Design, implementation and evaluation of workplace violence management educational program for nursing students

Workplace violence (WPV) represents a public health problem and has been the focus of research work in the scientific community across the globe (Tsukamoto et al., 2019). According to the National Institute for Occupational Safety and Health (NIOSH), WPVs are “violent acts, such as threats of assault and physical assaults directed toward persons at work or on duty” (Cavalcanti et al., 2018). All workers are at risk of WPV; healthcare professionals face a higher risk of physical or verbal abuse at work (Tsukamoto et al., 2021). The WPV is an outcome of the complicated relationship between many factors and working conditions, and the relationship between professional and aggressor are the major factors (Tsukamoto et al., 2019).

As a major group of frontline healthcare workers, nurses are highly affected by WPV, which increases the reluctance of many nurses to remain in the profession (Adebayo et al., 2022). Nursing teams directly interact with patients 24 hours a day, creating a vulnerable setting for violence (Palagi et al., 2015). Many nurses face direct or indirect violence, such as threats/harassment, stalking, table banging, door slamming, assault, object throwing, scratching, punching, theft, property damage, yelling, slander, intimidation, and swearing (Adebayo et al., 2022).

The whole workforce can be affected by violence, which leads to the degradation of care for patients and families. The negative outcomes of WPV on workers’ health have been shown by symptoms of stress, discouragement, and low self-esteem. Such symptoms can cause burnout syndrome (Edward et al., 2014). In addition, violence has to do with the emergence of workplace accidents and absenteeism, which affects workers’ satisfaction and recognition negatively (Pai et al., 2015).

Moreover, nursing students have an increased risk of becoming victims of WPV, which leads to unwanted and negative consequences like anxiety, fear, and anger (Solorzano Martinez & De Oliveira, 2021). Such experience shapes the perceptions and attitudes about the profession and nursing, which also make nursing students feel insecure about to job and specific clinical settings (Özcan et al., 2014; Tee et al., 2016). Nursing students deal with unique risk factors that worsen susceptibility to WPVs. Such factors include frequent rotation in different clinical sites, young age, inadequate experience, lack of knowledge, and the place of nursing students in the health care hierarchy. Studies in Iran and other countries have reported that nursing students face physical and verbal forms of WPVs in clinical settings (Koohestani et al., 2011; Koohestani et al., 2012; Solorzano Martinez & De Oliveira, 2021).

To effectively deal with WPV, nurses need proper education (Konttila et al., 2020). Education programs can positively affect nurses’ attitudes (Hahn et al., 2006). To improve resilience and better control of violence, violence management must be part of undergraduate nursing programs and educational programs for nurses. Only through such a coordinated and active approach can we promote more positive impressions about nursing programs and professions (Üzar-Özçetin et al., 2020). However, despite the importance of this topic, WPV management does not have an independent program in the nursing curriculum.

This study measured the effects of nursing students’ attitudes toward WPV management and confidence in coping with patient aggression through the design and implementation of a WPV education program.

1. Does an educational program on violence management alter nursing students' attitudes toward workplace violence management? 2. How does the educational program affect the nursing student's confidence in coping with patient aggression?

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