Nu_515 The Final Project PowerPoint

Nu_515 The Final Project PowerPoint

Introduction & Objectives

vOverview of Workplace Violence

vWorkplace violence against healthcare workers

vNeed to reduce workplace violence against Nurses

vWorkplace violence objectives of the presentation

Over 2 million American workers that include nurses and other healthcare professionals are victims of workplace violence every year. The Bureau of Labor Statistics show a rise in cases of violence among registered nurses, which accounts of close to 12% of the reported violent events (Jones, 2021). The American Nurses Association asserts that workplace violence leads to 13% of days away from work (ANA, 2021). The implication is that healthcare workers, especially nurses, continue to experience workplace violence in different forms that impact

Nu515 The Final Project PowerPoint
Nu515 The Final Project PowerPoint

s overall care delivery (Bernardes et al., 2020) . The purpose of this presentation is to offer a summary of the research work on the issue of workplace violence against nurses. The presentation discusses the problem and its effects on nursing care and patient outcomes, provides a summary of research findings on the solutions to issue and describes levels of evidence using a framework. In its final part, it describes the implementation of proposed solution as a practice change.

Nurses will feel empowered to perform when their nurse leaders show confidence in their abilities to do a good job. The reason for this is that nurses feel significant inside the company since they have the ability to make choices, propose and participate in activities without having to seek clearance from higher ups. Nurses’ work lives are improved when leaders demonstrate confidence in their job, are able to reward their organizations by increasing retention and improving the capacity to give higher quality care (Hughes, 2019). Good communication between nurses and their supervisors is essential in the development of these partnerships. Effective nurse performance has been shown to be associated with positive interpersonal ties amongst staff.

Problem of Workplace Violence Against Nurses

vDefinition of Workplace Violence

vForms of violence in Healthcare

vSignificance of understanding the problem

vHostility as a clear indication of violence

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Workplace violence against nurses and other healthcare practitioners is a concern as it affects overall performance

Nu_515 The Final Project PowerPoint
Nu_515 The Final Project PowerPoint

and threatens patient safety. Workplace violence entail physically and psychologically damaging actions that happen in the place of work or when one is on duty. Violent events account for about 12% of all injuries to registered nurses (Mustafa Al-Qadi, 2021). The Bureau of Labor Statistics opines that the RN rate of 12.7 violent events in every 10,000 full-time workers is three times greater than all occupations. The forms of violence against nurses include verbal aggression or lateral violence which accounts for close to 70% of the events while physical violence accounts for about 30% (Jones, 2021). In most cases, physical abuse co-exists with verbal aggression, suggesting that the latter may act as a predictor for potential physical violence. The National Institute for Occupational Safety and Health (NIOSH) asserts that violence against nurses is on the rise and there is need to understand it and develop effective interventions. Hostility between patients and nurses entails verbal threats and even physical altercations (Phillips, 2017). In most cases, nurses or affected individuals do not report these events for effective remedies.

Effects of Workplace Violence Against Nurses

vReduced Productivity and Performance

vThreatens Patient Safety

vImpacts Quality of Care and Interactions

vHigh Rates of Turnover

vExperiencing Assault, Rape and Homicide

In health care sector, nursing professionals are the most exposed and vulnerable to workplace violence because they provide direct help to patients and interact more with them. Workplace violence has negative effects on the nurses and healthcare professions. Violence reduces the productivity and performance of nurses as it creates a hostile work situation for the providers in their interactions with patients and even colleagues. This leads to poor patient outcomes (Shafran-Tikva et al., 2017). Violence leads to increased incidences of medication and medical errors that impact patient safety and quality of care. Violence also leads to the intention by nurses to leave the profession which exacerbates the nursing shortage problem and high turnover rates (Phillips, 2017). Violence exposes healthcare workers to assault, rape and even homicide. The implication is that nurses experience emotional instability and poor mental health.

