PROBLEM: the phenomenon of violence towards nurses and healthcare personnel in the emergency room is a problem that is found worldwide (Cannavò et al., 2017), a problem that affects nurses: INAIL, in the year 2022, makes I know that over 1600 episodes have been recorded in Italy. Violence manifests itself through aggressive verbal forms, up to actual acts of physical violence, with negative consequences on the work of healthcare personnel. Healthcare workers are at 5 times the risk of workplace violence than other workers and account for 73% of all non-fatal workplace injuries due to violence in the US (Ninan et al., 2024). This problem probably occurs in the same ways in all the countries studied, despite there being different socio-economic or cultural characteristics. Although the problem is known and growing in recent years, the phenomenon is underestimated (under-reporting) as, to date, the emergency room staff mainly reports the most serious events, deeming it less necessary to report aggressive events which we have not hesitated to physically violent forms. PURPOSE: The purpose of this review is to search in the literature which situations are considered to be present, if not favourable, the aggressive event (escalation) towards healthcare personnel and compare them with the strategies and interventions that the literature suggests to contain the phenomenon. SAMPLE: Nurses and emergency room healthcare personnel METHODS AND TOOLS: The search was carried out for this bibliographical review in scientific databases: Google Scholar, PubMed, ResearchGate and ScienceDirect. PubMed and Google Scholar are the most used. After an important screening, articles published from 2014 to 2024 and careful analysis were included, 6 articles and 2 articles excluded. The 6 articles included all come from different countries and of different types; were compared through the use of a table listing the indicators (present or absent) in the aggressive events for each article and a table comparing the strategies described in the same articles. RESULTS: the comparison of the studies made it possible to highlight how some situations, for example overcrowding and the length of waiting times, are co-present with the appearance of the aggressive event towards the triage operators; at the same time, the articles analyzed offer a representation of structural, training or organizational interventions, which seem to somehow reverse the trend of events, thus being able to hypothesize their effectiveness. CONCLUSION: Through this literature review we can conclude by saying that the problem of the phenomenon of aggression against nurses and emergency room staff is present worldwide, although often underestimated compared to minor aggressive events; It is known through the comparison of the studies analyzed that some situations, such as overcrowding and waiting times before taking charge of the patient, are to be considered triggers or facilitators of escalation. The importance of recognizing the first stages of escalation is fundamental to prevent and then manage the relationship with the user, even more so if some of the factors considered decisive are present. From this study it appears that the specific training of emergency room staff, both theoretical-practical and through simulation, is strategic for recognizing escalation early and containing any violent progression. In addition to this, the aspect linked to the layout and comfort of the rooms, the large number of staff on duty and the fact that the triage operator is not isolated from the rest of the staff also appears to be effective; the presence of video surveillance, direct call systems and/or law enforcement personnel is a deterrent. KEY WORDS:“Workplace violence”, “Aggresion”, “Emergency room”, “Emergency nurses”, “nurse”, “Managment nurse”, “Interventions strategies”, “Aggressive patient”, “managing".
PROBLEMA: il fenomeno della violenza verso gli infermieri e il personale sanitario in Pronto Soccorso è un problema che si riscontra a livello mondiale (Cannavò et al., 2017), problematica che interessa gli infermieri: l’Inail, nell’anno 2022, rende noto che sono stati registrati in Italia oltre 1600 episodi. La violenza si manifesta attraverso forme aggressive verbali, fino a veri e propri atti di violenza fisica, con conseguenze negative sul lavoro del personale sanitario. Gli operatori sanitari sono a rischio di violenza sul posto di lavoro 5 volte maggiore rispetto agli altri lavoratori e in USA rappresentano il 73% di tutti gli infortuni sul lavoro non mortali dovuti alla violenza (Ninan et al., 2024). Questo problema si presenta verosimilmente con le stesse modalità in tutti i Paesi studiati, nonostante vi siano diverse caratteristiche socio economiche o culturali. Il fenomeno risulta sottostimato (under-reporting) in quanto, ad oggi, il personale del Pronto Soccorso denuncia prevalentemente gli eventi più gravi, ritenendo meno necessario denunciare eventi aggressivi che non abbiamo esitato in forme violente fisicamente. SCOPO: Lo scopo di questa revisione è quello di ricercare nella letteratura quali sono ritenute le situazioni presenti, se non favorenti, l’evento aggressivo (escalation) verso il personale sanitario e confrontarle con le strategie e gli interventi che la letteratura suggerisce per contenere il fenomeno. CAMPIONE: Infermieri e personale sanitario dei Pronto Soccorso. METODI E STRUMENTI: La ricerca è stata effettuata per questa revisione bibliografica nelle banche dati di scientifiche: Google Scholar, PubMed, ResearchGate e ScienceDirect. PubMed e Google Scholar quelle maggiormente utilizzate. Sono stati inclusi, dopo un importante scrematura, articoli pubblicati dall’anno 2014 al 2024 e un’attenta analisi, 6 articoli e 2 articoli esclusi. Sono stati comparati gli articoli attraverso 2 tabelle. I 6 articoli inclusi sono provenienti tutti da Nazioni differenti e di diversa tipologia. RISULTATI: la comparazione