Jacqueline Pich

Patient‐related violence against emergency department nurses

In a finding that reflects international experiences, nurses in Australia have been identified as the occupation at most risk of patient-related violence in the health-care sector. A search of the literature was undertaken to explore this concept, with a focus on the emergency department and triage nurses. Significant findings included the fact that nurses are subjected to verbal and physical abuse so frequently that, in many instances, it has become an accepted part of the job. This attitude, combined with the chronic under-reporting of violent incidents, perpetuates the normalization of violence, which then becomes embedded in the workplace culture and inhibits the development of preventative strategies and the provision of a safe working environment. Nurses are entitled to a safe workplace that is free from violence under both the occupational health and safety legislation and the zero-tolerance policies that have been adopted in many countries including Australia, the UK, Europe, and the USA. Therefore, policy-makers and administrators should recognize this issue as a priority for preventative action.In a finding that reflects international experiences, nurses in Australia have been identified as the occupation at most risk of patient-related violence in the health-care sector. A search of the literature was undertaken to explore this concept, with a focus on the emergency department and triage nurses. Significant findings included the fact that nurses are subjected to verbal and physical abuse so frequently that, in many instances, it has become an accepted part of the job. This attitude, combined with the chronic under-reporting of violent incidents, perpetuates the normalization of violence, which then becomes embedded in the workplace culture and inhibits the development of preventative strategies and the provision of a safe working environment. Nurses are entitled to a safe workplace that is free from violence under both the occupational health and safety legislation and the zero-tolerance policies that have been adopted in many countries including Australia, the UK, Europe, and the USA. Therefore, policy-makers and administrators should recognize this issue as a priority for preventative action.

Patient-related violence at triage: A qualitative descriptive study

AIM The aim of the study was to describe the experiences of a group of triage nurses with patient-related workplace violence during the previous month. BACKGROUND Globally and within the Australian health industry, nurses have been reported to be the occupation at most risk of patient-related violence, with triage nurses identified as a high risk group for both verbal and physical violence. METHOD The study took place in the Emergency Department of a tertiary referral and teaching hospital in regional New South Wales, Australia. Data were collected from August to September 2008, and a qualitative descriptive methodology was employed. FINDINGS The participants all reported experiencing episodes of patient related violence that were perceived as inevitable and increasing in intensity and frequency. Themes included identification of precipitating factors such as long waiting times and alcohol and substance misuse. Organisational issues included lack of aggression minimisation training; lack of formal debriefing following episodes of violence and frustration at lengthy reporting processes. CONCLUSION In the context of the Emergency Department where patients present with a range of diagnoses and behaviours, it is unlikely that the issue of patient-related violence can be totally eliminated. However it can be prevented or managed more effectively on many occasions. Strategies to support staff and prevent and manage violence effectively should be a priority to provide a safe working environment and occupational health and safety for staff.

A structured approach to documenting a search strategy for publication: a 12 step guideline for authors.

AIM This paper describes a structured approach for documenting a search strategy, prior to the scholarly critique and review of the retrieved literature. BACKGROUND AND CONTEXT There has been a shift in publication expectations when it comes to the presentation of a literature review, from the more traditional narrative review to a more systematic approach, following a specific framework. METHODS This paper presents a 12 step framework for documenting the search strategy prior to undertaking a critique and synthesis of the retrieved literature. The authors provide a worked example about potential sources of cross contamination including hospital bath basins and soap and water bathing. DISCUSSION An overview of the 12 step framework is presented. This includes step-by-step instructions on how to conduct and write a search strategy for a literature review. A number of resources available for creating reviews and critiquing reviews are referenced, but these are not exclusive. CONCLUSION Reviews can be an important and valuable contribution when undertaken well, providing the reader with evidence of a clear structure. This paper provides a 12 step framework that will be of benefit to students, educationalists, and researchers required to embark on a review.

Review: Chlorpromazine Versus Penfluridol for Schizophrenia

Schizophrenia is a chronic and relapsing mental disorder that affects how a person thinks, feels and behaves. Symptoms typically first appear in people between the ages of 16 and 30 years of age and can be so severe as to be disabling. Sufferers experience formal thought disorder and some cognitive disturbances with symptoms categorised as positive or negative in nature. Positive symptoms include delusions and hallucinations while negative symptoms include poverty of speech, flattened affect, anhedonia and lack of motivation (Nikvarz, Vahedian, & Khalili, 2017). Front-line treatment to manage the symptoms of schizophrenia involves the use of anti-psychotic medications, such as chlorpromazine and penfluridol; however, patient compliance can be problematic due to the adverse side effects of the drugs and/or lack of insight in to their illness (Nikvarz et al., 2017). Chlorpromazine is recognised as benchmark anti-psychotic drug against which others are measured (Adams, Awad, Rathbone, Thornley, & Sores-Weiser, 2014). Its use is associated with a wide range of side effects, including extrapyramidal, anti-cholinergic and anti-histaminergic effects, for example dry mouth, blurred vision, urinary retention and tremors (Adams et al., 2014). Penfluridol is a long-acting anti-psychotic drug with similar side effects to chlorpromazine, however has the advantage of being able to be administered weekly.