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Aim: To identify the nature, degree and contributing factors of workplace violence (WPV) incidents experienced by Australian nursing students during clinical placement. Design: Descriptive cross‐sectional study. Methods: Data were collected from 13 September to 25 November 2022. Eligible participants included all nursing students enrolled in nursing degrees at any Australian university who had completed at least one clinical placement. An adapted version of the WPV in the Health Sector Country Case Study survey was used. Results: A total of 381 nursing students across eight states of Australia completed the survey. More than half of the students had experienced an episode of WPV; patients were the most frequent perpetrators. Personal factors of patients, staff and students, organizational factors and cultural norms within the workplace supported acts of WPV. Conclusion: Student nurses (SNs) most often experience violence from patients during direct care. Patient encounters are the core component of clinical placement. Education providers have a responsibility to effectively prepare students to be able to identify escalating situations and manage potentially violent situations. Registered nurses who supervise students during clinical placement require support to balance their clinical role with student supervision. Implications for The Profession: Experiencing WPV can negatively impact relationships between students, healthcare professionals and care recipients. This results in personal distress, decreased job satisfaction and potentially the decision to leave the nursing profession. Impact: What already is known: SNs are exposed to WPV during clinical placement. What this paper adds: More than half the SNs in this study experienced violence inclusive of physical, verbal, racial and sexual harassment. Patients were the predominant perpetrators. Implications for practice/policy: Interventions at individual and systemic levels are required to mitigate WPV. Reporting Method: This study is reported using the STROBE guidelines. [ABSTRACT FROM AUTHOR]

Introduction: Workplace violence is endemic, destructive, and escalating in frequency and severity in healthcare. There is a paucity of research on workplace violence in regional and remote hospital emergency departments (EDs). Objective: The aim of this study was to identify the perpetrator and situational characteristics associated with violent incidents in the ED across five regional and remote Australian sites. Method: This study audited hospital summary data, incident reports, and medical records for a 12-month period in 2018 to examine the perpetrator and situational characteristics of workplace violence incidents in five regional and remote Australian EDs. Results: Violent incidents were evenly spread throughout the week and across shifts. Most incidents were triaged as urgent, occurred within the first 4 hr, and had multidisciplinary involvement. Almost one in every six incidents resulted in an injury. Perpetrators of violence were predominantly young and middle-aged males and almost always patients, with most presenting with mental and behavioral disorders, or psychoactive substance use. Conclusions: Understanding the characteristics of perpetrators of violence can help in seeking to tailor interventions to reduce further violent behaviors. These findings carry implications for optimizing patient care, staff safety and resource management. [ABSTRACT FROM AUTHOR]

Offensive behaviour towards school employees is widespread and involves a number of potentially harmful acts. There is evidence that school employees' experiences of offensive behaviour are shaped by demographic, role and school-based factors that mediate the likelihood of victimisation. However, very few studies have investigated the prevalence and correlates of offensive behaviour against school leaders. This study analysed 13,028 survey responses from the Australia Principal Occupational Health, Safety and Wellbeing survey that were completed between the years 2011 and 2019. The analysis determined the prevalence of bullying, threats of violence and physical violence against government school leaders, the main perpetrators of these offenses and the moderating effects of key socio-demographic factors. Results from the study demonstrated that considerable proportions of Australian government school leaders were subjected to offensive behaviour with an average (pooled) prevalence of 36.2% for bullying, 48.6% for threats of violence and 38.7% for physical violence. School leaders report that students and parents are responsible for most offensive behaviours, but that colleagues also contribute considerably to incidents of bullying. Our findings illustrate that offensive behaviours against Australian school leaders are very high and that particular groups of school leaders are at elevated risk of victimization, especially female school leaders and to a lesser extent assistant principals and those inner or outer regional areas. [ABSTRACT FROM AUTHOR]

