The article explores workplace violence against healthcare workers at the University Hospital of Sassari, a growing issue both nationally and globally. Through a literature review, analysis of 2022–2024 incident-reporting data, and insights from an institutional interview, the evolution of the phenomenon and the initiatives implemented are explored. Most aggressions are verbal, concentrated in the Emergency Department, and directed mainly at nurses and younger professionals. The hospital has introduced a structured procedure including organizational measures, deescalation training, enhanced security, improved communication with patients and families, psychological support for affected workers, and strengthened reporting systems. Despite notable progress, workplace violence remains multifactorial and persistent, requiring integrated and continuous strategies.
References
Al-Natour A., Abuziad L., Hweidi L.I. (2023). Nurses’ experiences of workplace violence in the emergency department. Int Nurs Rev., Dec, 70(4): 485-493. DOI: 10.1111/inr.12788.
Ayasreh I.R., Hayajneh F.A. (2021). Workplace Violence Against Emergency Nurses: A Literature Review. Critical care nursing quarterly, 44(2), 187-202. DOI: 10.1097/CNQ.0000000000000353.
Azami M., Moslemirad M., YektaKooshali M.H., Rahmati S., Soleymani A., Bigdeli Shamloo M.B., Esmaeilpour-Bandboni M., Khataee M., Khorshidi A., Otaghi M. (2018). Workplace Violence Against Iranian Nurses: A Systematic Review and Meta-Analysis. Violence Vict, 33(6): 1148-1175. DOI: 10.1891/0886-6708.33.6.1148.
Azienda Ospedaliero Universitaria di Sassari (2025). Piano Integrato di Attività e Organizzazione 2025-2027.
Bayram B., Çetin M., Çolak Oray N. et al. (2017). Workplace violence against physicians in Turkey’s emergency departments: a cross sectional survey. BMJ Open, 7, e013568. DOI: 10.1136/bmjopen-2016-013568.
Cannavò M., Fusaro N., Colaiuda F., Rescigno G. and Fioravanti M. (2017). Studio preliminare sulla presenza e la rilevanza della violenza nei confronti del personale sanitario dell’emergenza. Clinica Terapeutica, 168(2). DOI: 10.7417/CT.2017.1990.
Davey K., Ravishankar V., Mehta N., Ahluwalia T., Blanchard J., Smith J. et al. (2020). A qualitative study of workplace violence among healthcare providers in emergency departments in India. Int J Emerg Med, 13(1): 33. DOI: 10.1186/s12245-020-00290-0.
Eshah N., Al Jabri O.J., Aljboor M.A. et al. (2024). Workplace Violence Against Healthcare Workers: A Literature Review. Sage Open Nursing, 10. DOI: 10.1177/23779608241258029.
Ferretti F., Gualtieri G., Carabellese F., Gusinu R., Masti A., Pozza A (2021). Aggression toward healthcare workers: The effect of indirect victimization on burnout dimension. J. Aggress. Maltreat. Trauma, 30: 1113-1123.
Geoffrion S., Hills D.J., Ross H.M., Pich J., Hill A.T., Dalsbø T.K., Riahi S., Martínez-Jarreta B., Guay S. (2020). Education and training for preventing and minimizing workplace aggression directed toward healthcare workers. Cochrane Database Syst Rev., Sep 8, 9(9), CD011860. DOI: 10.1002/14651858.CD011860.pub2.
Kim J. H., Lee N., Kim J. Y., Kim S. J., Okechukwu C., & Kim S. S. (2019). Organizational response to workplace violence, and its association with depressive symptoms: A nationwide survey of 1966 Korean EMS providers. Journal of occupational health, 61(1): 101-109.
Kumari A., Ranjan P., Sarkar S., Chopra S., Kaur T., Baitha U. (2022). Identifying predictors of workplace violence against healthcare professionals: A systematic review. Indian J Occup Environ Med, 26: 207‑24.
La Rocca A., Prestano G., Trombetta F. (2024). Le aggressioni e le violenze ai danni del personale sanitario. Primi risultati di una sperimentazione finalizzata a favorire le segnalazioni. Verso una revisione del Testo Unico della sicurezza?. Diritto della Sicurezza sul Lavoro, 1.
Li N., Zhang L., Xiao G., Chen J., & Lu Q. (2019). The relationship between workplace violence, job satisfaction and turnover intention in emergency nurses. International emergency nursing, 45: 50-55.
Lim M.C., Jeffree M.S., Saupin S.S., Giloi N., Lukman K.A. (2022). Workplace violence in healthcare settings: The risk factors, implications and collaborative preventive measures. Annals of Medicine and Surgery, 78, 103727. DOI: 10.1016/j.amsu.2022.103727.
