Now, you will zero in on some aspect of that issue that affects vulnerable and disenfranchised groups differently from the way it affects dominant cultural groups. Continuing to add sources as necessa

Now, you will zero in on some aspect of that issue that affects vulnerable and disenfranchised groups differently from the way it affects dominant cultural groups. Continuing to add sources as necessa
LITERATURE REVIEW: A SYNTHESIS MATRIX LA 498-CBE Approved Research Topic: My approved research topic is causes of violence against healthcare workers and how we can resolve them. JOURNAL NAME, ARTICLE NAME, DATE, PERMALINK AUTHOR(S) FOCUS/PURPOSE OF STUDY RESULTS AGREEMENTS WITH OTHER RESEARCHERS CONTROVERSIES/DISAGREEMENTS WITH OTHER RESEARCHERS IMPLICATIONS FOR FUTURE RESEARCH & PRACTICE Violence against doctors, a serious concern for healthcare organizations to ponder about Ahmed, Farah; Khizar Memon, Muhammad; Memon, Sidra Aggression; Violence; Protection; Harassments; Organization; Structure. Aggression and Violence against primary care physicians is reportedly common in Pakistan but there is no any documented study to-date on this burning issue. Similar to other research, this focus was in Pakistan. Focus is in Pakistan highlighting one country, does not discuss global implications. Need follow up case studies and types of providers and aggressors. Workplace Violence against Nurses, Job Satisfaction, Burnout and Patient Safety in Chinese Hospitals Liu, Jiali; Zheng, Jing; Liu, Ke; Liu, Xu; Wu, Yan; Wang, Jun; You, Liming Workplace violence against nurses remained a concern in building healthy work environments. Workplace violence was associated with less nurse job satisfaction, higher incidences of burnout and lower patient safety. Nurse job satisfaction and burnout mediated the effects of workplace violence on patient safety. Similar results with other studies. This study was only on nurses in China. Expand the study to include other hospital staff and providers. Workplace Violence Toward Mental Healthcare Workers Employed in Psychiatric Wards d’Ettorre, Gabriele; Pellicani, Vincenza Workplace violence (WPV) against healthcare workers (HCWs) employed in psychiatric inpatient wards is a serious occupational issue that involves both staff and patients; the consequences of WPV may include increased service costs and lower standards of care. assaults; psychiatric inpatients; risk assessment; risk management; violence Same type of results in a different kind of healthcare facility Focus was in a psychiatric setting where all patients are considered unstable. The purpose of this review was to evaluate which topics have been focused on in the literature and which are new in approaching the concern of patient violence against HCWs employed in psychiatric inpatient wards, in the past 20 years. Violence towards Emergency Nurses Ramacciati, Nicola; Ceccagnoli, Andrea; Addey, Beniamino; Rasero, Laura Physical and verbal aggression against health professionals, particularly nurses Attacks against healthcare providers has become more prevalent, the most vulnerable being nurses working in the Accident and Emergency Department. Research shows mostly the same results as other studies Focus was mostly in nurses on the emergency setting. Most international research into this issue focused on quantifying aggression, describing its nature, identifying perpetrators, stratifying risk and implementing preventive or mitigating interventions. Few studies investigated the nurses’ subjective perceptions. Preventing Emergency Department Violence through Design Lenaghan, Patricia A.; Cirrincione, Nicole M.; Henrich, Steven Historical trends of workplace violence showing the effect of threats and assaults on staff and regulations affecting workplace violence. Evidence-based considerations to inform the design of emergency departments to reduce, mitigate, or prevent violence against staff, visitors, and patients. Similar results with other studies but has more focus on policies referencing violence in the workplace. None found. Can these policies mitigate violence if implemented in more healthcare settings? Effectiveness of training on de-escalation of violence and management of aggressive behavior faced by health care providers in public sector hospitals of Karachi. Lubna Baig, Sana Tanzil, Shiraz Shaikh, Ibrahim Hashmi, Muhammad Arslan Khan, Maciej Polkowski Considering high burden of violence against healthcare workers in Pakistan APPNA Institute of Public Health developed a training to prevent reactive violence among healthcare providers. The purpose of this training was to equip healthcare providers with skills essential to control aggressive behaviors and prevent verbal and non-verbal violence in workplace settings. This study assesses the effectiveness of training in prevention, de-escalation and management of violence in healthcare settings. The overall self-perceived mean score of Confidence in Coping with Patient Aggression Instrument “(CCPAI)” scale was significantly higher in intervention group as compared to control group. No statistically significant difference was observed between intervention and control groups with regard to frequency of violence faced by HCPs post training and major perpetrators of violence. Violence against healthcare workers needs to be controlled. A quasi-experimental study was conducted in October, 2016 using mixed method concurrent embedded design. The study assessed