Interventions to Prevent Patient- and Visitor-Perpetrated Violence Against Nurses in the Emergency Department: A Scoping Review.
Mariarosaria Gammone, Daniela Cattani, Martina Barbieri and 6 others
PMID 41178600WHAT IT FOUND
Most ED violence interventions target nurses' skills before an incident, not the environment or the aggressor.
Simulation training and risk checklists are common, but evidence on whether they actually stop assaults is inconsistent and often short-term.
Key findings
01Simulation-based training programs were the most frequently reported intervention strategy, implemented in 20 of the identified studies.
02The majority of interventions (75%) were designed to be implemented before violent incidents occurred, primarily targeting healthcare workers rather than the care setting or perpetrators.
03While many studies reported efficacy, eight studies indicated insufficient or no evidence of effectiveness, and the review did not formally appraise study quality.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review did not conduct a formal critical appraisal of the included studies, so the quality of evidence for each intervention is unknown. Searches were limited to PubMed and CINAHL and English-language studies, which may have missed relevant grey literature or non-Western contexts. There is a lack of long-term follow-up data on the sustainability of these interventions. Interventions targeting environmental factors, such as overcrowding or spatial design, were underrepresented despite being known risk factors.
The easy way to misread this
Do not interpret the prevalence of simulation training as proof it reduces assault rates. The review found mixed evidence, with some studies showing improved confidence or knowledge but no significant change in physical violence incidents, and it did not assess the quality of these studies.