Lyver B., Singh B., Balzer N., Agnihotri M., Hulme J., Chan K., Sethi R., Reynolds C., Haines J., Whiteside R., Toppings M., Schulz-Quach C. (2025). Exploring the Impact of Workplace Violence in Urban Emergency Departments: A Qualitative Study. Healthcare (Basel), Mar 20, 13(6), 679. DOI: 10.3390/healthcare13060679.
Magnavita, N., Heponiemi, T., & Chirico, F. (2020). Workplace violence is associated with impaired work functioning in nurses: An Italian cross-sectional study. Journal of Nursing Scholarship, 52(3): 281-291. DOI: 10.1111/jnu.12549.
Mento C., Silvestri M. C., Bruno A., Muscatello M. R. A., Cedro C., Pandolfo G., Zoccali R. A. (2020). Workplace violence against healthcare professionals: A systematic review, Aggression and Violent Behavior, 51. DOI: 10.1016/j.avb.2020.101381.
Ministero della Salute (2024). Osservatorio Nazionale sulla Sicurezza degli Esercenti le Professioni Sanitarie e socio-sanitarie. Relazione attività anno 2024.
National Institute for Occupational Safety and Health (NIOSH) (2002). Violence – Occupational Hazard in Hospitals. Department of Health and Human Services: Publication No. 2002-2101. DOI: 10.26616/NIOSHPUB2002101.
Niu S. F., Kuo S. F., Tsai H. T., Kao C. C., Traynor V., & Chou K. R. (2019). Prevalence of workplace violent episodes experienced by nurses in acute psychiatric settings. PloS one, 14(1), e0211183. DOI: 10.1371/journal.pone.0211183.
ONSEPS (2025). Relazione sulle attività dell’Osservatorio nazionale sulla sicurezza degli esercenti le professioni sanitarie e socio-sanitarie, 2024.
Peng L., Xing K., Qiao H., Fang H., Ma H., Jiao M., Kang Z. (2018). Psychological violence against general practitioners and nurses in Chinese township hospitals: incidenceand implications. Health and quality of life outcomes, 16(1), 117. DOI: 10.1186/s12955-018-0940-9.
Pirisi L., Reginato E. (2023). La digitalizzazione a supporto del processo di implementazione del nuovo modello di assistenza territoriale della ASL di Sassari. DOI: 10.3280/mesa2022-123oa15599.
Ramacciati N., Gili A., Mezzetti A., Ceccagnoli A., Addey B., Rasero L. (2019). Violence towards Emergency Nurses: The 2016 Italian National Survey ‒ A cross‐sectional study. Journal of Nursing Management, 27(4): 792-805.
Regione Sardegna, Università di Cagliari, Università di Sassari (2017). Protocollo d’intesa tra la Regione Sardegna e le Università degli studi di Cagliari e Sassari, in applicazione del D. Lgs 517/1999.
Schablon A., Wendeler D., Kozak A., Nienhaus A., & Steinke S. (2018). Prevalence and Consequences of Aggression and Violence towards Nursing and Care Staff in Germany ‒ A Survey. International journal of environmental research and public health,15(6), 1274. DOI: 10.3390/ijerph15061274.
Serrano Vicente M.I., Fernández Rodrigo M.T., Satústegui Dordá P.J., Urcola Pardo F. (2019). Agression to health care personnel in Spain: a systematic review. Rev Esp Salud Publica, Oct 2, 93, e201910097.
Strickler J. (2018). Staying safe: responding to violence against healthcare staff. Nursing, 48(11), 58-62. DOI: 10.1097/01.NURSE.0000545021.36908.28.
Viottini E., Politano G., Fornero G., Pavanelli P.L., Borelli P., Bonaudo M., & Gianino M.M. (2020). Determinants of aggression against all health care workers in a large-sized university hospital. BMC Health Services Research, 20(1): 1-9, DOI: 10.1186/s12913-020-05084-x.
Wang J., Liu M., Zheng H., Xiang M. (2025). Workplace violence experiences of intensive care unit healthcare providers: a qualitative systematic review and meta-synthesis. BMC Health Serv Res., Mar 18. 25(1), 399. DOI: 10.1186/s12913-025-12446-w.
Yosep I., Mardhiyah A., Hendrawati H., Hendrawati S. (2023). Interventions for Reducing Negative Impacts of Workplace Violence Among Health Workers: A Scoping Review. J Multidiscip Healthc., May 22, 16: 1409-1421. DOI: 10.2147/JMDH.S412754.