effectiveness of de-escalation trainings among health care providers working in emergency and gynecology and obstetrics departments of two teaching hospitals in Karachi. Quantitative assessment was done through structured interviews and qualitative through Focus Group Discussions. Healthcare providers` confidence in coping with patient aggression was also measured using a standard validated tool”. De-escalation of violence training was effective in improving confidence of healthcare providers in coping with patient aggression. Predictors of Trivialization of Workplace Violence Among Healthcare Workers and Law Enforcers Steve Geoffrion; Nathalie Lanctôt; André Marchand; Richard Boyer; Stéphane Guay This study aims to identify individual and organizational predictors of trivialization of violence in 2 work sectors: healthcare and law enforcement. On the basis of data from a survey conducted among 1,141 workers from healthcare (e.g., nurses, orderlies.) and law enforcement (e.g., police, security agents), individual (sex, age, exposure to violence), and organizational factors (violence prevention training, support from colleagues and supervisors, presence of a “zero tolerance” policy and safety of physical environment) were used to predict trivialization of violence. Among the respondents of the final sample of the present study, 29.9% reported being the victim of at least one SVA in the past 12 months prior to their completion of the questionnaire, whereas 57.4% reported being the victim of at least one MVA. On the other hand, 43.2% recalled witnessing at least one SVA, whereas 62.6% stated having witnessed at least one MVA. Does having a controlled work environment help mitigate the risk? This study has some limitations. Because the survey is based on a convenience sample, the findings are not generalizable to the healthcare and law enforcement populations. Overall, our victimization variables were all positively skewed. On the basis of the identification of predictors of trivialization of workplace violence, this study has several implications for the practice of threat assessment and management. Violence against healthcare workers in a pediatric emergency department. Gillespie GL; Gates DM; Miller M; Howard PK The purpose of this qualitative study was to describe the workplace violence (WPV) that occurred in a pediatric ED and the negative effects on the workers. Participants perceived that both genders and all occupational groups were at risk for experiencing verbal and physical WPV. Common perpetrator characteristics were patients receiving a psychiatric evaluation and visitors exhibiting acute anxiety. Effects were experienced by workers, perpetrators, patient bystanders, and healthcare employers. It is concluded that WPV is a problem in this pediatric ED, and interventions need to be implemented to promote the safety of the workers and patients. Regardless of the Healthcare department, workplace violence continues to be a concern. Mirrors other finding only in a pediatric department. Findings from this study are limited in that participant interviews used only self-report data; violent events were not triangulated with safety-event reports or occupational injury reports. It is possible that the true scope of physical violence and physical injuries due to violence is higher than that described in this study. Another limitation is that participants might not have been able or were not ready to talk about all aspects of their experiences with WPV. In addition, participants were requested to limit the discussion to the single most stressful experience with WPV over the previous 6 months. Findings from this study suggest the need for two additional research studies. First, the incidence of WPV in a pediatric ED needs to be determined. It is anticipated that WPV in pediatric EDs is a much greater problem than currently appreciated in the literature, albeit of less frequency than in adult EDs. Second, there is a need to develop and test interventions aimed at reducing the incidence of WPV and decreasing the severity of negative consequences of WPV in a pediatric ED. It is believed that an intervention developed through an action research process in collaboration with ED stakeholders is likely to demonstrate a significant reduction in the incidence and severity of violent events. Violence against healthcare workers. Hinsenkamp M The objective evaluation of the problem is indispensable to counteract the trivialisation, the internalisation and unacceptable tolerance of the violence. Solutions are not easy but they are varied. Realistic and non-bailable penalties should be increased significantly to dissuade such aggression, but there should also be measures to protect medical personnel including training them to manage violent behaviour. On a broader scale, the youngest members of the population should be taught to respect and assist medical personnel. Violence against medical personnel due to drug abuse, ignorance, intolerance and a lack of respect has become an ordinary daily occurrence. It can come from patients, from relatives or friends, and sometimes from delinquents. None noted. It has taken time for these aggressions to be reported as for many years they were more or less considered part of professional confidentiality by health workers and even minimized by the hospital administration. However, their frequency has increased to the point where some medical unions are now reacting.
