Patient and visitor aggression in healthcare: a survey exploring organizational safety culture and team efficacy.

AIMS: This study investigates nurse managers' perception of organizational safety culture and team efficacy, in managing patient and visitor aggression (PVA), and determines the predictors of team efficacy.

BACKGROUND: PVA is a serious hazard in healthcare. A positive organizational safety culture regarding PVA enhances the safety and staff efficacy in managing PVA.

METHODS: A cross-sectional online survey including nurse managers in psychiatric and general hospitals (n=446) was conducted in Switzerland, Austria and Germany (November 2016 to February 2017). Data were analysed descriptively and through binary logistic regression.

RESULTS: The 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 organizational attitude' was twice as likely to predict high team efficacy. In comparison to psychiatric hospitals, general hospital managers perceived organizational safety cultures to be less positive.

CONCLUSIONS: A positive organizational safety culture leads to the perception that teams are more effective at managing PVA.

IMPLICATIONS: Consideration of the physical environment and a positive shared organizational attitude regarding PVA are crucial for high team efficacy. General hospitals could benefit from approaches utilized in psychiatry to enhance staff efficacy in managing PVA. This article is protected by copyright. All rights reserved.