Patient Aggression in Real Time on Geriatric Inpatient Units

Abstract

This study focused on verbal and physical aggression against nursing staff, in real time, by elderly patients. The aggressive incidents were recorded at the end of each shift when they were more likely to be accurately remembered. Before beginning the study, nursing staff were taught how to use the Modified Overt Aggression Scale (MOAS) to identify aggressive acts. High rates of verbal and physical aggression among the elderly were observed by nurses, and data show that 75% of nursing staff experienced aggression on their shift. They either experienced aggression themselves or observed aggression on every single shift; that is at least five violent incidents in a work-week. Even if one is not the target of aggression, such observation is associated with elevated levels of stress.

Violência Física E Psicológica Perpetrada No Trabalho Em Saúde

“…[16][17] Psychological violence has shown to be more prevalent than physical violence, 3,[16][17][18][19][20][21][22][23] which can reach to an average of 2.29 episodes of verbal aggression per 8-hour-shift and 1.18 episodes of physical aggressions. 24 The prevalence of verbal aggression identified in the literature (62% to 85%), 3,17-18,20-22 is higher than the findings of this study (48.7%), and may even be found in 100% of workers during the six months. 25 The findings of the present study revealed a 10% higher prevalence in cases of physical violence than what is seen in a study conducted in Lebanon.…”

“…The sample comprised of 269 subjects, 122 (45.4%) were nursing technicians, 90 (33.5%) were physicians, 27 (10%) were nurses and 30 (11.1%) were professionals from other health categories; 157 (58.4%) were women, who were 49 (+7.4) years old on average, 24 41.2% (n=111) of the sample reported having already witnessed some kind of physical violence in their workplace. 83% (n=112) of the victims of verbal aggression classified the situation as typical in their workplace.…”

Aggression and Violence: Perennial Concerns for Psychiatric-Mental Health Nursing

“…Elderly patients (especially those suffering from dementia and other cognitive impairments) are among the most likely perpetrators of verbal and physical aggression, and the nursing staff are the most likely targets (Lanza, 2016). A study published in our January issue showed that 75% of nursing staff on geriatric inpatient units either experienced aggression themselves or observed it being directed at others during every single shift they work (Lanza, 2016).…”

“…A study published in our January issue showed that 75% of nursing staff on geriatric inpatient units either experienced aggression themselves or observed it being directed at others during every single shift they work (Lanza, 2016). Research reported by Zhang, Punnett, Mawn, and Gore in this issue highlights the vulnerability of nursing assistants to assault in nursing homes, and research conducted by a team in New Zealand highlights vulnerability of staff in community healthcare settings where security measures are even less prevalent than in hospitals and aged care facilities, thus requiring staff to rely mainly on police when patients become aggressive (Baby, Swain, & Gale, this issue).…”

“…For example, Marilyn Lanza's work has been in the forefront of the psychiatric-mental health literature for decades, documenting ways to create a non-violent inpatient culture and help nurses who have been victims (e.g., Lanza, 1992;Lanza, 2016;Lanza, Demaio, & Benedict, 2005;Lanza, Rierdan, Forester, & Zeiss, 2009;.…”