A Study On The Expectations Of Nurses In The Emergency Department For Workplace Violence Prevention Measures

ObjectivesThis study aimed to explore the expectations of workplace violence prevention measures among emergency department nurses.To extract the highest scoring multiple violence prevention measure indicators to provide guidelines for the prevention and management of workplace violence among emergency department nurses in hospitals and to facilitate clinical translation of the combined application of multiple violence prevention measures.MethodsBased on Q method,the prevention measures of nurses’ workplace violence were initially formed through literature research and interviews,and the summarized contents were reviewed by experts.Nurses in emergency department were selected to rank the importance of preventive measures,and the data were obtained for statistical analysis.The specific steps are as follows:1.Formation of nurse workplace violence prevention measures(1)Methods of literature research: Databases and guideline websites both national and international were searched for literature on the prevention or management of workplace violence among nurses,and evaluation of literature quality and content analysis,Collecting high-quality results for initial construction of the violence prevention measures Q-set.(2)Interview method: The interview outline was designed according to literature,clinical practice and expert consultation.The nurses in the emergency department of three Grade III general hospitals in Lanzhou city of Gansu province were interviewed.Data was collected through semi-structured interviews.The contents were analyzed by Colaizzi method,and the preventive measures of workplace violence for emergency nurses were obtained.(3)Expert meeting method: 2 nursing management experts,6 clinical nursing workers,1qualitative research expert and 1 evidence-based nursing expert were invited to conduct a comprehensive review of the practicability,applicability,effectiveness and clinical significance of each violence prevention measure under the guidance of FAME structure.Determine the final Q set statements.2.Q ranking of workplace violence prevention measures for nurses(1)Questionnaire survey method: From three tertiary general hospitals in Lanzhou,Gansu Province,emergency department nurses who met the requirements were selected for ranking.Subjects were asked to answer demographic questions.A 9-rank normal distribution table was used.Participants completed the Q ranking by entering each Q statement number into the normal distribution table under the corresponding rank,based on their own approval of the preventive measures.(2)Statistical analysis: Data were analyzed with SPSS 25.0 software.Frequenciesand percentages were used to reflect qualitative data.The criterion scores for each item were obtained using principal component factor analysis.The number of factors was entered on the basis of eigenvalues of 1.0 or higher,and the best type was selected from the results,and standard scores(Z-scores)were used to select the appropriate items.Results1.Formation of nurse workplace violence prevention measuresFinally,14 literature studies were included,including 3 guidelines and 11 systematic reviews.The literatures qualified for quality evaluation were selected for content summary,including 1 guide and 7 systematic reviews.After interviewing 18 nurses in the emergency department,the content reached saturation.Data analysis showed that the prevention measures of violence against nurses by patients and their relatives were divided into 8 themes and 20 sub-themes.The content of interviews and literature summary was comprehensively reviewed through two expert meetings,in accordance with the FAME structure.Finally,40Q-set statements for workplace violence prevention measures for nurses were constructed.2.Nurse workplace violence prevention measures Q ranking results(1)General information: 13 emergency department nurses participated in the study,including 7.6% male,92.4% female,7.6% postgraduate,92.4% undergraduate,46.2% junior professional title,30.7% intermediate professional title,and 23.1% senior professional title.(2)Principal component analysis: In this study,the KMO test value is 0.699 > 0.5,the approximate chi-squared value of Bartlett’s sphericity test is 348.680,and the degree of freedom was 78,p=0.000,which satisfied the significance level and indicated the suitability for factor analysis.The factor loading was 0.408,and four principal component factors were obtained by factor rotation,which were recorded as factor 1,factor 2,factor 3,and factor 4.The number of people assigned to each factor was 4,3,3 and 3,respectively.The proportion of each factor explaining the total variation was 35.758%,20.928%,16.285% and 9.478%,respectively.Cumulatively,it explains 82.45% of the total variation.The final extracted common factors of nurses’ expectation of violence prevention measures in 4 emergency departments were namedas: Factor 1 expected to improve nurses’ clinical comprehensive ability,factor 2 expected to strengthen the organization and management of workplace violence,factor 3 expected to improve services for patients,and factor 4 expected to enhance security measures.Each common factor corresponds to 5 items of violence prevention measures with the highest score.Conclusion1.Q method was used to explore the expectation type of nurses in the emergency department for workplace violence prevention,and quantitative outcome indicators of multiple violence prevention measures under the two highest levels of each expectation factor were obtained,which had certain statistical significance.The quantitative results of the study provide a basis for the establishment of a number of violence prevention measures in hospitals,and help managers clearly formulate the scope and direction of violence prevention measures,which can be used in the management of workplace violence prevention for nurses in the emergency department of hospitals.2.The study is based on Q method,which not only considered the qualitative views of nurses,but also conducted quantitative research,which combined the characteristics of quantitative and qualitative research,conducted a more in-depth and comprehensive exploration of the research topic,and verified the important role of Q method in determining priorities in the nursing field.Solving different problems in the field of nursing has certain use value and is worth being recommended.