Risky Business. Interventions to Prevent Aggression Against Health Workers From Patients at Risk: An Integrative Review.

Aim: To identify best practices to prevent violence against healthcare workers by patients at risk for aggression in the adult inpatient setting.

Design: An integrative review.

Methods: Conducted using the Johns Hopkins Evidence-based Practice for Nurses and Healthcare Professionals Model. Title and abstract screening on 4186 articles resulted in 156 for full text review. Full text screening yielded 14 articles that met inclusion criteria.

Data sources: A search of the databases PubMed, CINAHL, Embase, and JBI from January 2019 to February 2023.

Results: The review revealed behavioural intervention teams, environmental changes, and coordinated communication plans were the most used strategies, however none demonstrated significant decreases in violence.

Conclusions: Health systems can implement strategies shown to decrease the incidence of violence in healthcare settings globally. Lack of consistency in the evidence suggests the need for further research to assess mitigating strategies for violence against healthcare workers in inpatient hospital settings.

Implications for the profession and/or patient care: Patient safety is a cornerstone of nursing practice; however, healthcare workers need to feel safe in their work environment. Violent events are chronically underreported, ill defined, and when reported, do not address change in the practice setting. Identifying strategies to address escalating behaviour before it results in violence is crucial for everyone's safety.

Impact: This integrative review exposes the scarcity of evidence available to address rising concerns about patients on healthcare provider violence (Type II) in the workplace. Although several assessment tools for identifying violent patients exist, evidence regarding prevention is woefully absent. The review highlights potential interventions for further study to equip healthcare workers to manage patients safely and effectively before an escalation occurs.

Reporting method: PRISMA checklist for integrative reviews.

Patient or public contribution: No patient or public contribution was part of this review.