الفهرس 
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Abstract
Workplace violence is now recognized as a specific category of violent crime that calls for distinct responses from employers, law enforcement, and the community. Workplace violence has a negative impact on the nursing organization and the safety of patients as well as on the individual nurses. It leads to sadness, anxiety, mistrust, and low self-esteem in the victim nurses. Also creates bad work environment, which leads to negative quality of care.
Workplace violence from patients has a negative effect on health care staff, causing more negative attitudes toward work tasks and the patients themselves and negative reactions from nurses. Healthcare and social service workers face an increased risk of work-related assaults resulting primarily from violent behavior of their patients.
Risk factors for development of workplace violence divided into: personal, environmental and organizational factors. Personal risk factors include nurses related factors, factors includes age ,level of experience, level of training while patient related factors includes mental disorder and history of violence. Environmental factors include physical design of workplace and safety measures. Organizational factors include reporting policies. Workplace violence prevention program and administrative support
The first step in prevention for employers and employees is recognizing that workplace violence is not just a law enforcement problem. Implementing an effective prevention plan will have a far greater impact on the reduction of workplace violence than focusing on what steps will be taken after an incident has occurred.
The aim of this study is to determine critical care nurses attitudes and reactions toward workplace violence risk factors. A descriptive research design was used to conduct this study. The present study setting included the critical care and emergency units of Kafer El Dawer Hospitals ( Kafer El Dawer General Hospital and Mubara of Kafer El Dawar Hospital)
The sample of the current study included 100 critical care nurses of both sex who are involved in direct patient s’ care.
To accomplish the aim of the current study two tools were designed and used for data collection. Tool one: ”Nurse’s attitude and reactions` toward workplace violence questionnaire”: It was initially developed by punett B (2007) and it was modified by the researcher after reviewing of the related literature. It was used to assess nurse s’ attitude and reactions toward workplace violence in critical care units. it divided into two parts: Part I included nurses’ demographic data and Part II included history of nurses for workplace violence. Tool two: ”Workplace violence risk factors assessment structured interview schedule” This tool was developed by the researcher after reviewing of the related literature to assess workplace violence risk factors in the critical care units. It included personal, environmental and organizational factors.
The most common results encountered by this research are:
The major characteristics of studied nurses were female (87.9%), more than one third of the studied sample (34.6%) had diploma degree and 31.8% had bachelor degree and most of them were married (78.5%)
All critical care nurses were exposed to workplace violence (100%). More than half of them (57%) exposed to verbal violence. The most of studied sample (72%) reported that patient relatives were the perpetrators of workplace violence. The majority of the studied sample (99.1%) reported that violence has psychosocial consequences which threaten nurses’ entity and nurses’ ethical behavior (85%). 70.1% of nurses reported that violence affects nurse’s relationships with their colleagues. Most of the nurses (77.6%) reported that violence increase turnover in nursing staff. 88.8% of studied sample use formal system and write report about the incident to the supervisor and the most of studied sample use anger reactions toward perpetrators of violence.
Nurses related factors included increase number of female nurses in the critical unit, previous experience violence, inadequate training in violence education, poorly support from hospital administration and inadequate mechanism of support after violent episode occurs. Patient’s related factors included patient history of violence, working with mentally ill individual psychtric patients, patients with alcohol and substance abuse impairment, hypoxic patients and post traumatic head injury patients. Environmental related factors were high use of temporary staff, low levels of staff patient interaction, lack of privacy and overcrowding, over admitting, lack of security measures, working in area has prevalence of weapons brought into critical unit, high stressful environment
It can be concluded from the present study that:
Critical care nurses were in the highest risk category for workplace violence and verbal violence is the most frequent type of violence among critical care nurses. The most perpetrators of workplace violence in the critical care and emergency units are patients’ relatives. The majority of the critical nurses had negative attitude toward workplace violence and used anger reaction against perpetrators of the violence.
There are many contributing factors to workplace violence in the critical care units including personal, environmental and organizational factors.
Based on the findings of this study it can be recommended that:
• Provide continous education for critical care and emergency nurses regarding workplace violence risk factors and how to avoid it
• The curriculum of the critical care and emergency nursing should include the workplace violence topic.
• Prepare booklets for critical care nurse about workplace violence and its risk factors.
• Nurse managers should focus on effective communication and should support nurses after incidents of violence.
• Nurse managers should participate in development, implementation, evaluation, and modification of the workplace violence prevention program
• Safety and security policies should be developed.
• Individual nurses should be recognize the risk factors of workplace violence to avoid violent attack from patients, relatives and their colleagues and should report any incidents of violence.
• Security measures , environmental controls, best practices for reducing ED violence should be implemented
• Policies that ensure reporting, recording, and monitoring of violence incidents should be established