Defining and classifying aggression and violence in health care work
- Authors: Hills, Danny
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 6 (2018), p. 607-612
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- Description: Background: There is considerable contention in defining workplace aggression, especially in health care. This can lead to challenges in effectively researching workplace aggression, and ensuring a sound basis for developing strategies to prevent and minimise its likelihood and consequences. Aim: The aim of this discussion paper is to provide a pragmatic definition of workplace aggression, based on a contemporary conceptualisation of human aggression, followed by a discussion on key classifications of workplace aggression. Methods: The argument presented draws on theoretical and applied literature to develop a case for adopting a pragmatic definition of aggression, with key classification components. Findings and Discussion: A highly practical conceptualisation of workplace aggression differentiates two main forms – verbal or written and physical aggression – and two main source groups – internal (co-workers) and external (patients, their relatives or carers and others external to the workplace). Conclusion: Clarity and consensus on defining and classifying workplace aggression, should provide a sound and coherent basis for researchers, policy makers, clinicians and health care organisations to successfully prevent and minimise this challenging and serious work health and safety concern. © 2018 Australian College of Nursing Ltd
- Authors: Hills, Danny
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 6 (2018), p. 607-612
- Full Text:
- Reviewed:
- Description: Background: There is considerable contention in defining workplace aggression, especially in health care. This can lead to challenges in effectively researching workplace aggression, and ensuring a sound basis for developing strategies to prevent and minimise its likelihood and consequences. Aim: The aim of this discussion paper is to provide a pragmatic definition of workplace aggression, based on a contemporary conceptualisation of human aggression, followed by a discussion on key classifications of workplace aggression. Methods: The argument presented draws on theoretical and applied literature to develop a case for adopting a pragmatic definition of aggression, with key classification components. Findings and Discussion: A highly practical conceptualisation of workplace aggression differentiates two main forms – verbal or written and physical aggression – and two main source groups – internal (co-workers) and external (patients, their relatives or carers and others external to the workplace). Conclusion: Clarity and consensus on defining and classifying workplace aggression, should provide a sound and coherent basis for researchers, policy makers, clinicians and health care organisations to successfully prevent and minimise this challenging and serious work health and safety concern. © 2018 Australian College of Nursing Ltd
Workplace aggression experiences and responses of Victorian nurses, midwives and care personnel
- Hills, Danny, Lam, Louisa, Hills, Sharon
- Authors: Hills, Danny , Lam, Louisa , Hills, Sharon
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 6 (2018), p. 575-582
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- Description: Background: Workplace aggression is a major work health and safety, and public health concern. To date, there has been limited investigation of population level exposure and responses to workplace aggression from all sources, and little evidence on the experiences, reporting and support-seeking behaviour of nurses, midwives and care personnel in Australian settings. Aim: To determine the 12-month prevalence of aggression experienced by nurses, midwives and care personnel from sources external and internal to the organisation, and the reporting behaviours and support sought from employers, health services, Trade Unions, work health and safety agencies, police and legal services. Methods: An online survey of the membership of the Australian Nursing and Midwifery Federation – Victorian Branch was conducted between 1 st May and 30th June 2017. Findings: In the previous 12 months, 96.5% of respondents experienced workplace aggression, with 90.9% experiencing aggression from external sources and 72.3% from internal sources. A majority indicated they just accepted incidents of aggression, and most rarely or never took time off work, sought medical or psychological treatment, or sought organisational or other institutional support, advice or action. Levels of satisfaction with institutional services were mostly neutral to poor. Discussion: Victorian nurses, midwives and care personnel work in aggressive and violent workplaces. The incivility endemic in health care likely sets the climate for the generation of and exposure to so much explicit aggression and violence. It appears that any systems or processes instituted to protect health care personnel from harm are failing. Conclusion: More targeted and effectively operationalised legislation, incentives and penalties are likely required. Further research may elaborate the extent of the impact of exposure to workplace aggression over time.
- Authors: Hills, Danny , Lam, Louisa , Hills, Sharon
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 6 (2018), p. 575-582
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- Reviewed:
- Description: Background: Workplace aggression is a major work health and safety, and public health concern. To date, there has been limited investigation of population level exposure and responses to workplace aggression from all sources, and little evidence on the experiences, reporting and support-seeking behaviour of nurses, midwives and care personnel in Australian settings. Aim: To determine the 12-month prevalence of aggression experienced by nurses, midwives and care personnel from sources external and internal to the organisation, and the reporting behaviours and support sought from employers, health services, Trade Unions, work health and safety agencies, police and legal services. Methods: An online survey of the membership of the Australian Nursing and Midwifery Federation – Victorian Branch was conducted between 1 st May and 30th June 2017. Findings: In the previous 12 months, 96.5% of respondents experienced workplace aggression, with 90.9% experiencing aggression from external sources and 72.3% from internal sources. A majority indicated they just accepted incidents of aggression, and most rarely or never took time off work, sought medical or psychological treatment, or sought organisational or other institutional support, advice or action. Levels of satisfaction with institutional services were mostly neutral to poor. Discussion: Victorian nurses, midwives and care personnel work in aggressive and violent workplaces. The incivility endemic in health care likely sets the climate for the generation of and exposure to so much explicit aggression and violence. It appears that any systems or processes instituted to protect health care personnel from harm are failing. Conclusion: More targeted and effectively operationalised legislation, incentives and penalties are likely required. Further research may elaborate the extent of the impact of exposure to workplace aggression over time.
