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To identify interventions and strategies to prevent patient- and visitor-perpetrated violence against nurses working in acute hospital Emergency Departments. Design Scoping review following the Joanna Briggs Institute guidelines.
A comprehensive literature search was conducted in PubMed and CINAHL to identify relevant studies published up to June 2024. The review included primary research studies employing quantitative, qualitative, and mixed-method approaches. Eligibility criteria focused on interventions aimed at preventing physical and verbal violence in acute hospital emergency settings, explicitly targeting nurses. The selection process followed PRISMA-ScR guidelines, with independent screening and data extraction by two reviewer pairs. Data Sources PubMed and CINAHL databases were searched for studies published up to June 2024.
A total of 40 studies were included, covering interventions across 11 countries, mostly from the United States. Interventions were categorised as organisational, environmental, or individual-focused. Training programs were the most common strategy, followed by risk assessment tools, defense strategies, multidisciplinary briefings, and technology-assisted interventions. Most interventions (73%) were implemented before violent incidents, 23% during, and 5% after. Healthcare workers, particularly nurses, were the primary target group, highlighting the need for effective preventive strategies.
Violence prevention interventions in Emergency Departments focus on pre-incident strategies, mainly organisational and individual-focused. Limited attention has been given to environmental interventions despite their role in mitigating workplace violence. Further research is needed to assess the long-term effectiveness of these strategies.
Addressing workplace violence in EDs ensures a safer work environment, improves staff retention, and enhances patient care quality.
This study did not include patient or public involvement in its design, conduct, or reporting.
Emergency departments (EDs) suffer from crowding due to patients with low urgency whose treatment is often inappropriate in many cases. Crowding in the ED may indicate inefficiencies in the primary care infrastructure. According to the literature, it is associated with individual and system-related factors, such as younger age, convenience of visiting the ED and a negative perception of care outside the hospital. However, patients’ motives driving decision-making for non-urgent visits to the ED in this post-pandemic period require further exploration. Therefore, this study aims to describe the proportion of potentially avoidable, non-urgent ED visits and to explore the associations between socio-demographic and clinical characteristics, patients’ motives, and potentially avoidable, non-urgent visits to the ED.
This multicentre cross-sectional study will be conducted in the ED of seven public hospitals in the South Tyrolean Health Service in the northern Italian Province of Bolzano-Bozen. A consecutive sample of 1000 adult patients (≥18 years) with clinical conditions that are triaged as ‘non-urgent’ (ie, Manchester Triage System priority level ‘blue’ or ‘green’) and consent to participate in the study will be included. Data will be collected in each ED over two full working weeks (24 hours, weekdays and weekends) between 1 September 2024 and 30 November 2024. For each patient, triage nurses and medical doctors will fill out a data collection sheet, including the triage code, diagnosis at discharge and avoidability of the ED visit. Patients will be surveyed using a structured questionnaire with standardised instruments (eg, the Patient Activation Measure and Mental Health Inventory) and self-developed items (eg, motives for ED visits and previous use of community care services). Data analysis will involve descriptive and inferential analyses (ie, 2 tests) to determine group differences. Multivariate multilevel modelling will be applied to explore the associations between individual, system and cultural factors and potentially avoidable, non-urgent visits.
Ethical approval for this study was obtained from the Medical Ethics Committee of the South Tyrolean Health Service (Nr. 41-2024). The results will be published in relevant scientific journals and communicated to the public and relevant institutions through dissemination activities, including press releases and stakeholder meetings. The findings will inform recommendations aimed at refining health policies and optimising access to primary and emergency care services.
ISRCTN registry (ISRCTN17355506).
To explore the topics and themes covered in published research studies in nursing about neurodegenerative disease, synthesise the available evidence, and discuss future directions.
Scoping review following the Joanna Briggs Institute guidelines.
A multi-step search strategy was applied across different databases to identify studies published in English or Italian up to September 2023. Data were analysed using a Nursing Data Matrix based on the nursing meta-paradigm and the Child Health and Nutrition Research Initiative (CHNRI) 4D-framework. Screening and data extraction were performed independently by pairs of reviewers; data were extracted and thematically analysed to identify existing research questions and potential priorities.
Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Embase databases were searched for studies published from 2013 to 2023.
A total of 351 studies met inclusion criteria. The majority of studies originated from the United States (35%). Parkinson's disease and Alzheimer's disease were the most studied conditions, while rare diseases were scarcely represented. Most studies focused on nursing care (39%), with limited attention to rehabilitation (0.8%) and cost-effectiveness (1%). Although 70% of articles included at least one nurse author, 22% lacked any nursing authorship despite addressing nursing-related topics. Thematic and matrix analyses revealed an uneven distribution of research, with a predominance of descriptive studies and limited work in discovery-oriented research.
This review provides a comprehensive overview of nursing research in neurodegenerative diseases, highlighting key themes and gaps. The findings informed the preliminary identification of new nursing research priorities in neurodegenerative diseases to guide future studies and enhance evidence-based nursing care.
The study highlights key trends and gaps in nursing research on neurodegenerative diseases, calling for a more inclusive, equitable, and comprehensive research agenda.
PRISMA-ScR guidelines.
This study did not include patient or public involvement in its design, conduct or reporting.
Review registration was done on Open Science Framework, and can be viewed at https://osf.io/tn5v9 (https://doi.org/10.17605/OSF.IO/TN5V9)
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