Patient and visitor aggression in healthcare: A survey exploring organisational safety culture and team efficacy

AimsThis study investigates nurse managers' perception of organisational safety culture and team efficacy in managing patient and visitor aggression , and determines the predictors of team efficacy. BackgroundPatient and visitor aggression is a serious hazard in healthcare. A positive organisational safety culture regarding patient and visitor aggression enhances the safety and staff efficacy in managing patient and visitor aggression. MethodsA cross-sectional online survey including nurse managers in psychiatric and general hospitals (n=446) was conducted in Switzerland, Austria and Germany (November 2016-February 2017). Data were analysed descriptively and through binary logistic regression. ResultsThe key results are as follows: Working in a mental health setting was 3.5 times more likely, consideration of the physical environment was four times more likely and a shared organisational attitude was twice as likely to predict high team efficacy. In comparison to psychiatric hospitals, general hospital managers perceived organisational safety cultures to be less positive. ConclusionsA positive organisational safety culture leads to the perception that teams are more effective at managing patient and visitor aggression. Implications for Nursing ManagementConsideration of the physical environment and a positive shared organisational attitude regarding patient and visitor aggression are crucial for high team efficacy. General hospitals could benefit from approaches utilized in psychiatry to enhance staff efficacy in managing patient and visitor aggression.