- Kidgell, Dianna, Hills, Danny, Griffiths, Debra, Endacott, Ruth
- Authors: Kidgell, Dianna , Hills, Danny , Griffiths, Debra , Endacott, Ruth
- Date: 2020
- Type: Text , Journal article , Review
- Relation: International Journal of Nursing Studies Vol. 109, no. (2020), p. 1-10
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- Description: Background: Trade agreements in the 21st century have evolved to include provisions that affect domestic public policy and public health in signatory countries. There are growing calls for health professionals and public health advocates to pursue an active advisory role in trade negotiations in order to anticipate and prevent negative outcomes for health services and public health. Aim: This scoping review explored current literature to identify existing knowledge of the implications of trade agreements for the nursing workforce, nursing practice and public health using as an example the 2018 'Comprehensive and Progressive Agreement for Trans-Pacific Partnership'. Design: Scoping review Data sources: Emerald Insight, Informit, Ovid MEDLINE, PubMed, ProQuest, Scopus, and a number of specialist Economics, International Trade and Business, and International Relations databases. Grey literature included national and international policy documents. Review method: Literature was selected according to extraction field criteria, supplemented by hand searching of relevant grey literature and snowballing references from the selected literature reference lists. Analysis was undertaken to identify key themes emerging from the literature. Review results: Six key themes relevant to nursing workforce, nursing practice or public health were 1. Lack of consultation with public health and health professionals in trade negotiations; 2. Implications of strengthened intellectual property provisions for equitable access to medicines (including biologics) and medical devices; 3. Threats to government capacity to regulate domestic policy for public health and health services through 'Investor State Dispute Settlement' provisions 4. Threats to government capacity to regulate domestic policy for public health and health services through 'Regulatory Coherence' 5. Potential limited benefits to communities and increased health inequities 6. Potential implications of increased temporary migration. Gaps were identified in the literature for implications for nursing practice and the nursing workforce from regulatory and labour provisions of trade agreements. Conclusions: The analysis of the literature reviewed is of international importance for the nursing workforce, nursing practice and public health. Policymakers must anticipate and respond to how the inclusion of labour or regulatory provisions in trade agreements will affect nursing practice and the nursing workforce, and how this may subsequently impact on the health of communities globally. (C) 2020 Elsevier Ltd. All rights reserved.
Nurse leadership in promoting and supporting civility in health care settings : a scoping review
- Ota, Marianne, Lam, Louisa, Gilbert, Julia, Hills, Danny
- Authors: Ota, Marianne , Lam, Louisa , Gilbert, Julia , Hills, Danny
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Journal of Nursing Management Vol. 30, no. 8 (2022), p. 4221-4233
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- Description: Aim: This scoping review aimed to identify the existing evidence on how nurse leaders promote and maintain civility amongst nurses in health care settings. Background: Research on managing workplace incivility in nursing, a prevalent and concerning issue worldwide, recommends nurse leaders to command cultural change through strong leadership and civility interventions. However, there is very little empirical evidence summarizing and analysing how nurse leaders pragmatically achieve civility, and combat workplace incivility, in the health care setting. Evaluation: A scoping review was undertaken using the electronic databases CINAHL, Emerald Insight, MEDLINE, PsychINFO, PubMed and Scopus. Google Scholar was used to search for grey literature. Key issues: The eight studies included in this review describe how nurse leaders promote and maintain civility under four key themes: (1) creating a shared vision, (2) educating self and others, (3) fostering accountability and (4) providing support. Conclusion: The review provides an overview of commonly used strategies and actions that pragmatically promote and maintain civility in the health care setting by nurse leaders, while also highlighting areas of future research needed to strengthen the evidence base. Implications for Nursing Management: It is important for nurse leaders to gain an understanding of evidence-based practices when addressing workplace incivility in order to address this prevailing problem for the future and safety of nurses moving forward. © 2022 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd.
- Authors: Ota, Marianne , Lam, Louisa , Gilbert, Julia , Hills, Danny
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Journal of Nursing Management Vol. 30, no. 8 (2022), p. 4221-4233
- Full Text:
- Reviewed:
- Description: Aim: This scoping review aimed to identify the existing evidence on how nurse leaders promote and maintain civility amongst nurses in health care settings. Background: Research on managing workplace incivility in nursing, a prevalent and concerning issue worldwide, recommends nurse leaders to command cultural change through strong leadership and civility interventions. However, there is very little empirical evidence summarizing and analysing how nurse leaders pragmatically achieve civility, and combat workplace incivility, in the health care setting. Evaluation: A scoping review was undertaken using the electronic databases CINAHL, Emerald Insight, MEDLINE, PsychINFO, PubMed and Scopus. Google Scholar was used to search for grey literature. Key issues: The eight studies included in this review describe how nurse leaders promote and maintain civility under four key themes: (1) creating a shared vision, (2) educating self and others, (3) fostering accountability and (4) providing support. Conclusion: The review provides an overview of commonly used strategies and actions that pragmatically promote and maintain civility in the health care setting by nurse leaders, while also highlighting areas of future research needed to strengthen the evidence base. Implications for Nursing Management: It is important for nurse leaders to gain an understanding of evidence-based practices when addressing workplace incivility in order to address this prevailing problem for the future and safety of nurses moving forward. © 2022 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd.