Potential Solutions to Workplace Violence Against Nurses

vEvidence-Based Practice Interventions

vCommitment from Management & Transformational Leadership

vOpen line of Communication

vCreating Awareness & Positive Organizational Culture

Potential solutions to the issue requires effective deployment of evidence-based practice interventions that include a commitment from management and hospitals’ administrations to improve and create a secure and safer workplace. Again, having open lines of communication enables employees to recognize and report violent acts before they can escalate. Raising awareness and developing a positive organization culture can help reduce and eliminate the problem in the workplace (Somani et al., 2021). Transformational leadership that involves and values employees’ opinions is important in addressing the issue as it encourages sharing of proven interventions to tackle the issue.

Research Articles on Potential Solutions to the Problem: Summary

vPreventive Measures to Create and Raise Awareness

vStudy by d’Ettorre et al. (2018)

vSummary of the Article

vRecommendations of the Study

vMultifaceted Approach to the Problem

At the core of the article is the need to have measures that creates and raise awareness about violence against nurses in the workplace. Through a systematic analysis, the authors identify predictors of violence against nurses like health conditions and use of alcohol and other intoxicating substances. The authors recommend that addressing the issue requires effective management that focuses on training courses on better interactions, enhancement of communication skills and accurate and effective reporting. The authors also assert the need to have effective workplace designs, especially in emergency rooms, to reduce susceptibility to violence. Therefore, both healthcare providers and organizations need to develop a multifaceted approach to the issues that include gaining insights into the problem to generate new research and better interventions.

Research Articles on potential Solution…

vStudy by Kremic et al. (2017)

vEncouraging reporting of verbal violence

vEffective interventions to reduce the problem

vOrganizational Measures

In their study on violence problem in nursing in Belgrade, Serbia, the authors evaluate the level and features of verbal violence against nurses. The authors enumerate predictors of verbal violence and the significance of effective reporting. Verbal violence is more prevalent but over 50% of these incidences are never reported. While the authors note that patient interactions and workplace environment predictor occurrence of verbal violence, they stress the need for better interventions to reduce and prevent the issues. The interventions proposed by the study include effective reporting and organizational measures like designing better workplaces to reduce susceptibility to violence and enhance nurses’ motivation to perform better.

Research Articles on potential Solutions & Recommendations

vHeckermann et al. (2020) Article

vAggression Management Training Courses

vEnhancing Nurses’ Awareness about their environment

vIdentification of early signs of offending


In their article, Heckermann et al. (2020) place emphasis on the significance of management training courses on aggression for nurses to reduce aggressive behaviors and identify subtle signs among patients. Aggression management courses refresh knowledge about violence and help nurses to develop effective preventive approaches and strategies to de-escalate violent conduct. through the training, nurses can identify early signs of offending from patients and visitors and apply strategies to de-escalate the situation. Hospitals need to increase training courses on emotional management of aggressive situations for nurses to effectively handle such events.

Hierarchy of Evidence for the Three Articles

vHierarchy of Evidence framework

vEssence of Critiquing Evidence

vLevel of Evidence for Article One by d’Ettorre et al. (2018)

vSignificance of the Article to the Problem

Hierarchy of evidence framework offers healthcare practitioners and research a chance to consider evidence and effectiveness in tackling a nursing issue. Through rating levels, health professional can determine reliability, biasness, and effectiveness of the studies. The hierarchy ranks evidence from research article in eight levels based on strengths and vigor of the research with level I considered as the most dependable and reliable, Critiquing presented evidence is essential in comprehending the issue of violence against nurses in healthcare workplace (Polit & Tatano-Beck, 2017). The first article by d’Ettore et al. (2018) is a systematic review of literature and shows different ways that providers and organizations can use to address the issue of workplace violence against nurses. The article proposes the use of a multifaceted approach to the issue; implying that it has gathered evidence from different studies. Therefore, its proposed strategies are evidence-based practices and effective in addressing the issue.