Aims: The aims of the study were to determine the types and prevalence of forensic mental health nurse exposure to patient aggression and explore the impact of these exposures on their physical and mental health and work absences. Design: Cross-sectional survey conducted January to April 2020. Methods: All 205 nurses working in an Australian high-security inpatient forensic mental health hospital were invited to participate. An online survey included the Perception of Prevalence of Aggression Scale to measure respondent exposure to types of patient aggression, and the SF-36v2 to measure mental and physical health. Absence from work and other work and individual characteristics were also explored. Results: Sixty-eight respondents completed the survey. Verbal abuse was the most experienced aggression type, followed by physical violence and observing violence, patient self-harming behaviours and sexual violence. Nurses who worked in acute units experienced significantly more exposure to overall aggression than nurses in non-acute units. Higher level of aggression was associated with number of days sick leave taken and days off due to aggression or violence. Higher level of aggression was associated with poorer mental health, and patient self-harming behaviour was associated with poorer physical health. Conclusions: Nurses in acute units experience higher levels of inpatient aggression and are therefore at increased risk of being impacted by the exposure. Findings indicate a psychological impact of exposure to frequent aggression and potential for an accumulative effect of exposure to traumatic events on nurse well-being. Nurses who are victim of, or witness, physical violence are most likely to take time off work. Impact: This study provides further evidence that forensic mental health nurses are frequently exposed to various forms of patient aggression. For some nurses, this exposure to patient aggression negatively impacted their mental and physical health. Employing organizations should therefore prioritize provision of formal support for nurses. No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study is to identify and map what is known about workplace violence involving midwives in Australia and New Zealand. Background: Research from the United Kingdom demonstrates that workplace violence within maternity services is a pervasive issue with significant and wide‐ranging clinical, individual and organisational consequences. To date, little is known about this issue within Australian and New Zealand maternity services. Evaluation: A scoping review, guided by Arksey and O′Malley's framework, was conducted. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews checklist. Just one identified study aimed to explore midwives' experiences of workplace violence. A further nine arrived at related results or themes. Key issues: Workplace violence is present in a variety of forms across maternity services in Australia and New Zealand. Its prevalence is, however, yet to be understood. Workplace violence causes physical and mental health issues for midwives, premature workforce attrition, and jeopardizes the quality and safety of maternity care. Conclusions: Workplace violence has been acknowledged as one of the key contributing factors towards premature attrition from the midwifery profession, with new graduate midwives most likely to leave. With the midwifery workforce ageing and evidence of serious clinical implications emerging, workplace violence needs urgent research and organisational attention. Implications for nursing management: Workplace violence is a key contributing factor towards recruitment and retention challenges for managers. To help tackle this, managers have a key role to play in identifying and effectively addressing workplace violence by acting as positive role models, taking a zero‐tolerance approach and fostering collegial relationships. Managers, holding key clinical leadership positions, are pivotal to ensuring all complaints raised are handled with transparency and consistency regardless of one's position within the clinical hierarchy and organisational structure. [ABSTRACT FROM AUTHOR]

Aims: This study ascertained nurses' perceptions about workplace violence management, strategies and support services. Background: Nurses regularly encounter verbal and physical violence in their workplace. Workplace violence has long‐term consequences on nurses' personal lives and professional work ability. However, more needs to be known about nurses' perceptions of violence management and interventions used. Methods: Ninety‐eight nurses from a regional public hospital in Queensland, Australia, completed a survey about workplace violence. Nurses worked in the Emergency Department, Intensive Care Unit or Mental Health Department. Results: Ninety‐five per cent of nurses stated that all violence should be reported, but 18% would take no action, and 22% would not complete an incident from. Perceptions and preferred responses differed for verbal and physical violence. Low‐level interventions and aggression management training were preferred by nurses. Nearly all nurses felt that they should be involved in the development of workplace violence policies. Conclusions: Nurses rate aggression management training highly, and they desire more input into violence policies. The under‐reporting of violent incidents remains an issue for future management. Implications for nursing management: Understanding nurses' perceptions of workplace violence management enables the identification of gaps when applying policy and adopting practical approaches to reduce the incidence and severity of workplace violence. [ABSTRACT FROM AUTHOR]

Background: Workplace violence is a regular feature of emergency departments (ED) and reported to be increasing in frequency and severity. There is a paucity of data from regional EDs in Australia. The aim of this study was to identify the perpetrator and situational characteristics associated with security alerts in regional emergency departments.Methods: This retrospective descriptive study was conducted in two regional Australian hospital EDs. All incident reports, hospital summary spreadsheets, and patient medical records associated with a security alert over a two-year period (2017 - 2019) were included. The situational and perpetrator characteristics associated with security alerts in the ED were recorded.Results: One hundred fifty-one incidents were reported in the two-year period. Incidents most frequently occurred on late shifts and in an ED cubicle. Most incidents included multiple disciplines such as ED staff and paramedics, police and psychiatric services. One hundred twenty-five incidents had sufficient information to categorise the perpetrators. Mental and behavioural disorders (MBD) were the most frequent perpetrator characteristic present in security alerts (n = 102, 81.6%) and were associated with increased severity of incidents. MBDs other than psychoactive substance use (PSU) were associated with 59.2% (n = 74) of incidents and 66.7% (n = 18) of injuries. PSU was associated with 42.4% (n = 53) of incidents. Following PSU and MBDs other than PSU, repeat perpetrators were the next most prominent perpetrator category (24.8% n = 31) and were almost always associated with an MBD (93.5% n = 29).Conclusions: Violence incidents in the ED are often complex, patients present with multiple issues and are managed across disciplines. Interventions need to extend from one size fits all approaches to targeting specific perpetrator groups. Since MBDs are one of the most significant perpetrator factors, interventions focussing on this characteristic are needed to address workplace violence in EDs. [ABSTRACT FROM AUTHOR]

