Safety and Health at Work

Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency (산업안전보건연구원)
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Prevalence and Effect of Workplace Violence against Emergency Nurses at a Tertiary Hospital in Kenya: A Cross-Sectional Study

  • Received : 2020.07.04
  • Accepted : 2021.01.14
  • Published : 2021.06.30
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Abstract

Introduction: Workplace violence (WPV) is a major occupational and health hazard for nurses. It affects nurses' physical and psychological well-being and impacts health service delivery. We aimed to assess the prevalence and describe the consequences of WPV experienced by nurses working in an emergency department in Kenya. Methods: We conducted a descriptive cross-sectional study among emergency nurses at one of the largest tertiary hospitals in Kenya. We collected data using a structured questionnaire adapted from the 'WPV in the Health Sector, Country Case Studies Research Instruments' questionnaire. We described the prevalence and effects of WPV using frequencies and percentages. Results: Of the 82 participating nurses, 64.6% were female, 57.3% were married and 65.8% were college-educated (65.8%). Participants' mean age was 33.8 years (standard deviation: 6.8 years, range: 23-55). The overall lifetime prevalence of WPV was 81.7% (n = 67, 95% confidence interval [CI]: 71.6%-88.8%) and the 1-year prevalence was 73.2% (n = 63, 95% CI: 66.3-84.8%). The main WPV included verbal abuse, physical violence, and sexual harassment. Most incidents were perpetrated by patients and their relatives. No action was taken in 50% of the incidents, but 57.1% of physical violence incidents were reported to the hospital security and 28.6% to supervisors. Perpetrators of physical violence were verbally warned (42.9%) and reported to the hospital security (28.6%). Conclusion: Workplace violence is a significant problem affecting emergency nurses in Kenya. Hospitals should promote workplace safety with zero-tolerance to violence. Nurses should be sensitised on WPV to mitigate violence and supported when they experience WPV.

Keywords

Acknowledgement

We thank the study participants for their willingness to participate in this study.

