Monthly Archives: May 2023

Word cloud generators have become popular tools for meetings and team-building events. Groups or teams are asked to use these applications to input words they feel best describe their team or their role. A “word cloud” is generated by the application that makes prominent the most-used terms, offering an image of the common thinking among participants of that role.

What types of words would you use to build a nursing word cloud? Empathetic, organized, hard-working, or advocate would all certainly apply. Would you add policy-maker to your list? Do you think it would be a very prominent component of the word cloud?

Nursing has become one of the largest professions in the world, and as such, nurses have the potential to influence policy and politics on a global scale. When nurses influence the politics that improve the delivery of healthcare, they are ultimately advocating for their patients. Hence, policy-making has become an increasingly popular term among nurses as they recognize a moral and professional obligation to be engaged in healthcare legislation.

To Prepare:

• Revisit the Congress.gov website provided in the Resources and consider the role of RNs and APRNs in policy-making. Here is the resources ( American Nurses Association (ANA). (n.d.). Advocacy. Retrieved September 20, 2018, from https://www.nursingworld.org/practice-policy/advocacy/ 
• Reflect on potential opportunities that may exist for RNs and APRNs to participate in the policy-making process.

Post an explanation of at least two opportunities that exist for RNs and APRNs to actively participate in policy-making. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities to participate in policy-making. Be specific and provide examples.

 ( 1 page for Discussion 2. APA format. 3 refences within past 5 years.) 

Sociologic Sciences Interactive Case Study

Complete the Sociologic Sciences Interactive Case Study following the readings and presentation for this week. Associate what you have learned about the theories to this case study. Then see the instructions below to complete a journal entry about your experience.

Click on the Sociologic Sciences Journal link above. Once opened, select the Sociologic Sciences Case Study Reflective Journal and follow the instructions listed within the journal.

1.5-2 page paper

apa format

references from the last 5 years, if using references

Melissa Hinkhouse

Advanced Pharmacology NURS-6521N-43

Professor Dr. Vicki Gardin

Discussion Board Week 1-Original Post

11/30/2020

I have worked in an outpatient behavioral health clinic for the past seven years with many different providers. I live in a rural community, many patients wait six to twelve months to be seen. Patients being treated for Attention Deficit Disorder must be officially tested before being seen by a Psychologist. For this discussion board post, I have changed the name of my patient to Paul to ensure patient confidentially. The provider I worked with this particular patient will also be referred to as PMHNP to ensure provider confidentiality. 

Paul was a ten-year-old Caucasian male referred to our clinic diagnosed per DSM criteria, confirmed via Psychologist testing with ADHD. When he saw the Psychologist, he was also diagnosed with mild depression and anxiety. He struggled with concentration, hyperactivity, impulse control, and disorganization. He presented to his appointment with his mother and father, clean, well-nourished, pleasant, interactive with staff, reported no medication allergies, current medication Zyrtec for seasonal allergies. Paul just had his well-child exam and is current on vaccinations and his primary care provider completed lab work to include CBC, CMP, TSH, Vit D, B12, and A1C, all have returned normal. Family history reported father has a history of ADHD (never medicated), brother has a history of depression and anxiety (never medicated treating with psychotherapy), no other significant family history to report. Paul’s current weight at his appointment was 30kg.

PMHNP spent one hour with Paul and his parents for the initial new patient appointment (Thursday). It was decided Paul would be prescribed Strattera (atomoxetine) 40mg once a day for one week then increase to 80mg once a day. I returned to work on Monday and received a call from Paul’s mom, she said he was acting strange. He was tearful, had been in his room with the door closed for most of the weekend, she stated on Sunday she went into his room and he was crying and said he was just thinking about dying and his parents dying. She stated he had already had his meds Sunday so she kept him with her that entire day and made Sunday night a campout night in the Livingroom so he would think it was fun and she could keep a close eye on him. I had a cancelation that morning for him to come to see PMHNP and he was in to see her within twenty minutes and removed from Strattera. His parents decided medications were no longer the route they wanted to try for treatment and a referral was made for psychotherapy. 

