Practice Issue and Evidence Summary Essay Sample

What is the Practice Issue? Workplace Violence  
Define the scope of the Practice Issue: In my faculty, the number of absenteeism has been increasing, especially among nurses on duty. They have been facing violent behavior such as physical and verbal abuse from both patients and coworkers while at work, thereby discouraging some nurses from reporting to work in time, while others fail to report to work completely. As a result, the nurses have suffered from stress, job dissatisfaction, anger, occupational strain, resulting in Post-Traumatic Stress Disorder. The institution, on the other hand, has suffered huge losses because it self-insures nurses and it has incurred full costs of spending more than $70,000 on nurses’ compensation and $20,000 on the damaged property. With an aim to reduce such losses, several interventions have been put in place to discourage workplace violence.   Firstly, the hospital has developed revised legislation that incorporates stiff penalties on persons that assault nurses. It has also established a violence prevention program for nurses, which involves training them on how to evade situations likely to trigger violence. It also includes keeping patients’ records as a way of monitoring the history of their previous violence. Additionally, the hospital has set up adequate lighting inside and outside the building to discourage violent acts at night.  
What is the practice area? _YES__ Clinical ___ Education  ___ Administration ___ Other (list)_________________________________
How was the practice issue identified? Tick all that apply) ___ Safety/risk management concerns _YES__ Unsatisfactory patient outcomes ___ Wide variations in practice ___ Significant financial concerns    ___ Difference between hospital and community practice __YES_ Clinical practice issue is a concern ___ Procedure or process is a time waster ___ Clinical practice issue has no scientific base __ Other:
Describe the rationale for your checked selections: Last year, an Emergency Department nurse was physically assaulted by a patient’s family members for denying specific services to their patient. On 12th Feb, 2017, another nurse on duty failed to report to work without an apology, and when asked why, she explained that a coworker had threatened her for not properly attending to a patient who happened to be his relative.   On 15thFebruary, a third nurse was absent for a reason that he has been frequently assaulted by his fellow workers for being the only male nurse in the department. He further explained that he was being forcefully involved each time a patient became aggressive. Since that time, several cases of absenteeism have been continuously reported among more than fifteen nurses on duty.   The majority of affected nurses claim they are harassed by patients, while others explain that they are stressed, abused, and bullied by their coworkers. A common characteristic that has been noticed among all the violated nurses is that complaints have been reported by their patients. This is partly because most of these affected nurses take longer to recover while others have died in the process.  
What evidence must be gathered? (check all that apply)
_YES__ Literature search ___ Guidelines ___ Expert Opinion ___ Patient Preferences___ Clinical Expertise ___ Financial Analysis ___ Standards (Regulatory, professional, community) ___ Other  
Describe the rationale for your checked selections: Several articles have been published about workplace violence as means of proving that nurses face violence at work. For instance, According to Physical Assault among Nursing Staff Employed in Acute Care, hospital workers are known to be at risk of physical assault (Rodriguez-Acosta, et al., 2010). Although anyone working in a hospital may be a victim of violence, nurses are at higher risks as they can easily suffer physical injuries, psychological trauma, guilt, changes in relationships with co-workers and families, fear of criticism by managers and supervisors, and feeling of incompetence (Rodriguez-Acosta, et al., 2010). Another article that acknowledges workplace violence is Physical assault, physical threat, and verbal abuse perpetrated against hospital workers by patients or visitors in six U.S. hospitals by Pompeii, et al. (2015). After conducting a survey on 11,000 hospital workers from different geographic areas, Pompeii et al. found out that 39% of them experienced violence at work, whereby, 2098 of them were physically assaulted, 2260 were physically threatened, and 5576 were verbally abused (2015). They also found out that the problem affected patients and hospitals in the long term since most patients reported dissatisfaction. The articles, therefore, prove that workplace violence is an occupational safety issue that extends to patients for whom the nurses care.   

Evidence Summary Worksheet

Describe the practice problem in your own words with reference to the identified population, setting, and magnitude of the problem in measurable terms: Workplace violence is a problem that has continuously increased among healthcare workers for years, affecting more than 30% of nurses in Southern Ethiopia. That suggests the frequency of the issue.
Find a source of evidence that is a systematic review article on a nursing topic that is relevant to your practice problem. Write the complete APA reference for the systematic review article you selected: Define the search terms for your systematic review: While searching online on the prevalence of workplace violence among nurses, we identified an article by Fute, Mengesha, Wakgari and Tessema (2015). The reference of the article is: Fute, M., Mengesha, Z. B., Wakgari, N., & Tessema, G. A. (2015). High prevalence of workplace violence among nurses working at public health facilities in Southern Ethiopia. BMC nursing, 14(1), 9.  
Identify the objectives of the article.   The article’s objective was to investigate the frequency of workplace violence among nurses at public health facilities in Southern Ethiopia. Provide a statement of the questions being addressed in the work and how they relate to your practice issue:   What violent practices do nurses face while at work?   Do nurses experience both physical and verbal abuse in hospitals   How prevalent are the practices in public health facilities?   The practice is very common in public hospitals as the number is continuously increasing each year.  
Summarize (in your own words) the interventions the author(s) suggest to improve patient outcomes.   Workplace violence can be improved through the establishment of health and safety programs for the prevention and management of workplace violence. Summarize the main findings by the authors of your systematic review including the strength of evidence for each main outcome.  Consider the relevance to your project proposal for the Milestone 2 project paper. In their research, the authors found out that workplace violence has been prevalent among healthcare workers, particularly nurses. Thus, it has affected 29.9% of nurses, accounting for 18% physical violence, 89% verbal abuses, and 13% sexual harassment. That shows an increase of 20% from the previous years when the act was limited. The increase has resulted from a lack of appropriate strategies that prevent violence (Fute, Mengesha, Wakgari & Tessema, 2015).  
Outline evidence-based solutions that you will consider for your project. With an aim to reduce violence among nurses, all hospital managers should encourage frequent reporting of all acts of violence against and among nurses. In addition, any worker reported for expressing violence towards a colleague should be suspended from work. Additionally, policymakers should stress workplace violence prevention strategies for all health facilities. Discuss any limitations to the studies performed that you believe impact your ability to utilize the research in your project. The study’s limitation was that the research was conducted only in public health facilities. Therefore, the article impacts my ability to utilize it in my project as it only limits me to conducting research on public facilities. However, my project is about workplace violence among workers in all kinds of healthcare facilities.

References

Fute, M., Mengesha, Z. B., Wakgari, N., & Tessema, G. A. (2015). High prevalence of workplace violence among nurses working at public health facilities in Southern Ethiopia. BMC nursing, 14(1), 9.

Pompeii, L. A., Schoenfisch, A. L., Lipscomb, H. J., Dement, J. M., Smith, C. D., & Upadhyaya, M. (2015). Physical assault, physical threat, and verbal abuse perpetrated against hospital workers by patients or visitors in six US hospitals. American journal of industrial medicine, 58(11), 1194-1204.

Rodríguez-Acosta, R. L., Myers, D. J., Richardson, D. B., Lipscomb, H. J., Chen, J. C., & Dement, J. M. (2010). Physical assault among nursing staff employed in acute care. Work, 35(2), 191-200.

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