References

  1. Liu J, Gan Y, Jiang H, Li L, Dwyer R, Lu K, et al. Prevalence of workplace violence against healthcare workers: a systematic review and meta-analysis. Occup Environ Med 2019;76:927-37. https://doi.org/10.1136/oemed-2019-105849
  2. Duncan SM, Hyndamn K, Estabrooks CA, Hesketh K, Humphrey CK, Wong JS, et al. Nurses' experience of violence in Alberta and British Columbia hospitals. Can J Nurs Res Archive 2016;32.
  3. Zhang S-E, Liu W, Wang J, Shi Y, Xie F, Cang S, et al. Impact of workplace violence and compassionate behaviour in hospitals on stress, sleep quality and subjective health status among Chinese nurses: a cross-sectional survey. BMJ Open 2018;8:e019373. https://doi.org/10.1136/bmjopen-2017-019373
  4. Chen X, Lv M, Wang M, Wang X, Liu J, Zheng N, et al. Incidence and risk factors of workplace violence against nurses in a Chinese top-level teaching hospital: a cross-sectional study. Appl Nurs Res 2018;40:122-8. https://doi.org/10.1016/j.apnr.2018.01.003
  5. Ebrahim SM, Issa SS. Work place violence against nursing staff working in emergency departments at general hospitals in Basra city. Indian J Public Health 2018;9:240. https://doi.org/10.5958/0976-5506.2018.00126.2
  6. Cheung T, Yip PS. Workplace violence towards nurses in Hong Kong: prevalence and correlates. BMC Public Health 2017;17:196. https://doi.org/10.1186/s12889-017-4112-3
  7. Tee S, Uzar Ozcetin YS, Russell-Westhead M. Workplace violence experienced by nursing students: a UK survey. Nurse Educ Today 2016;41:30-5. https://doi.org/10.1016/j.nedt.2016.03.014
  8. Boafo IM, Hancock P. Workplace violence against nurses: a cross-sectional descriptive study of Ghanaian nurses. Sage Open 2017;7. 2158244017701187.
  9. Najafi F, Fallahi-Khoshknab M, Ahmadi F, Dalvandi A, Rahgozar M. Antecedents and consequences of workplace violence against nurses: a qualitative study. J Clin Nurs 2018;27:e116-28. https://doi.org/10.1111/jocn.13884
  10. International Labor Organisation, International Council of Nurses, World Health Organization, Public Services International. Workplace violence in the health sector - country case studies research instruments: survey questionnaire (English) (joint program on workplace violence in the health sector). Geneva, Switzerland: International Labour Organisation; 2003. p. 1-14.
  11. Tiruneh BT, Bifftu BB, Tumebo AA, Kelkay MM, Anlay DZ, Dachew BA. Prevalence of workplace violence in Northwest Ethiopia: a multivariate analysis. BMC Nurs 2016;15:42. https://doi.org/10.1186/s12912-016-0162-6
  12. Madzhadzhi LP, Akinsola HA, Mabunda J, Oni HT. Workplace violence against nurses: Vhembe district hospitals, South Africa. Res Theory Nurs Pract 2017;31:28-38. https://doi.org/10.1891/1541-6577.31.1.28
  13. Magnavita N, Heponiemi T. Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study. BMC Health Serv Res 2012;12:108. https://doi.org/10.1186/1472-6963-12-108
  14. Sun S, Gerberich SG, Ryan AD. The relationship between shiftwork and violence against nurses: a case control study. Workplace Health Saf 2017;65: 603-11. https://doi.org/10.1177/2165079917703409
  15. Gacki-Smith J, Juarez AM, Boyett L, Homeyer C, Robinson L, MacLean SL. Violence against nurses working in US emergency departments. J Nurs Adm 2009;39:340-9. https://doi.org/10.1097/NNA.0b013e3181ae97db
  16. Ferri P, Silvestri M, Artoni C, Di Lorenzo R. Workplace violence in different settings and among various health professionals in an Italian general hospital: a cross-sectional study. Psychol Res Behav Manag 2016;9:263. https://doi.org/10.2147/PRBM.S114870
  17. Sisawo EJ, Ouedraogo S, Huang SL. Workplace violence against nurses in the Gambia: mixed methods design. BMC Health Serv Res 2017;17:311. https://doi.org/10.1186/s12913-017-2258-4
  18. Hamdan M, Abu Hamra A. Workplace violence towards workers in the emergency departments of Palestinian hospitals: a cross-sectional study. Hum Resour Health 2015;13:28. https://doi.org/10.1186/s12960-015-0018-2
  19. Mishra S, Chopra D, Jauhari N, Ahmad A, Kidwai NA. Violence against health care workers: a provider's (staff nurse) perspective. Int J Commun Med Public Health 2018;5.
  20. Hamdan M. Burnout among workers in emergency Departments in Palestinian hospitals: prevalence and associated factors. BMC Health Serv Res 2017;17:407. https://doi.org/10.1186/s12913-017-2356-3
  21. Dehnabi A, Radsepehr H, Dehnabi A. Investigating the factors affecting violence against emergency nurses in Sabzevar Medical Sciences Hospitals. Occup Hyg Health Promot J 2018;2:51-61.
  22. Oot Attorney-General, editor. The employment act 2007. Revised Edition 2012 [2007] ed. Nairobi: National Council for Law Reporting; 2012.
  23. Ukaya B. Cases of nurses being attacked at work on the rise. The Standard Online ed. Nairobi: Standard Media Group; 2019.
  24. Okeyo V. KNH nurse in critical condition after attack by patient's kin. Daily Nation. Nairobi: Nation Media Group; 2018.
  25. Ngasike L. KNH nurse hospitalised after angry mother strangles her over son's death. The Standard Online ed. Nairobi: Standard Media Group; 2018.
  26. Cherono S. Patient in custody after shooting nurse dead in Nairobi. Daily Edition ed. Nairobi: Nation Media Group; 2017.