 The only medication Paul takes on occasion is Zyrtec which is in an antihistamine drug class, Strattera is a selective norepinephrine reuptake inhibitor; there is no known drug interaction between the two medications. Reflecting on his age and the medication, Strattera has a black box labeled for suicidal ideation with adolescents diagnosed with ADHD (Eli Lilly and Company, 2003). Reviewing Paul’s labs, I also do not see that a prior ECG or LFT was complete before starting Strattera. Looking at the Pharmacokinetics of Strattera, it is metabolized in the liver and has been known to cause liver damage. Strattera can also raise blood pressure and has been reported to cause sudden cardiac death (Eli Lilly and Company, 2003). Reviewing Pharmacogenetics and the videos from our resources this week, we should have tested Paul’s CYP2D6, as it is essential for metabolization of Strattera and proper dosing (Speed Pharmacology, 2015). 

As a practitioner, I would have started treatment with an antidepressant, Wellbutrin (Bupropion) is often utilized off label for ADHD and might also assist with the treatment of his depression. Since most antidepressants work by increasing the levels of brain messenger chemicals (neurotransmitters), such as norepinephrine, serotonin, and dopamine, it makes sense that they might have effects similar to other ADHD stimulant and non-stimulant treatments that appear to work by similar mechanisms (Cleveland clinic, 2016). I would have also recommended Psychotherapy to go alongside the medication regimen. 

As a practicing PMHNP, I plan to focus my areas of focus on adolescents. It will be of the standard of care in my practice for all patients to be properly evaluated and diagnosed via official testing for ADHD and my patient will need to be actively utilizing psychotherapy while undergoing a medication regimen treatment if under my care. I have found through experience involving parents and patients in the treatment plan and education as a mental health case manager to assist with compliance and a more successful outcome for the adolescent. 

References

Cleveland clinic. (2016, July 18). ADHD medications: Strattera, antidepressants & more. 

Cleveland Clinic. https://my.clevelandclinic.org/health/drugs/12959-attention-deficit-hyperactivity-disorder-adhd-nonstimulant-therapy-strattera–other-adhd-drugs

Eli Lilly and Company. (2003). Medication Guide Strattera. www.strattera.com. https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021411s035lbl.pdf

Speed Pharmacology. (2015). Pharmacology – Pharmacokinetics (Made Easy) [Video]. https://www.youtube.com/watch?v=NKV5iaUVBUI&t=16s

Kyle Johnson Discussion week oneCOLLAPSE

Many factors play a role in how medications effects each individual including Pharmacokinetics and pharmacodynamics. According to Rosenthal & Burchum (2018), “Pharmacokinetics is the study of drug movement throughout the body”(p.4). Whereas Pharmacodynamics is the study of the response from medication entering the body (Rosenthal & Burchum, 2018). As a behavioral health nurse, I have seen patients that have been on antipsychotics for years, and even adolescents placed on their first antipsychotic.

Our psychiatrists try and use the newer antipsychotics such as Abilify, Risperdal, or Zyprexa as they are less likely to cause adverse reactions. Even with the atypical antipsychotics, patients can still be sensitive to these medications. One of my memorable admissions was a 40 year old female diagnosed with schizophrenia who comes in with command hallucinations to kill herself and is non-med complaint.  She has shown to be sensitive to antipsychotics. During this patient’s stay, her medications were restarted including Risperdal with Cogentin to help combat unwanted side effects such as neck stiffness. Shortly after the medication was restarted the patient became catatonic. Risperdal has been identified as a medication that can cause catatonia (Huang, et al., 2018). Risperdal was quickly discontinued and Ativan was started on this patient. Ativan has been shown to bring patients out of the catatonic state (Sienaert, at al., 2014).

After a few days the patient came out of the catatonic state the patient’s hallucinations came back and the patient tried to hang herself. Zyprexa and Clozaril were started. Shortly after the initiation of these medications the patient started to get better, but not for long. A week after starting the Clozaril the lab called with a critical lab value indicating agranulocytosis with a decreased neutrophil count (Voulgari, et al., 2015). The medication was stopped and the patient was sent to the medical center for further evaluation. After a week the patient was sent back to behavioral health. She was restarted on Zyprexa and Cogentin to good effect and was later discharged. Medications affect each individual differently requiring their providers to monitor them for adverse reactions. With the increased sensitivity with this patient, I would make sure to start any medication change with the lowest possible dose to monitor for side effects. I would choose medications with less potential for adverse reactions such as Zyprexa. I would lean towards choosing a depo preparation as the patient has a tendency to be non-compliant with treatment.

