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N. 134 (2025)

La governance del rischio aggressioni nel sistema sanitario pubblico: analisi organizzativa e strategie di mitigazione nell’Azienda Sanitaria Locale di Bari

DOI
https://doi.org/10.3280/mesa2025-134oa22050
Inviata
febbraio 11, 2026
Pubblicato
2026-04-24

Abstract

L’articolo analizza la governance del rischio aggressioni nel sistema sanitario pubblico, focalizzandosi sul caso studio dell’Azienda Sanitaria Locale (ASL) di Bari. Gli autori esaminano la fenomenologia della violenza contro gli operatori sanitari, evidenziando un trend statistico in costante ascesa che ha visto le segnalazioni nell’ASL Bari passare da 42 nel 2022 a 130 nel 2024.
Il contributo sostiene che la sicurezza del personale non sia solo una tutela del lavoratore, ma un pilastro della clinical governance essenziale per la qualità delle cure. Attraverso l’analisi di strategie manageriali quali l’introduzione dell’Infermiere di Processo e la formazione sulla de-escalation, il testo propone un modello di gestione proattiva che integri interventi strutturali e innovazione organizzativa per rigenerare il patto fiduciario tra istituzioni e utenza.

Riferimenti bibliografici

  1. Al-Omari H. (2025). Predictors of workplaceviolence against nurses in emergency departments: A systematic review and meta-analysis. Applied Nursing Research, 70, 151659.
  2. Al-Qadi M. M. (2021). Workplaceviolence in nursing: A concept analysis. Journal of Occupational Health, 63(1), e12226. DOI: 10.1002/1348-9585.12226.
  3. Anderson N. L. (2002). Sources of workplaceviolence in hospitals. AAOHN Journal, 50(6): 283-289.
  4. Arnetz J. E., & Arnetz B. B. (2001). Violencetowards health care staff and possible effects on the quality of patient care. Social Science & Medicine, 52(11): 1701-1710.
  5. Arnetz J., Hamblin L. E., Sudan S., & Arnetz B. (2018). Organizational determinants of workplaceviolence against hospital workers. Journal of Occupational and Environmental Medicine, 60(8): 693-699. DOI: 10.1097/JOM.0000000000001345.
  6. Boyle M. J., & Wallis J. (2016). Working towards a definition for workplaceviolence actions in the health sector. Safety in Health, 2(4). DOI: 10.1186/s40886-016-0015-8.
  7. Chapman R., & Styles I. (2006). An epidemic of abuse and violence: Nurse on the front line. Accident and Emergency Nursing , 14(4): 176-184.
  8. Copeland D., & Henry M. (2017). Workplaceviolence and perceptions of safety among emergency department staff members: Experiences, expectations, tolerance, reporting, and recommendations. Journal of Trauma Nursing, 24(2): 65-77. DOI: 10.1097/JTN.0000000000000269.
  9. D’Agostino F., & Balducci C. (2019). Workplace violence in healthcare: A review of interventions for prevention and management. La Medicina del Lavoro, 110(5): 369-381.
  10. D’Ettorre G., & Pellicani V. (2017). Workplace violence toward mental healthcare workers employed in psychiatric wards. Safety and Health at Work, 8(4): 337-342.
  11. Einarsen S., Hoel H., Zapf D., & Cooper C. L. (2020). Bullying and harassment in the workplace: Theory, research and practice (3rd ed.). CRC Press.
  12. Emary E. A. M., Arifin S. R. M., &Yusof M. Z. (2024). A qualitative systematic review of healthcare practitioners’ experience of workplaceviolence. Malaysian Journal of Medical Sciences, 31(1): 51-61. DOI: 10.21315/mjms2024.31.1.4.
  13. Federazione Nazionale Ordini Professioni Infermieristiche (FNOPI) (2024). Osservatorio sulle Aggressioni al Personale Sanitario: Rapporti annuali.
  14. Feller E. A., Ferri P., & Di Lorenzo R. (2023). Nursing Sensitive Outcomes evaluation in the Emergency Department: An Umbrella review. Acta Biomedica, 94(5), e2023225. DOI: 10.23750/abm.v94i5.14982.