Violence against social workers and other social service practitioners is prevalent across countries and service delivery settings, often accepted as implicit in working with vulnerable clients. A corresponding scholarly focus on workplace violence, and the factors that affect it, is, however, still developing. This is particularly stark in the domestic and family violence (DFV) and sexual assault (SA) sectors. To address this gap, this article explores the extent and impact of practitioners' exposure to workplace violence, and the mix of work and organisational factors that predict it. Analysis of survey data from Australian DFV and SA practitioners (N  = 903) enables a focus on the two main sources of workplace violence: violence from clients and violence from colleagues. Both types of violence were found to be prevalent, gendered and associated with emotional strain and intention to leave. We argue that in DFV and SA sectors, which respond to multiple forms of gendered violence, understanding the multifaceted nature of workplace violence, and the structural arrangements that underpin it, is necessary for planning strategies to prevent and address it. [ABSTRACT FROM AUTHOR]

Introduction: Female practitioners are often subjected to inappropriate patient sexual behaviour (IPSB). Adverse consequences of such sexual harassment include for the practitioner psychological stress effects and negative work-related consequences that contributes to career dissatisfaction and burnout. Confronting the issue within the healthcare context has been shown to be problematic because practitioners feel an obligation to protect the therapeutic relationship above their own personal discomfort. There is an absence of research on this topic with respect to female chiropractors and we proposed a qualitative study aimed to explore female chiropractors lived experiences of managing incidents of IPSB. Method: An Interpretive Phenomenological Analysis methodology was chosen for this study. In June and July of 2018 female chiropractors in Western Australian were recruited via Facebook sites and invited to participate in face-to-face interviews for an Honours degree study exploring the lived experience of IPSB. Results: Participants were seven female chiropractors currently practicing in Western Australia, who had experienced an incident of IPSB. Four super-ordinate themes emerged from the analysis; (1) familiar but inarticulable, (2) the cost of conflict, (3) I'm used to it, and (4) the element of surprise. Overall, the participants recognised the incidents as inappropriate but chose to ignore the situation as a means to avoid conflict in the treatment room. Recommendations are made to better manage IPSB including greater patient awareness of appropriate behaviour, specific curriculum content and assertiveness training in undergraduate programs and continuing professional education, as well as the creation of ethical guidelines for patient behaviour by regulatory bodies. Conclusion: This is the first study to give a forum for female chiropractors to discuss their experiences of IPSB. The domain of private practice is not immune to incidents IPSB and although similar to day-to-day non-clinical life is nonetheless surprising and impactful. [ABSTRACT FROM AUTHOR]

Aim and objectives: To evaluate and examine the utility of the Violence Prevention Climate scale by generalist healthcare professionals. Background: Workplace violence in general hospital settings remains a challenge for healthcare organisations. High rates of violence are still being reported towards healthcare workers, despite organisational violence prevention strategies being implemented. There is a major challenge to healthcare organisation in the measurement of the effectiveness of these interventions, traditionally completed via the reporting and monitoring of workplace violent incidents. A novel approach to measuring workplace violence is by studying hospital atmosphere or climate. Design: A cross‐sectional survey using the STARD guidelines was used. Methods: The Violence Prevention Climate scale was completed by 194 healthcare staff working in the emergency department, medical/surgical wards, respiratory/infectious disease, spinal care, renal unit, corrections health, and rehabilitation and community services of a major Australian tertiary referral hospital. The Violence Prevention Climate scale has previously been validated and used in mental health settings, but not general hospital settings. A content analysis of an open‐ended question on violence prevention management strategies was also conducted. Results: Comprising of 14 items with two factors (patients and staff), the study revealed a 9‐item staff factor scale that can be used in the general hospital setting, the patient factor did not show adequate reliability. The content analysis revealed seven categories of staff identified violence prevention and management strategies. Conclusions: The use of the 9‐item scale across an organisation annually, or added to existing organisational workforce surveys, could prove to be practical way of measuring the social climate of violence in a general hospital setting. Relevance to clinical practice: The results of which could guide clinical practice, workplace safety, policy and educational initiatives for the prevention and management of workplace violence. [ABSTRACT FROM AUTHOR]