References

Huang, M. W., Gibson, R. C., Moberg, P. J., & Caroff, S. N. (2018). Antipsychotics for schizophrenia spectrum disorders with catatonic symptoms. The Cochrane Database of Systematic Reviews, 2018(10), CD013100. https://doi.org/10.1002/14651858.CD013100

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

Sienaert, P., Dhossche, D. M., Vancampfort, D., De Hert, M., & Gazdag, G. (2014). A clinical review of the treatment of catatonia. Frontiers in psychiatry, 5, 181. https://doi.org/10.3389/fpsyt.2014.00181

Voulgari, C., Giannas, R., Paterakis, G., Kanellou, A., Anagnostopoulos, N., & Pagoni, S. (2015). Clozapine-Induced Late Agranulocytosis and Severe Neutropenia Complicated with Streptococcus pneumonia, Venous Thromboembolism, and Allergic Vasculitis in Treatment-Resistant Female Psychosis. Case reports in medicine, 2015, 703218. https://doi.org/10.1155/2015/703218

2 resources for each discussion, thank you

If you talk about a possible poor health outcome, do you believe that outcome will occur? Do you believe eye contact and personal contact should be avoided?

You would have a difficult time practicing as a nurse if you believed these to be true. But they are very real beliefs in some cultures.

Differences in cultural beliefs, subcultures, religion, ethnic customs, dietary customs, language, and a host of other factors contribute to the complex environment that surrounds global healthcare issues. Failure to understand and account for these differences can create a gulf between practitioners and the public they serve.

In this Assignment, you will examine a global health issue and consider the approach to this issue by the United States and by one other country.

To Prepare:

• Review the World Health Organization’s (WHO) global health agenda and select one global health issue to focus on for this Assignment.
• Select at least one additional country to compare to the U.S. for this Assignment.
• Reflect on how the global health issue you selected is approached in the U.S. and in the additional country you selected.
• Review and download the Global Health Comparison Matrix provided in the Resources.

The Assignment: (1- to 2-page Global Health Comparison Matrix; 1-page Plan for Social Change)

Part 1: Global Health Comparison Matrix

Focusing on the country you selected and the U.S., complete the Global Health Comparison Matrix. Be sure to address the following:

• Consider the U.S. national/federal health policies that have been adapted for the global health issue you selected from the WHO global health agenda. Compare these policies to the additional country you selected for study.
• Explain the strengths and weaknesses of each policy.
• Explain how the social determinants of health may impact the global health issue you selected. Be specific and provide examples.
• Using the WHO’s Organization’s global health agenda as well as the results of your own research, analyze how each country’s government addresses cost, quality, and access to the global health issue selected.
• Explain how the health policy you selected might impact the health of the global population. Be specific and provide examples.
• Explain how the health policy you selected might impact the role of the nurse in each country.
• Explain how global health issues impact local healthcare organizations and policies in both countries. Be specific and provide examples.

Part 2: A Plan for Social Change

Reflect on the global health policy comparison and analysis you conducted in Part 1 of the Assignment and the impact that global health issues may have on the world, the U.S., your community, as well as your practice as a nurse leader.

In a 1-page response, create a plan for social change that incorporates a global perspective or lens into your local practice and role as a nurse leader.

• Explain how you would advocate for the incorporation of a global perspective or lens into your local practice and role as a nurse leader.
• Explain how the incorporation of a global perspective or lens might impact your local practice and role as a nurse leader.
• Explain how the incorporation of a global perspective or lens into your local practice as a nurse leader represents and contributes to social change. Be specific and provide examples

 To support your work, use your course and text readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format. 

Assignment

Complete only the History, Physical Exam, and Assessment sections of the Aquifer virtual case: Family Medicine 07: 53-year-old male with leg swelling.

Discussion Question 1

Based on your performance and the expert feedback in your HISTORY collection, describe two missed questions and your understanding of why they were important to collect for this case history. Use specific references from your text to explain.

Discussion Question 2

Based on your performance and the expert feedback in your PHYSICAL EXAM collection, describe two errors in your exam performance or documentation. Use specific references from your text to explain the importance of these findings in correct assessment of this client.

Discussion Question 3

Based on your performance on the PHYSICAL EXAM collection, describe one key finding that you included in your list and describe a specific physical exam that you can perform at the point-of-care to further evaluate the finding. Use specific references from your text.

Discussion Question 4

Based on your performance and the expert feedback in your ASSESSMENT identification of problem categories, choose one missed/incorrect category and use specific references from your text to explain the importance of this category in arriving at correct differential diagnoses for this client.

