Workplace safety.
Subject: Nurses (Safety and security measures)
Patients (Safety and security measures)
Workplace violence (Risk factors)
Workplace violence (Prevention)
Authors: Scorzafava, Catherine
Jenkins, Peggy
Pub Date: 03/22/2009
Publication: Name: Journal of the New York State Nurses Association Publisher: New York State Nurses Association Audience: Academic Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2009 New York State Nurses Association ISSN: 0028-7644
Issue: Date: Spring-Summer, 2009 Source Volume: 40 Source Issue: 1
Topic: Event Code: 260 General services
Product: Product Code: 8043100 Nurses NAICS Code: 621399 Offices of All Other Miscellaneous Health Practitioners
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 213690027
Full Text: Chapman, R., Perry, L., Styles, I., & Combs, S. (2009). Predicting patient aggression against nurses in all hospital areas. British Journal of Nursing, 18(8), 476-483.

Workplace violence (WPV) between patients and nurses has become an increasingly significant problem ranging from verbal abuse, bullying, and threatening actions to physical assault. Nurses can use the WPV assessment tool to avoid a dangerous event by identifying five individual behaviors that show potential violence: staring, tone of voice, anxiety, mumbling, and pacing. Limited research has examined WPV in a nonpsychiatric setting. The purpose of this study was to identify factors that alert the nursing staff to the possibility of WPV between patients and nurses in a non-psychiatric setting.

The researchers used a qualitative case study explorative research design. Face validity was established through a pilot study. Informed consent was gathered from all participants. Written surveys were mailed to 322 nurses, 113 (34%) nurses working in a variety of hospital areas responded. Semi-structured interviews conducted with 35 participants reached theoretical saturation after 20 interviews. Theoretical saturation occurs when data gathered from interviews becomes repetitive.

The researchers' results reinforced the first five components to predicting WPV and recognized four additional components. The four additional components linked to an aggressive event were emotional cues, disease process, assertive/non-assertive behaviors, and resources. Patients may exhibit emotional cues such as fear, unhappiness, dissatisfaction with care, or frustration. Disease processes that may warn the nurse of a violent event are confusion, organic disorders, or intoxication with drugs or alcohol. Patients who are assertive or non-assertive may exhibit disrespectful and confrontational behaviors leading to violence. Resources and organizational factors predisposing a violent event include staff inexperience, staff knowledge/skill level, and long wait periods.

The study expands on a previous assessment tool by distinguishing additional behaviors to predict WPV in all hospital settings. This tool can help nurses to predict patient aggression and assist nurses to prevent WPV and promote patient safety, which supports the American Association of Critical-Care Nurses Healthy Work Environment initiative.


American Association of Critical-Care Nurses [AACN]. AACN stands for establishing and sustaining healthy work environments: A journey to excellence. American Journal of Critical Care, 14(3), 187-197

Catherine Scorzafava, Hartwick College, Oneonta, NY

Peggy Jenkins, Hartwick College, Oneonta, NY
Gale Copyright: Copyright 2009 Gale, Cengage Learning. All rights reserved.