The following is a summary of “Violence against healthcare professionals in intensive care units: a systematic review and meta-analysis of frequency, risk factors, interventions, and preventive measures,” published in the February 2024 issue of Critical Care by Berger et al.

Researchers conducted a retrospective study to examine the prevalence, risk determinants, ramifications, and mitigation strategies concerning violence targeting healthcare personnel within the ICU. 

They searched across PubMed, Scopus, Google Scholar, EMBASE, Cochrane, and Web of Science to identify research on violence directed at healthcare workers in adult ICUs. They gathered data on risk factors, patient attributes, and impacts on healthcare staff. Using established methodologies, they evaluated study quality, potential biases, and the level of evidence presented.

The results showed that 75 studies involving 139,533 healthcare workers from 32 countries were included. The overall median frequency of violence stood at 51% (IQR 37–75%). Up to 97% of healthcare workers experienced verbal violence, while up to 82% were victims of physical violence. Meta-analysis indicated an average frequency of 31% (95% CI 22–41%) for physical violence, 57% for verbal violence (95% CI 48–66%), and 12% for sexual violence (95% CI 4–23%). High heterogeneity was observed according to the I² statistics. Patients emerged as the most common perpetrators (median 56%), followed by visitors (median 22%). Twenty-two studies reported increased risk ratios of up to 2.3 or odds ratios of up to 22.9 for healthcare workers in the ICU compared to their counterparts. Risk factors for experiencing violence included young age, less work experience, and being a nurse. Patients displaying violent behavior were frequently male, older, and physically impaired by drugs. Violence was underreported in up to 80% of cases and correlated with higher burnout rates, increased anxiety, and greater turnover intentions. Overall, the level of evidence was assessed as low.

Investigators concluded that workplace violence in ICUs is a widespread, underreported threat to healthcare workers, demanding increased awareness, screening, and proactive prevention strategies while also investigating underlying risk factors.

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-04844-z