Factors associated with patient and visitor violence experienced by nurses in general hospitals in Switzerland: A cross-sectional survey

Aims. To explore nurses' experiences with patient and visitor violence, as well as other related factors, in Swiss general hospital settings. Background. Patient and visitor violence is a complex occupational hazard among health care professions, with nursing in general, experiencing the highest rate of patient and visitor violence. International research has found that staff and patient attributes, interaction between staff and patients, as well as environmental characteristics are important factors associated with the occurrence of patient and visitor violence. Previous studies, however, have only partially described these factors in the general hospital setting. Mainland European general hospital settings are even less well researched. Design. A retrospective cross-sectional survey was conducted in 2007. Methods. A total of 291 nurses working in different clinical departments in general hospitals provided data. The questionnaire used was a modified German version of the Survey of Violence Experienced by Staff. Results. The findings revealed that 72% of nurses had experienced verbal patient and visitor violence and 42% physical patient and visitor violence in the past 12 months. Also, 23% were physically injured and 1.4% took one or more days of sick leave. Patient and visitor violence was distressing for the nursing staff. A higher risk for patient and visitor violence was observed with registered nurses nursing anxious or cognitively impaired patients, for rehabilitation units with longer-term nurse-patient/nurserelative interactions and for workplaces with an absence of formal procedures for patient and visitor violence. Conclusions. The results indicate that the clinical setting has little impact on the occurrence of patient and visitor violence. Patient and visitor violence appears to be influenced more by the additional factors specific to the type of interaction and situation. Research should follow up on these specific findings to further improve policies, procedures and intervention strategies. Relevance to clinical practice. To prevent patient and visitor violence, Swiss general hospitals should take into consideration the risk factors associated with patient and visitor violence. Existing policies, procedures and staff education should be improved on