Evidence Levels of Articles 2 and 3

vSummary of the Article by Kremic et al. (2017)

vLevel of Evidence

vA cross-sectional study with robust evidence

vReporting and Reasons for Failure to Report

vArticle 3 Level of Evidence Heckermann et al. (2020)


The second article has evidence compiled about the prevalence of violence among nurses in primary care settings in Belgrade Serbia. At the core of the study is the need for effective reporting as one way of addressing the issue of workplace violence against nurses. The cross-sectional study provides the foundation for nurses to use more effective designs to substantiate early discoveries (Kremic et al., 2017). The level of evidence is robust and is ranked at seventh level based on hierarchy of evidence framework. The evidence on solutions to workplace violence in the article comes from one area and does not have numerous sources like the systematic reviews.  The third article by Heckermann (2020) is level seven based on the model since it is a qualitative descriptive study that evaluates the effects of aggression management training for nurses and other healthcare workers. Evidence from the study informs nurses and healthcare organizations to develop effective interventions focused on increasing awareness on aggression and ways to prevent them, particularly early identification of signs of offending.

Recommended Solutions from the Articles to Address Workplace Violence against Nurses

vEffective Reporting

vTraining Courses on Aggression Management

vOrganizational and Management Commitment

vOrganizational Culture and Effective Communication

Based on their levels of evidence, the three articles and research studies recommend the need for a multifaceted approach where healthcare workers, especially nurses, can engage in and use various strategies to mitigate the issue.  These include effective reporting mechanisms that enhances management’s response to the issue, training courses on aggression management and other components of violence, especially identification of early signs, and organizational commitment to designing better workplaces, especially emergency rooms (Heckermann et al., 2020). The studies also recommend the need for a positive organizational culture and effective communication as essential in addressing the issue of workplace violence against nurses.

Implementing the Proposed Solutions as Practice Change

vIntegrate changes through effective change Model (s)

vShared Vision

vEffective Leadership & Organizational Culture

vReadiness for Change


Implementing practice change is essential in attaining better outcomes and dealing with the issue of workplace violence against nurses. In this case, organizations need to possess certain elements for a practice change to occur and be maintained. These include having a shared vision, effective leadership and organizational culture and ensuring that employees are ready for change by creating urgency for changes (Nilsen et al., 2019). The proposed solutions are multifaceted implying that it requires different approaches at the same time to reduce violence against healthcare. Therefore, organizations must consider the elements to implement these approaches as practice changes. They can use models like Kotter’s change process or Lewin’s change theory.


vViolence against Nurses

vEffects of Violence

vNeed for Evidence-based Practice Interventions

vUnderstanding level of evidence for implementation

vImplementing solutions as Practice Changes

Violence against healthcare workers, especially nurses, continues to impact care delivery due to its negative effects. These include high turnover rates and threats to patient safety and quality of care. As such, stakeholders need to implement evidence-based interventions like effective reporting, effective communication and training programs on aggression management. The EBP interventions also include effective reporting, a commitment from the management and better organizational culture. As such, implementing these interventions requires stakeholders to interrogate evidence and understand the different levels for implementation. Further, implementing these solutions as practice changes requires organizations and professionals to consider certain elements like a shared vision and effective leadership.


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American Nurses Association (ANA) (2021). Workplace Violence.  violence2/

Bernardes, M. L. G., Karino, M. E., Martins, J. T., Okubo, C. V. C.,Galdino, M. J.

Q., & Moreira, A. A. O. (2020). Workplace violence among nursing   professionals. Revista brasileira de medicina do trabalho, 18(3), 250-

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d’Ettorre, G., Mazzotta, M., Pellicani, V., & Vullo, A. (2018). Preventing

and managing workplace violence against healthcare workers in

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  89(Suppl 4), 28. DOI: 10.23750/abm.v89i4-S.7113

Jones, M. (2021). Preventing Workplace Violence in Healthcare.