{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:05:44Z","timestamp":1791824744609,"version":"4.3.4"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine triggers, responses, and outcomes for patient\u2010related violence and\/or aggression events during acute hospitalisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This was a descriptive observational study undertaken at two healthcare organisations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Pre\u2010existing data were extracted from organisational incident reports and individual medical records during a retrospective period (1\/1\/2023 to 30\/6\/2023) and a prospective period (7\/6\/2024 to 16\/11\/2024). Violence and\/or aggression events requiring an organisational response that involved patients hospitalised in general ward areas at a metropolitan (Site A) and a regional (Site B) site were included. Data were analysed using descriptive statistics and content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The sample included 100 retrospective cases and 42 prospective cases. The most prevalent causes for hospitalisation related to a medical or mental health condition and dementia. Confusion and irritability were the most common forms of behaviour of concern prior to the event. Physical restraint was utilised more frequently in the prospective period compared with the retrospective period. Chemical restraint was used in approximately half of the cases in both study periods. A form of physical violence was the most prevalent behavioural symptom in both periods, followed by verbal aggression and inability to be re\u2010directed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with a pre\u2010existing medical condition, confusion and\/or dementia are frequently involved in violent and\/or aggressive events in ward settings. Physical and chemical restraints are commonly used to manage violence and aggression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession<\/jats:title>\n                    <jats:p>Alternative strategies are needed to manage occupational violence and aggression to minimise the need for physical and\/or chemical restraint.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>This study addresses a gap in evidence regarding triggers, responses and outcomes for patients exhibiting violence and aggression in ward settings during hospitalisation. Patients with dementia, confusion and irritability frequently exhibit behaviours of concern, exposing healthcare workers to potential physical and psychological harm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>STROBE checklist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>No Patient or Public Contribution<\/jats:title>\n                    <jats:p>This study did not include patient or public involvement in its design, conduct, or reporting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.70313","type":"journal-article","created":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T03:54:26Z","timestamp":1775274866000},"page":"3418-3430","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Triggers, Responses, and Outcomes for Patient Related Violence and\/or Aggression Events During Acute Hospitalisation: A Documentary Analysis"],"prefix":"10.1111","volume":"35","author":[{"given":"Debra","family":"Kerr","sequence":"first","affiliation":[{"name":"Western Health  St Albans Victoria Australia"},{"name":"School of Nursing &amp; Midwifery Centre for Quality &amp; Patient Safety Research in the Institute for Health Transformation, Deakin University  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5065-2726","authenticated-orcid":false,"given":"Alison M.","family":"Hutchinson","sequence":"additional","affiliation":[{"name":"School of Nursing &amp; Midwifery Centre for Quality &amp; Patient Safety Research in the Institute for Health Transformation, Deakin University  Geelong Victoria Australia"},{"name":"Barwon Health  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Ilarda","sequence":"additional","affiliation":[{"name":"Safety, Risk and Emergency Management Western Health  St Albans Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1686-1476","authenticated-orcid":false,"given":"Louise","family":"Alexander","sequence":"additional","affiliation":[{"name":"School of Nursing &amp; Midwifery Centre for Quality &amp; Patient Safety Research in the Institute for Health Transformation, Deakin University  Geelong Victoria Australia"},{"name":"Mental Health Nursing, Alfred Deakin Partnership, Alfred Mental &amp; Addiction Health, School of Nursing &amp; Midwifery Centre for Quality &amp; Patient Safety Research in the Institute for Health Transformation, Deakin University  