Background: Workplace violence (WPV) remains an international problem. This raises challenges for staff in meeting their duty of care to consumers while enforcing zero tolerance for violence directed toward them. Purpose: The aim of the study was to expose the values and beliefs underpinning practice and reveal any flawed assumptions or evidence, upon which decisions related to WPV are made. By increasing staff awareness, the secondary aim is to decrease staff stress when confronted with conflicting policies and duty of care responsibilities. Methodology: Explanatory research as part of a larger descriptive study was used. Semistructured interviews with a sample of managers and staff (n = 99) in Victorian Health Services (Australia) were performed. Initial descriptive analysis identified a tension between duty of care, worker safety, and zero tolerance. This article reports the secondary analysis to examine these relationships in depth. Findings: Feeling obligated and providing care for aggressive patients was difficult while maintaining own safety: "You cannot do both." Although there were contrasting views about the merits of zero tolerance, policies were rarely enacted: "We cannot refuse to treat." In congruency between legislative requirements creates confusion for decision-making: "Which Act trumps what?" Conclusion: Despite policies supporting zero tolerance, staff do not enact these because they prioritize duty of care to consumers before duty of care to self. Zero tolerance, with incongruent legislation, compounds this tension and impairs decision-making. [ABSTRACT FROM AUTHOR]

Objectives: Despite a policy of zero tolerance towards workplace violence (WPV) in Australian public hospital EDs, the incidence of WPV continues to increase. The aim of this study was to characterise security responses to WPV within an adult level 4 ED. Methods: A retrospective single‐centre review of episodes of WPV perpetrated by adults occurring within the ED was conducted between 1 January 2013 and 31 December 2015. Cases were identified using a prospectively recorded security register that records all events of security personnel attendance. The presence of police officers on initial presentation was the primary exposure variable. Results: There were 1853 violent episodes committed by 1224 patients requiring security intervention during the study period, with half the episodes (n = 916; 49%) involving perpetrators who had committed at least two or more violent acts during the study period. Most cases (n = 1057, 57%; 95% CI: 55–59) occurred in the absence of police presence. Only 144 (7.8%) cases were managed by the presence of security personnel without physical security interventions. Conclusions: EDs should not rely on police response to prevent or handle violence. The finding of a high proportion of events being perpetrated by repeat offenders indicate that data sharing between EDs for identification of perpetrators of WPV can be useful for prevention of future episodes. ACEM policy for WPV in EDs should encompass further details on security credentialing and preventive strategies towards minimisation of WPV in the Australian EDs. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Workplace violence (WPV) is an increasingly concerning occupational hazard within the ED. The aim of the present study was to evaluate the incidence and characteristics of WPV in an adult ED. Methods: A retrospective cohort study was conducted to identify the incidence of ED WPV in an adult metropolitan ED. Data were obtained from the activity records of security staff from 1 January 2013 to 31 December 2015 for all incidents of patient‐perpetrated violence. Data on patients identified from these records as requiring security staff intervention for violence in the ED were collected through an explicit chart review. Data on patient illicit drug or alcohol exposure and acute psychiatric diagnoses were also collected. Results: There were 1853 episodes of patient‐perpetrated WPV identified over the study period. The incidence of WPV over the 3 years was 103 (95% CI: 98–108) per 10 000 of the presenting population, with a significant increase from 2013 to 2015 (IRR 1.07; 95% CI: 1.04–1.10; P < 0.01). Drug and/or alcohol exposure was observed in 1145 (61.8%) patients. Among the drug‐ and/or alcohol‐affected violent population, three quarters (840/1145 = 73.4%) did not have a concurrent psychiatric diagnosis that required assessment during the violent presentation. Conclusion: The rate of WPV was increasing within this Australian ED during the study period. The majority of violent patients were affected by drugs and/or alcohol in the absence of a psychiatric diagnosis. Interventions to reduce access to and misuse of alcohol and illicit drugs could have a substantial impact on the concerning increase of violence in the ED. [ABSTRACT FROM AUTHOR]