Now, you will zero in on some aspect of that issue that affects vulnerable and disenfranchised groups differently from the way it affects dominant cultural groups. Continuing to add sources as necessa
CAUSES OF VIOLENCE AGAINST HEALTHCARE WORKERS AND HOW WE CAN RESOLVE THEM Causes of Violence against Healthcare Workers and How We can resolve them Student Name College Causes of Violence against Healthcare Workers and How We can resolve them. Hospitals are elementary places to all humans in the world. Hospital is a place where people run to get treatment for various diseases affecting normal health status. Countrywide, people expect proper care and support from healthcare centers more than in any other place such a police station or an educational facility. Proper healthcare identifies the necessity of a hospital to the public. However, hospitals consist of various people such as patients, healthcare workers, support staffs, and medical insurers. Each group benefits differently from the healthcare facilities. Healthcare managers, as well as administrators, play a crucial role to ensure they resolve issues affecting healthcare workers. For instance, they have to internalize on the issues affecting hospital employees to enhance smooth operation in healthcare institutions. Hospital leaders should express the care and appreciation of their employees globally to avoid frequent strikes. Moreover, they should aim to provide quality-based services to health workers. The community has to appreciate all hospital employees for perfect job performance. Managers can end the suffering of health employees in the health sector. The health workers feel motivated to provide better quality services to the patients when managers and government officials adhere to their rights. Violence is a common incidence in Pakistan hospitals as health workers face harassment from patients and other department working closely with the medical institution. Patients as well as patients’ relatives’ abuse health workers affecting the overall response of the medics to the patients. Abuse is a common form of violence than is either through verbal or physical harassment (Ramacciati, Ceccagnoli, Addey & Rasero, 2018). Many of the patients who feel they have enough money can talk ill to the health care providers into demotivation. Their monetary wealth makes them feel special and more important the other people in the hospital who may require close attention from the health employees. It has caused unnecessary rising levels of death cases in Pakistan that is preventable. The aggression has continued to occur in many of the Pakistan hospitals due to drunk people using an abusive language to the hospital employees (Ahmed, Khizar Memon & Memon, 2018). Most of the physicians are subject to harassment by patients, for instance, those in power or in the upper class of society. They feel inferior in their duties as they feel some patients have more influence than the hospital regulations who try to serve all patients equally. Form of harassment is common to some workers. The female workers face various challenges from their employers or those employers with more power. Females experience sexual harassment from the male employer during job recruitment. Many cases that are in the judiciary system are about women sexual harassment towards girls in Pakistan. Furthermore, the organization and structure of the healthcare system neglect female gender. The health facilities should have clear defining the rights of patients as well as the right of healthcare workers. It will avoid violation of healthcare employees’ rights. Besides, the court has to protect female employees to avoid sexual harassment by their employers. The courts have to bear more weight of the sexual harassment of the women to end such incident from happening in the future. The hospitals should have isolation wards for drunk patients, and they can call the police to assist in handling them. Stopping violence in the health sector will enable healthcare employees to provide quality-based services. Nurses are an essential element to the overall performance in the healthcare system. They act as patients’ advocates and all over the world. Their input in hospitals makes patients feel more comfortable. They educate the patients on what they expect from a different department in a medical facility. Nurses act as parents to patients who do not have relatives in the hospitals. Violence against nurses in healthcare workstations is a common issue. It demotivates many of the nurses in putting more effort into their daily duties. Nurses like any other healthcare workers face insults from the patients on any mistakes they commit. Many insults from the patients to the nurses create a harsh environment for any health work. Nurses are not the only healthcare workers abused in hospitals but also physicians and health providers face workplace violence in health centers (Baig et al., 