Discussion Question 5

Based on your performance and the expert feedback in your ASSESSMENT of differential diagnoses, describe one incorrect/missed differential diagnosis and use specific references from your text to support the inclusion of the diagnosis for this client.

Attached is the case scenario

Week 2 Project – Due

Nov 25, 2020 10:59 PMNSG3039-Information Management and Technology CP02

Change Proposal

In a Microsoft Word document of 4-5 pages formatted in APA style, develop a change proposal for a new technology that will contribute to a safer patient environment.
In your paper address each of the following criteria:

• Describe how the change proposal for the new technology will:
  • impact patient safety.
  • be measured to assess the impact of your change.
  • be communicated to staff and implemented.
• Examine human factors related to change and resistance to change.

On a separate references page, cite all sources using APA format. Helpful APA guides and resources are available in the South University Online Library. Below are guides that are located in the library and can be accessed and downloaded via the South University Online Citation Resources: APA Style page. The American Psychological Association website also provides detailed guidance on formatting, citations, and references at APA Style.
• APA Citation Helper
• APA Citations Quick Sheet
• APA-Style Formatting Guidelines for a Written Essay
• Basic Essay Template

Please note that the title and reference pages should not be included in the total page count of your paper.

 Client I use in week 3 practicum Assignment: 

A 14 year old male African American came in with his mum. He was alert and oriented x3. He was dressed appropriately for the weather and was observed as being hyperactive, restless and irritable. He exhibits symptoms of agitation, feeling of worthlessness, worry, and lack of focus and concentration. Client denies suicidal or homicide ideations, no drug or alcohol abuse, he never been arrested and is not involved in gang activity. He further denies any physical, sexual, or emotional abuse, had never been arrested, and is not involved in gang activity. He further denies any physical sexual or emotional abuse . Client reported that he had an altercation with his mother concerning his disrespected behavior towards her because he rejects any authoritative control and engaged in a disruptive altercation with his mother . He subquently left the home seeking the local police for assistance

Diagnosis: 

Adjustment disorder with mixed anxiety and depressed mood

Assignment

Part 1: Progress Note

Using the client family from your Week 3 Practicum Assignment, address in a progress note (without violating HIPAA regulations) the following:

• Treatment modality used and efficacy of approach
• Progress and/or lack of progress toward the mutually agreed-upon client goals (reference the treatment plan for progress toward goals)
• Modification(s) of the treatment plan that were made based on progress/lack of progress
• Clinical impressions regarding diagnosis and or symptoms
• Relevant psychosocial information or changes from original assessment (e.g., marriage, separation/divorce, new relationships, move to a new house/apartment, change of job)
• Safety issues
• Clinical emergencies/actions taken
• Medications used by the patient, even if the nurse psychotherapist was not the one prescribing them
• Treatment compliance/lack of compliance
• Clinical consultations
• Collaboration with other professionals (e.g., phone consultations with physicians, psychiatrists, marriage/family therapists)
• The therapist’s recommendations, including whether the client agreed to the recommendations
• Referrals made/reasons for making referrals
• Termination/issues that are relevant to the termination process (e.g., client informed of loss of insurance or refusal of insurance company to pay for continued sessions)
• Issues related to consent and/or informed consent for treatment
• Information concerning child abuse and/or elder or dependent adult abuse, including documentation as to where the abuse was reported
• Information reflecting the therapist’s exercise of clinical judgment

Note: Be sure to exclude any information that should not be found in a discoverable progress note.

Part 2: Privileged Note

Based on this week’s readings, prepare a privileged psychotherapy note that you would use to document your impressions of therapeutic progress/therapy sessions for your client family from the Week 3 Practicum Assignment.

In your progress note, address the following:

• Include items that you would not typically include in a note as part of the clinical record.
• Explain why the items you included in the privileged note would not be included in the client family’s progress note.
• Explain whether your preceptor uses privileged notes. If so, describe the type of information he or she might include. If not, explain why.

Write an answer based on this assignment. Use at least 2 references. Not use the same that appears here.

Discussion Chapter 9

Try taking a different route to class the next time it meets. Before you do this, think about how many changes, large and small, you will have to make to do this.

Will you have to leave earlier to bein class on time?