  27. Odenyo A. Nurse shot dead by patient at chiromo hospital. The Standard Online ed. Nairobi: Standard Media Group; 2017.
  28. Spector PE, Zhou ZE, Che XX. Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: a quantitative review. Int J Nurs Stud 2014;51:72-84. https://doi.org/10.1016/j.ijnurstu.2013.01.010
  29. Banda CK, Mayers P, Duma S. Violence against nurses in the southern region of Malawi. Health Sa Gesondheid 2016;21:415-21. https://doi.org/10.1016/j.hsag.2016.01.002
  30. Talas MS, Kocaoz S, Akguc S. A survey of violence against staff working in the emergency department in ankara, Turkey. Asian Nurs Res (Korean Soc Nurs Sci 2011;5:197-203. https://doi.org/10.1016/j.anr.2011.11.001
  31. Wafula P. Violence against women and girls in public road transport and connected spaces in Nairobi county, Kenya. In: Mwaura N, Kihonge L, editors. Nairobi: Flone Initiative; 2018.
  32. Lu L, Dong M, Wang SB, Zhang L, Ng CH, Ungvari GS, et al. Prevalence of workplace violence against health-care professionals in China: a comprehensive meta-analysis of observational surveys. Trauma Violence Abuse 2020;21:498-509. https://doi.org/10.1177/1524838018774429
  33. National Crime Research Centre. Gender based violence (GBV) in Kenya. Nairobi, Kenya: National Crime Research Centre; 2014.
  34. The sexual offences act (Number 3 of 2006). Kenya Council of Law Reporting; 2009.
  35. Jafree SR. Workplace violence against women nurses working in two public sector hospitals of Lahore, Pakistan. Nurs Outlook 2017;65:420-7. https://doi.org/10.1016/j.outlook.2017.01.008
  36. Alyaemni A, Alhudaithi H. Workplace violence against nurses in the emergency departments of three hospitals in Riyadh, Saudi Arabia: a crosssectional survey. NursingPlus Open 2016;2:35-41. https://doi.org/10.1016/j.npls.2016.09.001
  37. Cashmore AW, Indig D, Hampton SE, Hegney DG, Jalaludin BB. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records. BMC Health Serv Res 2012;12:245. https://doi.org/10.1186/1472-6963-12-245
  38. Ramacciati N, Gili A, Mezzetti A, Ceccagnoli A, Addey B, Rasero L. Violence towards emergency nurses: the 2016 Italian national survey-A cross-sectional study. J Nurs Manag 2019;27:792-805. https://doi.org/10.1111/jonm.12733
  39. Bayram B, Cetin M, Oray NC, Can IO. Workplace violence against physicians in Turkey's emergency departments: a cross-sectional survey. BMJ Open 2017;7.
  40. Hossain MM, Sharma R, Tasnim S, Kibria GMA, Sultana A, Saxena T. Prevalence, characteristics, and associated factors of workplace violence against healthcare professionals in India: a systematic review and meta-analysis; 2020.
  41. Ndirangu EW, Sarki A, Mbekenga C, Edwards G. Professional image of nursing and midwifery in East Africa: an exploratory analysis; 2020.
  42. Mellgren C, Andersson M, Ivert A-K. "It happens all the time": women's experiences and normalization of sexual harassment in public space. Women & Criminal Justice 2017;28:262-81. https://doi.org/10.1080/08974454.2017.1372328
  43. Kennedy M, Julie H. Nurses' experiences and understanding of workplace violence in a trauma and emergency department in South Africa. Health SA Gesondheid 2013;18.
  44. Hogarth KM, Beattie J, Morphet J. Nurses' attitudes towards the reporting of violence in the emergency department. Australasian Emerg Nurs J: AENJ 2016;19:75-81. https://doi.org/10.1016/j.aenj.2015.03.006
  45. Albadry AA, El-Gilany A-H, Abou-ElWafa HS. Workplace violence against security personnel at a university hospital in Egypt: a cross-sectional study. F1000 Research 2020;9:347. https://doi.org/10.12688/f1000research.23252.1
  46. Babiarczyk B, Turbiarz A, Tomagova M, Zelenikova R, Onler E, Cantus DS. Reporting of workplace violence towards nurses in 5 European countries-a cross-sectional study. Int J Occup Med Environ Health 2020;33:325-38. https://doi.org/10.13075/ijomeh.1896.01475
  47. Spelten E, Thomas B, O'Meara P, van Vuuren J, McGillion A. Violence against Emergency Department nurses; Can we identify the perpetrators? PLoS One 2020;15:e0230793. https://doi.org/10.1371/journal.pone.0230793
  48. Dafny HA, Beccaria G. I do not even tell my partner: nurses' perceptions of verbal and physical violence against nurses working in a regional Hospital. J Clin Nurs 2020.
  49. Kamchuchat C, Chongsuvivatwong V, Oncheunjit S, Yip TW, Sangthong R. Workplace violence directed at nursing staff at a general hospital in southern Thailand. J Occup Health 2008;50:201-7. https://doi.org/10.1539/joh.O7001
  50. Abate A, Abebaw D, Birhanu A, Zerihun A, Assefa D. Prevalence and associated factors of violence against hospital staff at amanuel mental specialized hospital in Addis Ababa, Ethiopia. Psychiatry J 2019;2019:3642408.
  51. Boafo IM, Hancock P, Gringart E. Sources, incidence and effects of nonphysical workplace violence against nurses in Ghana. Nurs Open 2016;3: 99-109. https://doi.org/10.1002/nop2.43
  52. Ramacciati N, Ceccagnoli A, Addey B, Giusti GD, Tan MF, et al. Nursing management of aggression in a Singapore emergency department: a qualitative study. Nurs and Health Sci 2015;17:307-12. Nurs Health Sci. 2016;18:270-1. https://doi.org/10.1111/nhs.12188