The aims of this study were to explore women’s and health professionals’ perspectives of preconception care and whether expanding the role of practice nurses (PNs) to provide preconception care is acceptable. In a descriptive qualitative approach, 23 semistructured interviews and three focus groups were conducted with women (n=14), PNs (n=8), GPs (n=10) and practice managers (n=2) in the state of Victoria, Australia, between September and December 2019. An inductive process of thematic analysis identified five themes and 12 subthemes. Women and health professionals viewed preconception to be when a woman is planning a pregnancy. Women wanted personalised preconception care, and receiving this from a PN was considered to be acceptable. If the role of PNs is expanded, PNs would require training and professional recognition of their role to provide preconception care. Funding barriers were discussed by PNs, GPs and practice managers, along with potential solutions, such as Medicare item numbers and checklists to streamline consultations. Other resources in the wider community, such as schools, were identified as important aspects of a coordinated approach. Overall, expanding the role of PNs to provide preconception care was acceptable to women and health professionals to increase women’s awareness and uptake of preconception care.

BackgroundWorkplace 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. AimTo 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 -VictorianBranch was conducted between 1st May and 30th June 2017. FindingsIn 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. DiscussionVictorian 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 2 explicit aggression and violence. It appears that any systems or processes instituted to protect health care personnel from harm are failing. ConclusionMore 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. SUMMARY STATEMENT ProblemThere 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 in Australian settings. What is already knownWorkplace aggression in health care is a major work health and safety, and public health concern. It can impact of clinician health and well-being, workforce participation decisions, and the quality and safety of care. What this paper addsThe extraordinarily high prevalence of workplace aggression experienced by Victorian nurses, midwives and care personnel, and their subsequent responses and support-seeking actions, including for legal redress, are highlighted. Recommendations are made for improvement to failing or inadequate systems and processes to protect health care personnel from harm.

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