Summary Introduction Over the last 10 years, the rate of people presenting with challenging behaviour to emergency departments (EDs) has increased and is recognised as a frequent occurrence facing clinicians today. Challenging behaviour often includes verbal aggression, physical aggression, intimidation and destruction of property. Aim The aim of this research was to (i) identify the characteristics and patterns of ED-reported incidents of challenging behaviour and (ii) explore emergency nurses’ perceptions of caring for patients displaying challenging behaviour. Methods This was a multi-method study conducted across two metropolitan Sydney district hospitals. Phase 1 involved a 12-month review of the hospital's incident management database. Phase 2 involved a survey of emergency nurses’ perceptions of caring for patients displaying challenging behaviour. Results Over 12 months there were 34 incidents of aggression documented and the perpetrators were often male ( n = 18; 53.0%). The average age was 34.5 years. The majority of reported incidents ( n = 33; 90.1%) involved intimidation, verbal assault and threatening behaviour. The median time between patient arrival and incident was 109.5 min (IQR 192 min). The median length of stay for patients was 302.5 min (IQR 479 min). There was no statistical difference between day of arrival and time of actual incident ( t -test p = 0.235), length of stay ( t -test p = 0.963) or ED arrival to incident time ( t -test p = 0.337). The survey ( n = 53; 66.2%) identified the average ED experience was 12.2 years (SD 9.8 years). All participants surveyed had experienced verbal abuse and/or physical abuse. Participants ( n = 52) ranked being spat at ( n = 37; 71.1%) the most difficult to manage. Qualitative survey open-ended comments were analysed and organised thematically. Thematic analysis The survey identified three themes which were (i) increasing security, (ii) open access and (iii) rostering imbalance. Conclusion The study provides insight into emergency nurses’ reported perceptions of patients who display challenging behaviour. All emergency nurse participants reported being regularly exposed to challenging behaviour and this involved both physical and verbal abuse. This was in contrast to a low incident hospital reporting rate. ED clinicians need to be better supported with targeted educational programmes, appropriate ED architecture and reporting mechanism that are not onerous. [ABSTRACT FROM AUTHOR]

Aim(s): To ascertain nurses' perceptions about, and suggestions for, management solutions to workplace violence perpetrated by patients., Background: Violence towards nurses from patients in the workplace is high in Australia. There is a need for good management responses, and experienced nurses can provide logistical suggestions about effective strategies., Method(s): This study uses an exploratory qualitative design. Focus group interviews were undertaken with 23 nurses working in a regional public hospital in Queensland, Australia. The COREQ research reporting checklist was followed, and the qualitative data were transcribed and thematically analysed manually and by NVivo., Results: Policy implementation, training, staff movement, seclusion, debriefing and a full reporting cycle were identified as central themes. Workplace violence management happens before, during and after a violent event., Conclusion(s): Weak processes undermine management; staff training on de-escalation is needed. Affected staff need freedom to move from the ward. Better medical orders should be in place before an event. A full debriefing and feedback cycle are required, along with easier reporting processes., Implications for Nursing Management: Nursing management can reduce violence by ensuring better institutional support, consistent follow-up and complete feedback procedures. Legal support, follow-up mechanisms and staff training in de-escalation are key points., (© 2021 John Wiley & Sons Ltd.)

Providing care to methamphetamine-related callout events in the prehospital environment is often complex and resource-intensive, requiring staff to manage agitation and violence-related side effects of methamphetamines. In Australia, emergency responders are increasingly required to attend events related to methamphetamines, even though reports suggest methamphetamine use across Australia has declined. The aim of the study was to explore Australian police and paramedic experiences attending methamphetamine-related events. A qualitative descriptive phenomenology design was employed using semi-structured interviews with employed police (10) and paramedics (8) from Australia. Data were analyzed using thematic analysis. Participants described the complexities associated with providing prehospital care to people affected by methamphetamines. Participants described associated domestic/family violence, increased levels of violence, challenges with communication, and responder emotional and psychological distress and physical injury. Violence associated with methamphetamine use is a critical factor in prehospital care. Workplace violence and family/domestic violence are important issues that require further research to ensure families and staff are well supported and have the services they need to continue responding to people affected by methamphetamine use., (© 2022 The Authors. Nursing & Health Sciences published by John Wiley & Sons Australia, Ltd.)

