Wellbeing at work: going towards a global approach to violence in the ER

Introduction. In the ER, nurses are the health practitioners most exposed to acts of violence at work. For some time now, many international studies have focused on this phenomena and have presented solutions. Italy has only recently started to highlight the phenomenon, and our research group is developing a global operating approach to the problem of violence towards healthcare operators in the ER, and particularly during triage activities, based on a theoretical model obtained from studies on this issue, and from our experiences achieved in the field and research activities. Aim. This study aimed at presenting the first step in delineating the layout of a “Global Approach to Violence in the ER,” to enhance the professional wellbeing of nurses in the ER, especially during triage activities. Materials and Methods. Through studies of the databases, PubMed and CINAHL, we identified 36 studies on Workplace Violence in the ER that analyzed the risk factors, triggering causes, strategies and the corrective actions and interventions. Results and Conclusions. A synoptic interpretation of the selected studies pointed out 30 factors. These were grouped according to the nurse’s viewpoints into four fields: external, internal, environmental/contextual, and organizational. The complexity of the phenomenon and the strong interrelation between various factors suggested that the problem of violence in the ER could be effectively faced only with a “multi-dimensional” analysis of the operating ambiences and interventions that had a “multi-directional” target. The laying down of the “Global Approach to Violence in the ER” will act as the base for the construction of a specific risk rating scale, to assess the phenomenon of aggressions.