  15. Ferri P., Stifani S., Accoto A., Bonetti L., Rubbi I., & Di Lorenzo R. (2020). Violence against nurses in the triage area: A mixed-methods study. Journal of Emergency Nursing, 46(3): 384-397.
  16. Hall L. H., Johnson J., Watt I., Tsipa A., & O’Connor D. B. (2016). Healthcare staff wellbeing, burnout and patient safety: A systematic review. PLOS ONE, 11(7), e0159015. DOI: 10.1371/journal.pone.0159015.
  17. Hegney D. G., Eley R., Plank A., Buikstra E., & Parker V. (2017). The impact of workplace violence on health care professionals’ mental health: A systematic review of qualitative studies. Journal of Clinical Nursing, 26(19-20): 2824-2839.
  18. International Labour Office (ILO), International Council of Nurses (ICN), World Health Organization (WHO), & Public Services International (PSI) (2002). Framework guidelines for addressing workplaceviolence in the health sector. International Labour Office.
  19. Kim S., Mayer C., & Jones C. B. (2022). Relationships between nurses’ experiences of workplace violence, emotional exhaustion and patient safety. Journal of Research in Nursing , 27(1-2): 101-111.
  20. Liu J., Gan Y., Jiang H., Li L., Dwyer R., Lu K., ... & You H. (2020). Workplace violence against healthcare professionals in China: A cross-sectional study. Journal of Nursing Management, 28(2): 246-254.
  21. Ministero della Salute (2007). Raccomandazione n. 8 per prevenire gli atti di violenza a danno degli operatori sanitari.
  22. Ministero della Salute (2024). Relazione attività anno 2024 dell’Osservatorio nazionale sulla sicurezza degli esercenti le professioni sanitarie e socio-sanitarie.
  23. Needham I., Abderhalden C., Halfens R. J., Fischer J. E., & Dassen T. (2005). The Impact of Patient Aggression on Carers Scale: Instrument derivation and psychometric testing. Journal of Psychiatric and Mental Health Nursing, 12(3): 285-291.
  24. O’Brien C. J., van Zundert A. A. J., &Barach P. R. (2024). The growing burden of workplace violence against healthcare workers: Trends in prevalence, risk factors, consequences, and prevention – a narrative review. eClinicalMedicine, 72, 102641.
  25. OccupationalSafety and Health Administration (OSHA) (2015). Guidelines for preventing workplace violence for healthcare and social service workers (OSHA 3148-06R). U.S. Department of Labor.
  26. Olagnero J. M., Silvestro A., & Deiana C. (2024). L’introduzione dell’infermiere di processo in pronto soccorso: Valutazione dell’impatto clinico. Assistenza Infermieristica e Ricerca, 43(4): 181-186.
  27. Ramacciati G., & D’Artizio F. (2016). Violence towards healthcare workers: A review of the literature. Journal of Nursing Management, 24(7): 834-842.
  28. Richmond J. S., Berlin J. S., Fishkind A. B., Holloman Jr G. H., Lattimore P., & Stuppy D. J. (2012). Verbal de-escalation of the agitatedpatient: Consensus statement of the American Association for Emergency Psychiatry Project BETA De-escalation Workgroup. Western Journal of Emergency Medicine, 13(1): 17-25.
  29. Roche M., Diers D., Duffield C., & Catling-Paull C. (2010). Violence toward nurses, the work environment, and patient outcomes. Journal of Nursing Scholarship, 42(1): 13-22.
  30. Spector P. E., Zhou Z. E., & Che X. X. (2014). Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: A quantitative review. International Journal of Nursing Studies, 51(1): 72-84.
  31. Vento S., Cainelli F., & Vallone A. (2020). Violence against healthcare workers: A worldwide phenomenon with serious consequences. Frontiers in Public Health, 8, 570459. DOI: 10.3389/fpubh.2020.570459.
  32. Xu S., Gu Y. F., & Dong A. H. (2023). Impact of an emergency department nursing intervention on continuity of care, self-care, and psychological symptoms. World Journal of Psychiatry, 13(12): 1046-1052. DOI: 10.5498/wjp.v13.i12.1046.