Setting and Access to Potential Subjects
The study setting will be in an acute care setting. The study will target nurses who have been subjected to any form of physical or verbal assault while they were in a hospital setting (Baydin, 2014). The target population for this study will be nurses who have had direct contact with the patients and their families in an emergency department. The inclusion criteria for this study will be:
- Both the male and female nurses
- Nurses in all shifts i.e. early shifts-7a.m.-7p.m.; mid- 11a.m.-11p.m. and 3p.m.-3a.m. and night shifts 7p.m.-7a.m.
- Human Resource Department personnel
- Physicians from the emergency department
- Security Personnel
The exclusion criteria will include the following:
- Secretaries from the emergency department
- Clinical technicians from the emergency department
- Float pool nurses
It is important to point out that there will be no need of an informed consent form for the hospital employees that will be involved in this study because the dataset will be de-identified. Therefore, the researchers will not be able to link the reported incidents to the individual employees who will participate in this study (Polit, 2010).
The amount of time that will be needed to successfully complete this project will be two years. The timeline of the project will be broken down as follows:
- Selection of the targeted research participants ( the researcher anticipates that he will be able to select 5,000 nurses in different hospitals to participate in this study) 3 months
- Offer training of the intervention strategy that will reduce WPV 2 months
- Development of questionnaires and interview questions that will be used in this study 1 month
- Prospective respondents participating in a pilot study 2 months
- Rectification of the questionnaire and interview questions based on the feedback provided by the participants in the pilot study 1 month
- Conducting validity and reliability tests of the research instrument that will be used 1 month
- Distribution of the questionnaires 1 week
- Collection of the questionnaires 1 month
- Conducting Interviews 2 months
- Analysis of the data that is collected 4 months
- Interpretation of the results 7-9 months
- Writing the report 1 month
An important point to note is that this timeline is subject to change based on the complexity or simplicity of the tasks involved. The researcher will rely on the human resource management in the selection of the targeted participants and their involvement in the study (Kelley, 2014). The researcher will use the online survey monkey to distribute and also collect the questionnaires from the research participants. The use of the Survey monkey is recommended because of its ability to protect the anonymity of the individual participants. The questionnaires are designed for nurses, while the interview questions are meant for the supervisors and human resource department personnel (Leon et al., 2011). The targeted number for the nurses, physicians and security personnel (questionnaires) will be 4,800, supervisors-100 and human resource department personnel-100 (interview questions). It is important to note that some activities will take place con-currently such as offering training and development of the questionnaires.
Implementation of the Solution
The proposed solution to help hospital employees working in acute care settings deal with aggressive patients or visitors is providing them with employee safety training and education programs that prepare them to be ready to deal with the situation (Hahn et al., 2013). The safety training and education programs if implemented effectively will lead to a reduction of frequency and severity of WPV (Heckemann et al., 2015). The researcher of this study proposes the use of the Haddon matrix which will use a variety of host factors, vector and vehicle factors and physical or social environmental factors to educate and train nurses on how to reduce their likelihood of experiencing violent incidents while they are performing their duties in a hospital setting (Ramacciati et al., 2016). The table below is an illustration of the proposed Haddon matrix.
Host Factors Vector and vehicle factors Physical/social environmental factors
Provision of education and training
Implementation of relevant policies and procedures that will prevent patient aggression, behavioral de-escalation and conflict resolution
Management of aggressive patients Communicating with patients and their family members hat violence will not be tolerated within the hospital premises and there will be consequences for such behaviors.
Communicating with patients on a regular basis ( after every 30 minutes) to reduce anxiety that may be caused by long wait periods Implement a policy that communicates to the hospital employees that violence is not acceptable
Develop mechanism to alert staff when patients and visitors that are prone to violence are within the hospital premises
Creation of safe rooms for aggressive patients and visitors
Security or police response team
Education and training to deal with such situations
Nonviolent crisis intervention programs Isolation of the violent patients and visitors Development of an appropriate security plan
Implement necessary procedures to deal with violent incidents
Create adequate procedures to investigate violent incidents
Conducting a de-brief of the situation
Mandatory reporting of all types of assaults-physical, verbal, and bullying Report to security personnel
Maintain the patient's or visitor's name for future reference Create adequate procedures to review the violent incidents
Methods and Instruments Used in the Implementation of the Proposed Solution
The researcher will use a mixed methods approach- use of questionnaires to collect data from nurses, physicians and security personnel in an acute care setting. Interview questions will target supervisors and human resource management personnel in this study. A simple random sample will be used as it provides each member of the target population with an equal chance or probability to be selected for this study (Vladutiu et al., 2015).
