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Patient and visitor aggression in healthcare: a survey exploring organizational safety culture and team efficacy.

Journal article
Authors Birgit Heckemann
Sabine Hahn
Ruud J G Halfens
Dirk Richter
Jos Mga Schols
Published in Journal of nursing management
Volume 27
Issue 5
Pages 1039-1046
ISSN 1365-2834
Publication year 2019
Published at Institute of Health and Care Sciences
Pages 1039-1046
Language en
Keywords aggression and violence; cross-sectional studies; general hospital; mental health; nurse manager; psychiatry; safety culture
Subject categories Health Sciences


This study investigates nurse managers' perception of organizational safety culture and team efficacy, in managing patient and visitor aggression (PVA), and determines the predictors of team efficacy.PVA is a serious hazard in healthcare. A positive organizational safety culture regarding PVA enhances the safety and staff efficacy in managing PVA.A cross-sectional online survey including nurse managers in psychiatric and general hospitals (n=446) was conducted in Switzerland, Austria and Germany (November 2016 to February 2017). Data were analysed descriptively and through binary logistic regression.The key results are as follows: 'Working in a mental health setting' was 3.5 times more likely, 'consideration of the physical environment' was four times more likely, and a 'shared organizational attitude' was twice as likely to predict high team efficacy. In comparison to psychiatric hospitals, general hospital managers perceived organizational safety cultures to be less positive.A positive organizational safety culture leads to the perception that teams are more effective at managing PVA.Consideration of the physical environment and a positive shared organizational attitude regarding PVA are crucial for high team efficacy. General hospitals could benefit from approaches utilized in psychiatry to enhance staff efficacy in managing PVA. This article is protected by copyright. All rights reserved.

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