Violence towards emergency nurses: an update of a narrative review of theories and frameworks

Background: Workplace violence (WPV) in emergency departments (EDs) remains a growing concern worldwide, necessitating updated theoretical perspectives. A 2018 review identified 24 frameworks, but ongoing healthcare challenges, particularly the COVID-19 pandemic, warrant a re-examination and expansion of these models. Methods: A narrative review was conducted using PubMed/Medline, CINAHL, Scopus, and ProQuest databases for studies published from 2017 onward, focusing on theoretical frameworks explaining WPV in EDs. Results: The 18 included studies in this review introduce novel or refined theories addressing psychosocial, organizational, and environmental factors that trigger or mitigate WPV. Frameworks range from physiological deterioration and psychosocial moderation to architectural design and resilience-based models. These compre- hensive approaches reflect a growing consensus on the need for integrated, multilevel interventions. Conclusions: Contemporary theories underscore WPV as a multifactorial issue requiring solutions that go beyond single-factor models. By examining the broader interplay among patients, staff, organizational, and environ- mental determinants, these frameworks offer valuable insights for more effective, holistic WPV prevention and management strategies in EDs.