts nurse and patient safety
- Training improves nurse confidence, knowledge, and recognition of aggression
- Multicomponent strategies, de-escalation, communication, and risk tools like ABRAT, are most effective
- Improved reporting systems increase incident reporting and early identification of violence
- Environmental and safety interventions can reduce violence and nurse burnout
- Overall outcomes include reduced WPV, improved preparedness, and enhanced nurse well-being
Future Implications and Conclusion
- Workplace violence (WPV) significantly impacts nurse safety and patient care
- Increase focus on prevention strategies in acute care settings
- Promote early identification and prevention of aggressive behaviors
- Implement workplace violence prevention training into annual competencies
- Enhance reporting systems to improve accuracy and staff compliance
- Explore additional safety tools (wearable panic devices)
- Utilize multicomponent interventions, including:
- De-escalation training
- Communication skills
- Recognizing warning signs
- These strategies can improve nurse safety, promote a safer environment, and enhance patient outcomes.
The ABRAT tool was highly effective. Nurses completed a 7-item checklist based on patient history, the reason for the visit, and observed behaviors.
- History of aggression or violence
- History of mental illness
- Reason for ED visit related to behavioral/psychiatric issues
- Agitation
- Confusion
- Staring
- Aggressive or threatening behavior