Pediatric residents reported individual barriers, personal safety concerns, lack of efficacy, and contextual factors as reasons to not speak up about patient safety. Concerns about the safety of speaking up and the efficacy of speaking up were correlated with teamwork and safety culture, respectively.

No abstract

Workplace violence in healthcare settings is alarmingly common and represents significant financial and human cost. The aim of this scoping review was to identify and summarize evidence on strategies to prevent and/or manage workplace violence in healthcare settings. Searches were limited to evidence-based clinical practice guidelines and systematic reviews published between 2015 and 2021. Multiple databases were searched and screened. Quality of the included guidelines and reviews was also assessed. Three guidelines and 33 systematic reviews were included. Both the Occupational Safety and Health Administration 2015 and Registered Nurses’ Association of Ontario 2019 guidelines provided useful recommendations for building a comprehensive prevention program. Evidence-based risk assessment, prevention and management, and education and training are all central components. Regular reassessment and adjustment is required. Included reviews ( n = 33) were grouped into five main categories: violence toward nurses ( n = 10); violence toward healthcare workers in general ( n = 8); violence in the emergency department ( n = 5); violence related to mental health ( n = 5); and measurement related to workplace violence ( n = 5). Multicomponent interventions were often more effective than those applied in isolation. We found consistent support for certain strategies including education and training, post-incident debriefing, multidisciplinary rapid response teams, and environmental modifications; however, the strength of evidence and certainty of conclusions were limited across reviews. This scoping review found that strong leadership that cultivates and enforces a culture of inclusivity, support, and respect is a prerequisite for a successful workplace violence prevention program. Rigorous comparative effectiveness research testing interventions are needed.

Douma have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/ investigative use of a commercial product/device. Objectives After completing this article, readers should be able to: 1. Delineate the role of the family and multidisciplinary team in providing compassionate, family-centered end-of-life care in the neonatal intensive care unit (NICU). 2. Describe care practices and communication strategies that can be used by the health-care team to facilitate quality end-of-life care in the NICU. 3. Understand the importance of bereavement support and follow-up for families after they return home. AbstractProviding compassionate, family-centered end-of-life care to infants and their families in the neonatal intensive care unit (NICU) is challenging for caregivers. Quality end-of-life care is a process that requires clear and consistent communication delivered by a compassionate multidisciplinary team within a framework of shared decisionmaking. The knowledge and communication skills of the interdisciplinary team can greatly influence the ability of the parents to cope effectively with their loss around the time of death and after they return home. Structured bereavement follow-up and staff support programs provide ongoing support for families and caregivers.

No abstract

No abstract

No abstract

No abstract