Understanding aggression displayed by patients and families towards intensive care staff: A systematic review

• Published in: Journal of the Intensive Care Society Vol. 25; no. 3; pp. 266 - 278
• Main Authors: Sridharan, Varadaraj, Leung, Kelvin CY, Peisah, Carmelle
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.08.2024
• Subjects: Original; workplace violence; ICU; staff; families; Aggression; patients
• ISSN: 1751-1437; 1751-1437; 2057-360X
• DOI: 10.1177/17511437241231707

Objectives: The objective of this systematic review was to synthesise literature pertaining to patient and family violence (PFV) directed at Intensive Care Unit (ICU) staff. Design: Study design was a systematic review. The data was not amenable to meta-analysis. Data Sources and Review Methods: Electronic searches of databases were conducted to identify studies between 1 January 2000 and 6 March 2023, limited to literature in English only. Published empirical peer-reviewed literature of any design (qualitative or quantitative) were included. Studies which only described workplace violence outside of ICU, systematic reviews, commentaries, editorials, letters, non-English literature and grey literature were excluded. All studies were appraised for quality and risk of bias using validated tools. Results: Eighteen studies were identified: 13 quantitative; 2 qualitative and 3 mixed methodology. Themes included: (i) what is abuse and what do I do about it? (ii) who is at risk? (iii) it is common, but how common? (iv) workplace factors; (v) impact on patient care; (vi) effect on staff; (vii)the importance of the institutional response; and (viii) current or suggested solutions. Conclusions: This systematic review demonstrated that PFV in the ICU is neither well-understood nor well-managed due to multiple factors including non-standardised definition of abuse, normalisation, inadequate organisational support and general lack of education of staff and public. This will guide in future research and policy decision making.