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7814-9743","authenticated-orcid":false,"given":"Susan","family":"Perlen","sequence":"additional","affiliation":[{"name":"School of Nursing &amp; Midwifery Centre for Quality &amp; Patient Safety Research in the Institute for Health Transformation, Deakin University  Geelong Victoria Australia"},{"name":"Barwon Health  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Davies","sequence":"additional","affiliation":[{"name":"Western Health  St Albans Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trish","family":"Mant","sequence":"additional","affiliation":[{"name":"Head Practice Development Unit Barwon Health  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Skazlic","sequence":"additional","affiliation":[{"name":"Barwon Health  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Petrunic","sequence":"additional","affiliation":[{"name":"Western Health  St Albans Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Mrhar","sequence":"additional","affiliation":[{"name":"Barwon Health  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7457-3221","authenticated-orcid":false,"given":"Adam","family":"Searby","sequence":"additional","affiliation":[{"name":"Mental Health Nursing Monash University  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,3]]},"reference":[{"key":"e_1_2_15_2_1","unstructured":"American Hospital Association.2017.\u201cCost of Community Violence to Hospitals and Health Systems.\u201dMilliman Research Report July 26.https:\/\/www.aha.org\/system\/files\/2018\u201001\/community\u2010violence\u2010report.pdf."},{"key":"e_1_2_15_3_1","unstructured":"Australasian College for Emergency Medicine.2024.\u201cViolence in Emergency Departments.\u201dhttps:\/\/acem.org.au\/getmedia\/6496564f\u20108330\u201047a3\u20109ae5\u201016af7453808f\/P32\u2010Violence\u2010in\u2010the\u2010ED."},{"key":"e_1_2_15_4_1","unstructured":"Australian Institute for Health and Welfare.2024.\u201cDementia in Australia.\u201dhttps:\/\/www.aihw.gov.au\/reports\/dementia\/dementia\u2010in\u2010aus\/contents\/health\u2010services\u2010used\u2010by\u2010people\u2010with\u2010dementia\/hospitalisations\u2010due\u2010to\u2010dementia."},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010015\u20100743\u20101"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/23297018.2024.2349036"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jonm.13724"},{"key":"e_1_2_15_8_1","volume-title":"Reducing Restrictive Interventions: A Literature Review and Document Analysis","author":"Department of Health","year":"2013"},{"key":"e_1_2_15_9_1","unstructured":"Department of Health and Human Services (DHHS).2017.\u201cCode Grey Standards.\u201dhttps:\/\/www.health.vic.gov.au\/sites\/default\/files\/migrated\/files\/collections\/policies\u2010and\u2010guidelines\/c\/code\u2010grey\u2010standards\u2010sep\u20102017\u2010pdf.pdf."},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102648.2007.04569.x"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102648.2006.03956.x"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912\u2010023\u201001265\u20101"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102016\u2010015257"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.15837"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpm.12905"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17010299"},{"key":"e_1_2_15_17_1","unstructured":"Lim R. M.McDonald M.Welz andM.Rose.2022.\u201cA Retrospective Review of \u2018Code Grey\u2019 Emergency Response Calls at Cabrini Malvern (Part 2). Poster. Cabrini Research Forum. Unpublished.\u201dhttps:\/\/www.cabrini.com.au\/app\/uploads\/51.\u2010Roxanne\u2010Lim\u2010A\u2010retrospective\u2010review\u2010of\u2010code\u2010grey\u2010emergency\u2010response\u2010calls\u2010at\u2010Cabrini\u2010Malvern\u2010Part\u20102.pdf."},{"key":"e_1_2_15_18_1","volume-title":"Violence and Aggression: Short\u2010Term Management in Mental Health, Health and Community Settings. 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National Guidance Material","author":"Safe Work Australia","year":"2021"},{"key":"e_1_2_15_25_1","unstructured":"Safe Work Australia.2024.\u201cWorkplace and Work\u2010Related Violence and Aggression in Australia.\u201dhttps:\/\/data.safeworkaustralia.gov.au\/report\/work\u2010related\u2010violence\u2010aggression\u2010australia."},{"key":"e_1_2_15_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.shaw.2021.04.004"},{"key":"e_1_2_15_27_1","unstructured":"State of Victoria.2011.\u201cInquiry Into Violence and Security Arrangements in Victorian Hospitals and in Particular Emergency Departments.\u201dFinal Report. 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