Nursing perspectives on reducing sedentary behaviour in sub-acute hospital settings : a mixed methods study
- Hills, Danny, Ekegren, Christina, Plummer, Virginia, Freene, Nicole, Kunstler, Breanne, Robinson, Tracy, Healy, Ellen, Vo, Jennifer, Gasevic, Danijela, Crabtree, Amelia
- Authors: Hills, Danny , Ekegren, Christina , Plummer, Virginia , Freene, Nicole , Kunstler, Breanne , Robinson, Tracy , Healy, Ellen , Vo, Jennifer , Gasevic, Danijela , Crabtree, Amelia
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 31, no. 9-10 (2022), p. 1348-1361
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- Description: Aim and objectives: To determine the factors influencing nurses’ decisions and capacity to reduce sedentary behaviour in hospital inpatients in sub-acute hospital settings. Background: Sedentary behaviour in hospital inpatients is a complex issue that can be resistant to resolution. There is little research investigating factors influencing nurses’ promotion of reduced levels of sedentary behaviour in sub-acute hospital settings. Design: An explanatory sequential design was employed, comprising quantitative and qualitative phases. Methods: An online survey was conducted with a convenience sample of 138 nurses from five Australian states. Logistic regression modelling identified demographic and behavioural characteristics of nurses who often encouraged patients to reduce their sedentary behaviour. In-depth interviews were conducted with 11 ward nurses and nurse managers, with the content subjected to thematic analysis. STROBE and GRAMMS checklists were employed. Results: Nurses recognised their role in promoting reduced sedentary behaviour but faced a range of personal and organisational barriers in achieving this outcome for patients. Few nurses were aware of national physical activity and sedentary behaviour guidelines. Five themes emerged from interviews (nursing role, care challenges, expectations of advocates, teamwork and improving the experience). Overall, many nurses experienced a lack of agency in promoting reduced sedentary behaviour and cognitive dissonance in feeling unable to undertake this role. Conclusions: The results of this study are significant in confirming that reducing sedentary behaviour in hospital inpatients is influenced by a range of complex and multi-level factors. There is a fundamental need for organisational and clinical leadership in building a culture and climate in which staff feel empowered to promote reduced sedentary behaviour in their patients. Relevance to clinical practice: The results of this study highlight the importance of taking action to reduce sedentary behaviour in sub-acute hospital settings. A co-design approach to developing interventions in local health services is warranted. © 2021 John Wiley & Sons Ltd.
- Authors: Hills, Danny , Ekegren, Christina , Plummer, Virginia , Freene, Nicole , Kunstler, Breanne , Robinson, Tracy , Healy, Ellen , Vo, Jennifer , Gasevic, Danijela , Crabtree, Amelia
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 31, no. 9-10 (2022), p. 1348-1361
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- Reviewed:
- Description: Aim and objectives: To determine the factors influencing nurses’ decisions and capacity to reduce sedentary behaviour in hospital inpatients in sub-acute hospital settings. Background: Sedentary behaviour in hospital inpatients is a complex issue that can be resistant to resolution. There is little research investigating factors influencing nurses’ promotion of reduced levels of sedentary behaviour in sub-acute hospital settings. Design: An explanatory sequential design was employed, comprising quantitative and qualitative phases. Methods: An online survey was conducted with a convenience sample of 138 nurses from five Australian states. Logistic regression modelling identified demographic and behavioural characteristics of nurses who often encouraged patients to reduce their sedentary behaviour. In-depth interviews were conducted with 11 ward nurses and nurse managers, with the content subjected to thematic analysis. STROBE and GRAMMS checklists were employed. Results: Nurses recognised their role in promoting reduced sedentary behaviour but faced a range of personal and organisational barriers in achieving this outcome for patients. Few nurses were aware of national physical activity and sedentary behaviour guidelines. Five themes emerged from interviews (nursing role, care challenges, expectations of advocates, teamwork and improving the experience). Overall, many nurses experienced a lack of agency in promoting reduced sedentary behaviour and cognitive dissonance in feeling unable to undertake this role. Conclusions: The results of this study are significant in confirming that reducing sedentary behaviour in hospital inpatients is influenced by a range of complex and multi-level factors. There is a fundamental need for organisational and clinical leadership in building a culture and climate in which staff feel empowered to promote reduced sedentary behaviour in their patients. Relevance to clinical practice: The results of this study highlight the importance of taking action to reduce sedentary behaviour in sub-acute hospital settings. A co-design approach to developing interventions in local health services is warranted. © 2021 John Wiley & Sons Ltd.
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