In order to be in class on time, I would have to leave earlier, since as a nurse, you are an agent of change in a formal and informal legitimate influence and whose resolution is to direct and guide growth. Arriving in class on time is an important virtue that should be checked on. Nurses should be a good role model to the other health professionals and be a guidance to them. In real life scenario, timekeeping is essential. There is a need to be at the frontline on time to provide a necessary change in the working station, hence improving work procedures and much importantly, the patient care.

Will you meet different people on your way to class?

By taking a different route and leaving earlier, I would probably meet different people on my way to class. The new route to class may allow me to recognize other individuals that I had not acknowledged before during my previous route. Therefore, on the way, I will encounter other determined nursing students.

See different sights?

By changing the route to class, I would be exposed to new sights, buildings, and locations. When you accept the new change, there are some other aspects that may be altered like thoughts, feelings, and behaviors, which may bring positive results to the new experience.

Would you change your route to class on the day of the final exam?

I would not change my route to class on the day of the final exam. I believe that changing the route on such an important day would lead to disorganizing of the plans and maybe a form of time-wasting, since it is something new and requires adjustment. In this regard, it may be better to analyze the situation to see if the change you are making is necessary. If not, following the same route will prevent further delays or new changes and challenges to previous plans.

Why or why not? Summarize the positives and negatives of this small change. Relate your responses to this change to the way staff nurses feel when an administrator makes what he or she thinks is a “minor” change.

Changing routes may be necessary if a previous routine may be affecting the success of an outcome. For instance, an administrator may provide staff nurses with a change that he or she believes is necessary for improving the outcome of a task. The change may positively affect patient care and overall health. However, this small change may negatively impact staff nurses in that their daily routine might be altered, which may affect and delay their performance throughout the day. For this reason, a leader should be knowledgeable about the change being implemented and the way it may positively and negatively impact those involved.

Think about a change that has occurred in your life. Some examples may be a change of role, a move, a marriage, a birth, a divorce, or a death

How did you react to the change?

The death of a loved one is a process that is inevitable, since it happens without someone’s concession or plans. Although my reaction was not at all pleasant, one learns ways to cope with the situation since you become affected in one way or another. The environment also gives you good exposure to how to overcome the challenges that you encounter. Learning to accept the situation is the best way to approach challenges the way they come.

Would you have reacted differently if you had had more information?

If I had known all of the details of my family member’s condition, I believe I would have reacted differently to the situation, since I would have had a good exposure on how to deal with the situation and would have known what to expect. Although death is a subject no one is mentally prepared for, having more information about the situation would have helped explain what was going on and would have provided me with a glimpse of what was to come.

Using Lewin’s model describes the essential elements in the situation and how you eventually achieved a comfortable outcome.

Lewin’s model relates efficiently to real-life situations in managing change in oneself and involves three steps, which include unfreezing, changing, and refreezing (“Lewin’s change theory,” 2019). He describes how to tackle a problem adequately and how you develop pathways on encountered solutions if it requires change. The change agent should recheck the affected systems to ensure the shift stabilizes well and is maintained. Using this theory, I first directed behavior away from the existing situation. Then, I found a way to distract myself in order to change the unpleasant feeling brought on by the death of my family member. Lastly, I implemented the distraction method regularly in order to make it a daily habit and try to surpass the inevitable tragedy.

References

Balsanelli, A. P., David, D. R., & Ferrari, T. G. (2018). Nursing leadership and its relationship with the hospital work environment. Acta Paul Enferm., 31(2), 187-193.

Lewin’s change theory. (2019). Nursing Theory. https://nursing-theory.org/theories-and-models/lewin-change-theory.php

Miles, J. M., & Scott, E. S. (2019). A new leadership development model for nursing education. Journal of Professional Nursing, 35(1), 5-11.

In 100-150 words please provide feedback to this discussion…

Perception of Workplace Violence in the Emergency Department

This article is a cross-sectional study using healthcare professionals, surveying their workplace violence history, the amount of violence, and the type by emergency room nurses and physicians. Types of abuse were conducted as verbal, physical and conformation. Information also led to the impact of workplace violence on staff and how satisfied, feeling scared, loss of sleep and missing work were caused. One strength of this article was the questionnaire and the data that was provided using statistical analysis. A weakness of the article is the conclusion and what the results showed and how they affected staff at the VA hospitals and the huge impact that violence had on staff members.

