Effectiveness of organizational interventions vs usual care for reducing incidence and mitigating impact of workplace violence in registered nurses: a systematic review protocol

Review questions i) How effective are organizational interventions (e.g., strategies, protocols, or policies) compared to usual care or no intervention in reducing the incidence and severity of verbal and physical violence in the workplace against RNs? ii) How effective are post-incident support interventions (e.g., debriefing, counselling, or organizational response protocols) compared to usual support or no intervention in reducing psychological burden and promoting resilience in RNs affected by WPV? Inclusion criteria The inclusion criteria for this review were developed based on the PICO framework, which takes into account four key elements: population, intervention, comparator, and outcome. Population This review will include studies on RNs, regardless of demographics or healthcare setting (including both hospital and community settings). Only studies with clearly disaggregated data on RNs will be included. Interventions Eligible interventions include a variety of strategies, such as organizational measures (e.g., structured incident reporting systems, environmental risk assessments, early warning protocols). Training may involve in-person workshops, simulation-based activities, and de-escalation techniques. Technology-based approaches include e-learning platforms, mobile health applications, wearable alarms, real-time surveillance systems, and artificial intelligence tools for monitoring and triage. Comparators This review will consider studies comparing the intervention with passive comparators, such as no intervention or usual institutional practices, or with active comparators, including alternative strategies or variations of the same intervention. Where applicable, alternative interventions focused on WPV implemented as separate arms in comparative or multi-arm studies will also be considered. Comparator characteristics, such as mode of administration (passive or interactive), frequency, intensity, setting, and timing, will be described when available. Outcomes This review will consider studies that include the following outcomes: both primary and secondary outcomes related to the prevention and management of WPV against RNs. The primary outcome of interest will be the frequency of WPV. Secondary outcomes will include a range of individual and organizational indicators. First, the review will consider changes in nurses' knowledge, attitudes, and skills regarding the prevention and de-escalation of WPV. Second, it will examine indicators of personal well-being and safety, such as levels of psychological distress, perceptions of workplace safety, symptoms of burnout, or self-efficacy in managing violent incidents. Thirdly, organizational and occupational outcomes will be examined, such as absenteeism, job abandonment, and changes in employment patterns (e.g., shift to part-time work, departmental transfer), which may reflect broader institutional impact.