Nurses' Perceptions of the Factors Which Cause Violence and Ways of Preventions in the Emergency department: A Qualitative Study

Background: Violence has been increasing worldwide. The prevalence of violence in the healthcare sector is continuously rising, and the most vulnerable places for violence is emergency departments due to the critical nature of the workplace environment. Little is known about the factors that contribute to the nurse’s violence, the impact of workplace violence on nurses, and the preventive methods. understanding these issues from nurses' experience and perception could enhance the workplace environment and quality of healthcare. Research methodological design: A qualitative approach, in-depth individual interviews were conducted with a convenient sample of 15 emergency department nurses at hospitals in Palestine who experienced or witnessed workplace violence. Open-ended questions were used to gain in-depth information about nurses' experience in relation to workplace violence at emergency departments. Thematic content analysis approach was used in data analysis. Findings: The results showed that nurses at the emergency department experienced workplace violence. Three major themes were found to present the factors that contribute to nurses’ violence. These themes are: Knowledge and attitude related-issues, External-related factors and System-related issues. Four major themes from the analysis of the interviews emerged relating to the staff feelings, which are: Feeling overwhelmed, feeling distressed, feeling indignity and feeling helpless and fearful. Study participants offered some prevention methods to decrease workplace violence, and some suggestions to handle violence. The results showed that there is no clear known system of how to report violence. Conclusions: : Numerous factors contribute to the prevalence of workplace violence in emergency departments. Hospital administrations have to ensure the safety of all employees by using suitable precautions, properly functioning alarm systems and training of the staff. There is an extensive need for psychological support after violent incidents by hospital managers, society and the legal system. In addition, universities have to develop communication, violence and stress management-training courses.