Reference:

Seema Sachdeva, Nayer Jamshed, Praveen Aggarwal, & Suman R Kashyap. (2019). Perception of workplace violence in the emergency department. Journal of Emergencies, Trauma and Shock, 12(3), 179–184. https://doi-org.lopes.idm.oclc.org/10.4103/JETS.JETS_81_1

Physical and Verbal Assault on Medical Staff in Emergency Hospital Departments in Abha City, Saudi Arabia.

A questionnaire was used to evaluate workplace violence on emergency room medical staff of different emergency rooms around Saudi Arabia. This article had a strong background thesis and it provided the reader with facts about workplace violence. The different emergency room staff were used to collect data from staff using demographics, work history, and personal data and then the violence history questions were included. A weakness of this article was that it lacked relevance in demographics, marital status and age in my opinion to the thesis at hand.

Reference:

Alqahtani, M. A., Alsaleem, S. A., & Qassem, M. Y. (2020). Physical and Verbal Assault on Medical Staff in Emergency Hospital Departments in Abha City, Saudi Arabia. Middle East Journal of Family Medicine, 18(2), 94–100. 

Workplace Violence and Perceptions of Safety Among Emergency Department Staff Members: Experiences, Expectations, Tolerance, Reporting, and Recommendations

This article started with a great abstract, summarizing key details to be explained later on in the article. Statistics and comparisons were used to explain the impact and severity of workplace violence and the effect on health care providers. A study was conducted at a Level 1 Shock Trauma Center with strategies already in place with a survey sent out electronically analyzing demographics and violent incidents. The ENA definition of WPV which states “any physical assault; emotional or verbal abuse; or threatening, harassing or coercive behavior in the work setting that causes physical and/or emotional harm” (Copeland & Henry, 2017). A weakness of this article was that only one facility in the area was analyzed and difficult to compare the results of the surrounding areas.

Reference:

Copeland, D., & Henry, M. (2017). Workplace Violence and Perceptions of Safety Among Emergency Department Staff Members: Experiences, Expectations, Tolerance, Reporting, and Recommendations. Journal of Trauma Nursing, 24(2), 65–77. https://doi-org.lopes.idm.oclc.org/10.1097/JTN.0000000000000269

Workplace Violence against Residents in the Emergency Department and Reasons for not Reporting Them; a Cross-Sectional Study

Emergency Department residents were analyzed in a cross-sectional study of three teaching hospitals in Iran. A questionnaire was used analyzing demographics and the type and the reporting incidents when the violence was present. A strength of this article was the referencing of the World Health Organization and the statistics used to create a strong background of workplace violence and the prevalence. A weakness of this article was the limitation of time due to the time constraint that was conducted for the study. The study only analyzed 1 year of experiences despite longer educational programs of how long residents are in their practicum. 

Reference:

Emam, G. H., Alimohammadi, H., Sadrabad, A. Z., & Hatamabadi, H. (2018). Workplace Violence against Residents in the Emergency Department and Reasons for not Reporting Them; a Cross Sectional Study. Emergency, 6(1), 1–7.

Quality of work-life and its association with workplace violence of the nurses in emergency departments

Nurses were analyzed on how violence affected their home life, using a descriptive-correlational study with a questionnaire. The article had a strong and detailed introduction explaining the importance of the quality of work life. High quality work-life can create nursing retention and delivery of quality patient care. A weakness of this article was the details of the questionnaire were lengthy and divided into 3 different parts analyzing in-depth information of the nurses which can take a significant amount of time. 

Reference:

Eslamian, J., Akbarpoor, A. A., & Hoseini, S. A. (2015). Quality of work-life and its association with workplace violence of the nurses in emergency departments. Iranian Journal of Nursing & Midwifery Research, 20(1), 56–62.

Worker, workplace, and community/environmental risk factors for workplace violence in emergency departments

Six different emergency departments were used in cross-sectional research design, completing a survey on demographics. Over 280 respondents completed the survey and answers were analyzed. The article had great breakdowns of charts, common answers among hospital personnel and the different types of violence. A weakness in this article was the different variables of workplaces in different areas of the United States. Depending on the demographic area can change the environment for nurses and staff who are completing the surveys. 

Reference:

Gillespie, G. L., Pekar, B., Byczkowski, T. L., & Fisher, B. S. (2017). Worker, workplace, and community/environmental risk factors for workplace violence in emergency departments. Archives of Environmental & Occupational Health, 72(2), 79–86. https://doi-org.lopes.idm.oclc.org/10.1080/19338244.2016.1160861