- Does this survey evaluate effectively the acute care staff perception of safety?
- How well did the proposed intervention plan (workplace violence prevention plan-WPVPP) mitigate violent in the acute care setting?
- Did you feel safe at the workplace before the implementation of the WPVPP?
- Do you feel that you can now handle an aggressive patient or visitor than was the case before?
- Does the proposed WPVPP provide enough or relevant information in relation to reduction of violent incidents in the hospital setting?
- Does it lead to an improved perception of safety by the hospital staff who are prone to dealing with aggressive patients and visitors?
- Is the WPVPP easy to read and interpret?
- Would you recommend the implementation of this WPVPP in different hospitals?
Scoring on the Likert Scale will be as follows:
- Slightly Unlikely
- Most Likely
- Excellent or Definitely
- How regularly do hospital staff report that they have been victims of workplace violence?
- What steps or process did you undertake to deal with these cases?
- Were they effective? Did the employees feel safe?
- Describe the turnover rate as a result of employees being victims of violent incidents at the workplace?
- Do you feel that the Haddon matrix will lead to a reduction of violent incidents in the hospital settings?
- What do you feel are the strong and weak points of this intervention measure?
- Is it a cost-effective approach?
Process for Delivering the Intervention Solution
The researcher plans to use video and books as ways to deliver the intervention solution. The video will provide the research participants with illustrations of how the intervention plan has effectively been used in different hospital and other workplace settings to reduce violent incidents (Wu et al., 2015). The video clips will show them how different workers effectively used the Haddon matrix to reduce their exposure to violence. On the other hand, the books will be provided for them to read and refer on the new information that they have acquired.
Data from both the questionnaire and interview questions will be collected and stored by the researcher. Data from the questionnaire will be collected inform of the responses based on the Likert scale that was developed. The researcher will analyze the date using the SPSS software and in particular using the paired t-test to assess the statistical differences between the pre-and post-intervention stages (Polit, 2010). Data collection from the interview questions will be through the use of a mobile phone. The responses from the open-ended interview questions will be analyzed using ATLAS software. It will code the responses from the interviewees, help in the formulation of variables that will be used for data analysis purposes.
Management of Barriers
A majority of healthcare workers feel that being subjected to some form of either physical or verbal assault at the workplace is part of their job and even if they report nothing will be done to address the problem. This has led to underreporting of workplace violence by nurses who are working in acute-care settings. Also, there are cases whereby when nurses find themselves in such positions, they provide a verbal report to their supervisors alerting them of the situation. In addition to that, employees may be unwilling to report violent incidents because they feel that the patient is the one that will be provided priority. Therefore, to address this barrier, there is the need to change the existing hospital policies. The employees should be allowed to report all acts of violence via an electronic reporting system or verbally to their supervisor who is then required to register the reported violent incidents in the electronic system within a period of 24 hours after receiving the verbal report.
Feasibility of the Implementation Plan
For the project to be successful, the researcher has to take into consideration a variety of costs ranging from training to transport costs in this study. The table below provides a budget plan that will provide the researcher with a guideline of the expected costs of this research.
Task Cost ($) Rationale
Travel costs to various healthcare facilities 500 The researcher will have to travel to the selected health facilities for recruitment of the research participants and also conducting interviews
Purchase of the required software (ATLAS and SPSS) 200 These software will be used to analyze quantitative (SPSS) and qualitative (ATLAS) datasets
Provision of educational materials for the intervention plan ( videos, and books) 700 These materials will be used to offer the required training to the research participants during the period of the study
Purchase of external disks (25GB) 400 To store information during the interview sessions
Computer-related costs 300 Sending and receiving the questionnaires during the period of the study. Also for data analysis purposes
Communication Costs 300 Mainly to organize and schedule interview dates with the research participants ( supervisors and HRD personnel)
Other Expenses 550 These are overhead costs that the researcher may encounter during the period of the research such as hotel and food costs when travelling
Baydin, A. (2014). Workplace Violence in Emergency Department and its Effects on Emergency Staff. International Journal of Emergency Mental Health and Human Resilience, 16(2). doi:10.4172/1522-4821.1000112
Hahn, S., Mller, M., Hantikainen, V., Kok, G., Dassen, T., & Halfens, R. J. (2013). Risk factors associated with patient and visitor violence in gene...
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