A Survey of Workplace Violence from Clients against Healthcare Workers in Emergency and Intensive Care Units

Abstract

Introduction Violence in healthcare settings is unacceptable. Healthcare workers, who perform crucial lifesaving tasks and emergency care, should not be exposed to high-risk situations that can jeopardize their human-being and the quality of care provided to clients. In addition, underreporting these incidents leads to inaccurate data, which hinders the development of effective prevention strategies and management plans.

Objective To investigate the prevalence, characteristics, underlying causes, and impacts on work of workplace violence directed at nurses and other healthcare workers in emergency and intensive care units. Design A survey research using the Ecological model as the conceptual framework Methodology A total of 111 healthcare workers, including 79 nurses and 32 other healthcare workers, from the emergency and intensive care units of a university hospital in Phitsanulok province were recruited through convenience sampling. Data were collected using a two-part survey on workplace violence: 1) demographic data, and 2) experiences of workplace violence. The instrument was validated by three experts, achieving an item-objective congruence (IOC) of .96. The two-day test-retest reliability resulted in a correlation coefficient (r) of .991. Data were analyzed using descriptive analysis. 

Results The study revealed that 51.4% of healthcare workers in emergency and intensive care units experienced violence from clients. Verbal violence was most common (46.0%), followed byphysical violence (30.6%), and psychological violence, such as unauthorized image, audio, or video recording (29.7%). Registered nurses experienced a higher prevalence of violence (53.2%) compared to other healthcare workers (46.9%). Emergency unit workers reported higher rates of violence (74.2%) than those in intensive care units (42.5%). The underlying causes of violence included perpetrators being under the influence of alcohol or drugs (63.2%), long waiting times for treatment (56.1%), illness conditions (50.9%), and poor communication (40.4%). After experiencing violence, only 12.3% of victims officially reported the incidents. Reasons for not reporting included believing that reporting would not make any changes (48.0%) and having other tasks to complete (40.0%). The impacts of workplace violence included decreased confidence and job satisfaction (94.7%), considering quitting or changing workplaces (89.5%), impaired job performance (82.5%), attempts to improve performance to avoid future problems (77.2%), taking leave due to distress (71.9%), and increased risk of practical errors (61.4%). 

Recommendations It is essential for the administrators to urgently develop policies and implement specific risk management guidelines to prevent and manage all forms of violence against nurses and other healthcare workers, ensuring their safety. This is particularly important in situations involving clients under the influence of alcohol or drugs, or in congested settings with a high volume of clients. Additionally, training nurses and other healthcare workers in effective communication skills is crucial for fostering a safe and supportive work environment.