Exploring post-event strategies for workplace violence affecting hospital staff: A scoping review

Background
Violence against healthcare workers is a pervasive global issue that endangers care delivery and staff wellbeing. While this issue has been gaining traction in health research and policy for decades, the translation of knowledge into effective protective measures is inconsistent, and the evidence base for tertiary prevention strategies (focusing on the post-violence stage) is particularly sparse.

Aims
This scoping review aimed to map the available evidence on post-violence strategies in global hospital settings, identify gaps in the literature, and provide direction for future research.

Methods
In January 2024, searches were conducted using MEDLINE, Embase, Web of Science, CINAHL, PsycINFO, and Health Management Information Consortium, supplemented by Google Scholar. A narrative synthesis guided by the Haddon Matrix (Haddon, 1980) categorised strategies by focus on staff (victims), aggressors (vectors), or the physical and social environment. A summary of the articles’ data relevance and methodological rigour was undertaken.

Results
Twenty-seven articles met the inclusion criteria. Post-violence strategies included: (1) staff support via debriefs and psychological, clinical, and procedural assistance; (2) behaviour management, individualised plans, alerts, and accountability measures for aggressors; and (3) system-level risk mitigation through incident investigations, structured feedback procedures, and integrated monitoring and risk management. Few articles examined post-violence strategies as standalone interventions.

Discussion
Most articles equated success with violence reduction, reflecting a traditional (Safety-I) focus on risk mitigation. Little attention was given to other variables such as staff perceptions of safety, violence climate, and job-related affect. Incorporating a Safety-II perspective—which emphasises resilience and adaptive performance—could enable hospitals to both learn from adverse events and strengthen ongoing operational capabilities.

Conclusions
Post-event strategies are typically embedded within broader workplace violence programmes, with limited disaggregation of their specific effects. This gap highlights a valuable avenue for future research to explore the distinct impact of post-violence interventions.

REFERENCES

Haddon, W. (1980). Advances in the epidemiology of injuries as a basis for public policy. Public Health Reports, 95(5), 411–421.