2018). For instance, insurers can abuse all health providers to attract attention to their patients in hospitals. Family and relatives abuse nurses and doctors to get better attention from hospitals to their patients in the ward systems. Medical personnel has to undergo proper training sessions to avoid such as incidence in healthcare centers. Nowadays people can use technology advances to avoid biases in hospitals. Physicians use the internet to communicate with patients. It can be helpful because the physicians may not necessarily need to see the patients based on the condition. A psychiatric section in hospitals is more vulnerable to violence to both health staff and patients. Healthcare workers involved in the psychiatric wing face a serious occupational issue which may lower the quality of standards dispatched by the hospitals. Workplace violence is an ever-rising problem of psychiatric patients in many hospitals for the past 20 years (d’Ettorre & Pellicani, 2017). For example, the patients are harsh and ruthless to the nurses in the psychiatric facility hence new nurse employees cannot handle this section. However, if nurses have only trained for this section, they have various training to know the unique type to expect in a normal healthcare facility. Doctors in a psychiatric section have to monitor the behaviors of the patients well to avoid falling into conflicts between the patients and the nurses. Physicians should have the ultimate power in solving chaos in the psychiatric section in the healthcare centers. Nurses in the psychiatric region in a healthcare facility should have frequent training to deal with the patients in a humane way. Some nurses have resigned their job due to harassment faced in the psychiatric wards. The hospital should have strict rules for the patients and relatives of the patients to avoid abuse of the healthcare employees. Employers in medical institutions should help healthcare workers in resolving disputes that are beyond the nurses and physicians. For instance, some of the government officials or medical insurers may attack the healthcare workers in case of a patient in this branch of the hospitals. Furthermore, healthcare personnel in the psychiatric section have to undergo frequent guidance to avoid mental assault due to high-risk situations in hospitals. Nurses in the emergency and accident department are more prone to verbal and physical aggression. They find a hard time coping with what to do in a harsh health environment. Patients are on the frontline to abuse nurses when they fail to get treatment as soon as possible. It has brought fear among the many nurses in this unit if someone does not regain his or her normal health status. However, various health problems emerge in the section that hardens the nurses’ work. Besides, some nurses in the emergency unit have little training in dealing with current issues in this section. Some nurses may have disabilities that can limit them from helping patients involved in different accidents (Geoffrion, Lanctôt, Marchand, Boyer & Guay, 2015). For instance, a pregnant nurse cannot handle a patient involved in a serious road accident or third-degree burn patient. The healthcare employers have to safeguard the welfare of the nurses despite the job challenges in their field. Historical trends in the healthcare system are the cause of workplace violence to many health staffs. The medical system has policies that are more bias to some people regardless of the same job position performed (Gillespie, Gates, Miller & Howard, 2010). Initially, black Americans and other races in the United States faces many form discrimination in the workplaces as compared to fellow white Americans. White Americans patients received better treatment services in the health facilities than any race. It cultivated hatred and racial discrimination of other people, as people lost faith in the healthcare institutions. Employment sector in the health facilities availed more job opportunities to the white American race regardless of possessing the qualities with other races. Some of the races employees had more skills and work experience than the favored white American population. Many black American lived in poor condition due to lack of employment. Gender discrimination is also a common issue in the United States. The healthcare institutions preferred men handling services in a healthcare facility despite having similar job quality with female employees. It led to female employees regretting their gender for not qualifying for some job opportunities in hospitals. Medical institutions have to avoid any form of workplace violence based on any form of discrimination to all healthcare employees and patients. Healthcare employers have to subject their employees to relevant training to cope with workplace violence. Pakistan has witnessed violence to its healthcare workers more than any other nation in the world. Healthcare personnel such