degli studi ha permesso di evidenziare come alcune situazioni, ad esempio il sovraffollamento e la lunghezza dei tempi di attesa, risultino co-presenti alla comparsa dell’evento aggressivo nei confronti degli operatori di triage; nel contempo, gli articoli analizzati offrono una rappresentazione di interventi strutturali, formativi o organizzativi, che sembrano in qualche modo invertire il trend degli eventi, potendo quindi ipotizzarne l’efficacia. CONCLUSIONE: Attraverso questo elaborato di revisione della letteratura si può concludere dicendo che il problema del fenomeno delle aggressioni agli infermieri e al personale di Pronto Soccorso sia presente a livello mondiale, anche se spesso sottostimato rispetto agli eventi aggressivi di lieve entità; si rende noto attraverso la comparazione degli studi analizzati come alcune situazioni, come il sovraffollamento (overcrowding) e i tempi di attesa prima della presa in carico del paziente, siano da ritenere elementi scatenanti o facilitanti l’escalation. Da questo studio risulta che la formazione specifica del personale di PS, sia teorico-pratica che attraverso la simulazione, risultano essere strategici per riconoscere precocemente l’escalation e contenere l’eventuale progressione violenta.Oltre a ciò, risulta essere efficace anche l’aspetto legato alla disposizione e il comfort dei locali, la numerosità del personale in servizio e il fatto che l’operatore di triage non sia isolato dal resto del personale; risulta come deterrente la presenza di videosorveglianza, sistemi di chiamata diretta e/o di personale delle Forze dell’Ordine. PAROLE CHIAVE: “Violenza sul posto di lavoro”, “Aggressione”, “Pronto soccorso”, “Infermieri di area d’ emergenza”, “Infermieri”, “gestione infermieristica”, “Strategie d’intervento”, “Pazienti aggressivi”, “gestione”.
"Il fenomeno delle aggressioni al personale di Pronto Soccorso: analisi delle situazioni e confronto con le strategie di contenimento degli eventi"
ROMANI, MARCO
2022/2023
Abstract
PROBLEM: the phenomenon of violence towards nurses and healthcare personnel in the emergency room is a problem that is found worldwide (Cannavò et al., 2017), a problem that affects nurses: INAIL, in the year 2022, makes I know that over 1600 episodes have been recorded in Italy. Violence manifests itself through aggressive verbal forms, up to actual acts of physical violence, with negative consequences on the work of healthcare personnel. Healthcare workers are at 5 times the risk of workplace violence than other workers and account for 73% of all non-fatal workplace injuries due to violence in the US (Ninan et al., 2024). This problem probably occurs in the same ways in all the countries studied, despite there being different socio-economic or cultural characteristics. Although the problem is known and growing in recent years, the phenomenon is underestimated (under-reporting) as, to date, the emergency room staff mainly reports the most serious events, deeming it less necessary to report aggressive events which we have not hesitated to physically violent forms. PURPOSE: The purpose of this review is to search in the literature which situations are considered to be present, if not favourable, the aggressive event (escalation) towards healthcare personnel and compare them with the strategies and interventions that the literature suggests to contain the phenomenon. SAMPLE: Nurses and emergency room healthcare personnel METHODS AND TOOLS: The search was carried out for this bibliographical review in scientific databases: Google Scholar, PubMed, ResearchGate and ScienceDirect. PubMed and Google Scholar are the most used. After an important screening, articles published from 2014 to 2024 and careful analysis were included, 6 articles and 2 articles excluded. The 6 articles included all come from different countries and of different types; were compared through the use of a table listing the indicators (present or absent) in the aggressive events for each article and a table comparing the strategies described in the same articles. RESULTS: the comparison of the studies made it possible to highlight how some situations, for example overcrowding and the length of waiting times, are co-present with the appearance of the aggressive event towards the triage operators; at the same time, the articles analyzed offer a representation of structural, training or organizational interventions, which seem to somehow reverse the trend of events, thus being able to hypothesize their effectiveness. CONCLUSION: Through this literature review we can conclude by saying that the problem of the phenomenon of aggression against nurses and emergency room staff is present worldwide, although often underestimated compared to minor aggressive events; It is known through the comparison of the studies analyzed that some situations, such as overcrowding and waiting times before taking charge of the patient, are to be considered triggers or facilitators of escalation. The importance of recognizing the first stages of escalation is fundamental to prevent and then manage the relationship with the user, even more so if some of the factors considered decisive are present. From this study it appears that the specific training of emergency room staff, both theoretical-practical and through simulation, is strategic for recognizing escalation early and containing any violent progression. In addition to this, the aspect linked to the layout and comfort of the rooms, the large number of staff on duty and the fact that the triage operator is not isolated from the rest of the staff also appears to be effective; the presence of video surveillance, direct call systems and/or law enforcement personnel is a deterrent. KEY WORDS:“Workplace violence”, “Aggresion”, “Emergency room”, “Emergency nurses”, “nurse”, “Managment nurse”, “Interventions strategies”, “Aggressive patient”, “managing".File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/65098