The Bureau of Labor Statistics estimates that there are 2.53 million cooks and chefs in the United States. Of those, one in four reports experiencing physical violence in the workplace-roughly 632,500 victims. While shocking, this figure fails to account for the psychological and sexual violence that also plagues commercial kitchens. Workplace harassment and bullying is not limited to the United States and has been documented in Scottish, English, Scandinavian, French, Malaysian, Korean, and Australian kitchens. Why is violence so prevalent in kitchens, and how has it become a behavioral norm? Using data from 50 in-depth interviews with kitchen workers and analysis of food media, this article shows that while kitchen workplace violence can be attributed to typical causes, such as occupational stress, there is an overlooked source: the normalization of violence through food media. By exploring television shows, like "Hell's Kitchen," and chef memoirs, like Bourdain's Kitchen Confidential, readers will see how bullying and harassment are romanticized in these mediums, glorified as a product of kitchen subculture, and consequently normalized in the kitchen.

The article reports on a study that examines incidence of workplace violence in the remote area nursing workforce in Australia. A total of 349 nurses working in remote regions across the country were the subject of the study. Findings of the study revealed that verbal aggression, physical violence, and property damage are the most frequently experience forms of violence encountered by nurses working in remote areas.

Workplace violence is common in health-related occupations that involve substantial contact with clients, such as nursing, general practice, pre-hospital care and emergency medicine. Research has also been conducted that explores violence in social work; however, the majority has emerged from the UK and USA, and is limited due to definitional shortcomings and the scope of violence. In Australia, there is a paucity of research that has explored the prevalence of violence in social work. Thus, the aim of the research was to determine the prevalence of six forms of workplace violence, and determine factors that may predict the occurrence of violence towards social workers. A questionnaire was developed that focused on social workers' experiences of six forms of violence (verbal abuse, property damage/theft, intimidation, physical abuse, sexual harassment and sexual assault). The questionnaire was randomly distributed to 1,000 social workers across Australia. Participation was voluntary and social workers completed the questionnaire anonymously. Analyses revealed that the majority of social workers (67 per cent) had experienced at least one form of violence in the past twelve months. The most common form of violence was verbal abuse followed by intimidation, and sexual assault was the least common form of violence experienced. Factors that predicted violence emerged for all six forms of violence examined. Based on the results of this research, it can be concluded that workplace violence is common in social work, particularly verbal abuse and intimidation. Factors that predict violence can be used to develop interventions aimed at preventing and managing workplace violence. [ABSTRACT FROM PUBLISHER]

This paper reports findings from the first, qualitative stage of a national sequential, mixed method study of bullying in the Australian nursing workplace. Twenty-six nurses who had experience of workplace bullying were recruited from two Australian public sector health care organizations. Examining the narrative data from the viewpoint of bullying being a corrupt activity we present an alternative perspective on group acts of bullying. By exploring bullying as corrupt behaviour, this paper challenges the assumption that bullying can be principally considered a series of isolated events stemming from interpersonal conflict, organizational pressures, or poor work design. Corruption in organizations has not previously been linked with or compared to bullying. In revealing the manner in which actors can engage in corrupt conduct that includes bullying, the findings from our study offer important implications for the management of workplace bullying as a serious and corrupt activity. [ABSTRACT FROM AUTHOR]

Introduction: Workplace violence carries a substantial economic loss burden. Up to 10% of all traumatic brain injury (TBI) admissions result from physical assault. There remains a paucity of research on assault as a mechanism of injury, taking into account sex, and its association with work re-entry., Objectives: The aim of this study was to characterise, by sex, the sample of workers who had sustained a work-related mild TBI (wr-mTBI) and to assess the independent influence of assault, as a mechanism of injury, on time away from work., Methods: A population-based retrospective cohort of workers' compensation claimants in Australia (n=3129) who had sustained a wr-mTBI was used for this study. A multivariable logistic regression analysis assessed whether workers who had sustained wr-mTBI as a result of assault (wr-mTBI-assault) were more likely to claim time off work compared with workers who had sustained a wr-mTBI due to other mechanisms., Results: Among claimants who sustained a wr-mTBI, 9% were as a result of assault. The distribution of demographic and vocational variables differed between the wr-mTBI-assault, and not due to assault, both in the full sample, and separately for men and women. After controlling for potential confounding factors, workers who sustained wr-mTBI-assault, compared with other mechanisms, were more likely to take days off work (OR 2.14, 95% CI 1.53 to 2.99) within a 3-month timeframe., Conclusion: The results have policy-related implications. Sex-specific and workplace-specific prevention strategies need to be considered and provisions to support return-to-work and well-being within this vulnerable cohort should be examined., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers., Methods: The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data., Results: The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client's homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress., Conclusions: Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the needs among all staff., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)