as nurses, physicians, patients, and supporting staff have to undergo various education to avoid violation of hospitals’ employees’ rights (Hinsenkamp, 2013). The managers have to check hospitals occasionally to check those individuals who tend to harass healthcare employees. Training sessions for the employees has to be frequent as they take turns in the hospitals for better equipment of all employees. Employees can gain better skills and knowledge in a proper way of handling aggressive patients and provide relevant health services to all patients. It helps to reduce discrimination levels in the hospitals as well as promoting job unity among the workers. The training sessions will help the workers to dispatch quality-based services to all patients regardless of the gender, race, age or physical disabilities. In the healthcare system, we should have a law enforcement plan and policy that will deter violence to the workers. Strict policies have to concur with the harassment of female workers. The health employees, as well as supervisors, have prevented any form of exposure to violence of the respective employees. The healthcare facility should have zero tolerance for violence to its workers. All health centers should be able to predict violence in the workplaces to avoid future violation of health workers’ rights (Lenaghan, Cirrincione & Henrich, 2018). The health leaders have to work in hand with police officers and security agents eliminate any violence towards and from their employees. Protection of healthcare employees will motivate them towards carrying their respective duties daily. Violence is evident in some healthcare units than others, for example, emergency department and psychiatric unit. Health workers in the department should undergo enough training before employment. The nurses in this department should have more awareness of patients prone to violence to take immediate action. The nurses have to undergo frequent training to understand the effects of violence on them. Other hospitals workers such as the physicians should attend appropriate training for violence occurrences. The health workers can have various seminars, which will enable them to share different experiences of healthcare workers. Employers have to promote the safety of workers in a medical institution to avoid mental suffering of employees. However, health personnel with the traumatic experience of violence should attend respective rehabilitation centers to heal emotionally, physically, and mentally (Liu et al., 2019). Rehabilitation centers will set the effected group of workers back to duty, as they provide quality-based services to the patients and other staff members. The healthcare administration has to champion for the rights of its personnel due to drug abuse, lack of respect, and intolerance of the patients. Furthermore, the judiciary systems have to lay down strict policies and laws to patients mistreating healthcare employees. References Ahmed, F., Khizar Memon, M., & Memon, S. (2018). Violence against doctors, a serious concern for healthcare organizations to ponder about. Annals of Medicine and Surgery, 25, 3-5. DOI: 10.1016/j.amsu.2017.11.003 Baig, L., Tanzil, S., Shaikh, S., Hashmi, I., Khan, M., & Polkowski, M. (2018). Effectiveness of training on de-escalation of violence and management of aggressive behavior faced by health care providers in a public sector hospital of Karachi. Pakistan Journal of Medical Sciences, 34(2). DOI: 10.12669/pjms.342.14432 d’Ettorre, G., & Pellicani, V. (2017). Workplace Violence Toward Mental Healthcare Workers Employed in Psychiatric Wards. Safety and Health at Work, 8(4), 337-342. DOI: 10.1016/j.shaw.2017.01.004 Geoffrion, S., Lanctôt, N., Marchand, A., Boyer, R., & Guay, S. (2015). Predictors of trivialization of workplace violence among healthcare workers and law enforcers. Journal of Threat Assessment and Management, 2(3-4), 195-213. DOI: 10.1037/tam0000048 Gillespie, G., Gates, D., Miller, M., & Howard, P. (2010). Violence Against Healthcare Workers in a Pediatric Emergency Department. Advanced Emergency Nursing Journal, 32(1), 68-82. DOI: 10.1097/tme.0b013e3181c8b0b4 Hinsenkamp, M. (2013). Violence against healthcare workers. International Orthopedics, 37(12), 2321-2322. DOI: 10.1007/s00264-013-2129-5 Lenaghan, P., Cirrincione, N., & Henrich, S. (2018). Preventing Emergency Department Violence through Design. Journal of Emergency Nursing, 44(1), 7-12. DOI: 10.1016/j.jen.2017.06.012 Liu, J., Zheng, J., Liu, K., Liu, X., Wu, Y., Wang, J., & You, L. (2019). Workplace violence against Nurses, job Satisfaction, burnout, and patient safety in Chinese hospitals. Nursing Outlook. DOI: 10.1016/j.outlook.2019.04.006 Ramacciati, N., Ceccagnoli, A., Addey, B., & Rasero, L. (2018). Violence towards Emergency Nurses. The Italian National Survey 2016: A qualitative study. International Journal of Nursing Studies, 81, 21-29. DOI: 10.1016/j.ijnurstu.2018.01.017