Workplace violence against nursing interns and patient safety: The multiple mediation effect of professional identity and professional burnout

Background: Most nursing interns have suffered some form of workplace violence in clinical settings, which has been linked to the jeopardizing of patient safety. Although previous research studies have examined the effect of workplace violence on patient safety, few studies have examined whether workplace violence is associated with patient safety through professional identity and professional burnout among nursing interns.Aims: To test whether professional identity and professional burnout play mediating roles in the relationship of workplace violence and patient safety among nursing interns.Design: Cross-sectional study.Methods: The study included 466 nursing interns from three tertiary grade A hospitals. The Workplace Violence Scale, the Professional Identity Scale, the Maslach Burnout Inventory-General Survey, and the Patient Safety Behaviour Scale were used to gather data. Associations among workplace violence, professional identity, professional burnout, and patient safety were assessed by correlation and the serial-multiple mediation analysis.Results: Workplace violence, professional identity, professional burnout and patient safety were significantly correlated. Workplace violence can have a direct positive impact on patient safety of nursing interns, but also an indirect impact on patient safety through three paths: the independent mediating role of professional identity, the independent mediating role of professional burnout, and the chain mediating role of professional identity and professional burnout.Conclusions: Our findings suggest that workplace violence can affect patient safety through decreasing professional identity and increasing professional burnout among nursing interns. Interventions aimed at decreasing workplace violence among nursing interns would be beneficial for professional attitude and patient safety.