Adverse Events and Aggressions Against Healthcare Professionals in Hospitals, Wards and Emergency Departments

Abstract

specific legislative measures, national monitoring systems and institutional recommendations. This systematic narrative review aims to analyse adverse occupational events and aggressions against healthcare professionals in hospitals, clinical wards and emergency departments, with attention to prevalence, risk factors, consequences, reporting systems, Italian regulatory responses and prevention strategies.
A systematic narrative search was conducted using PubMed/MEDLINE, Google Scholar, institutional repositories, Italian Ministry of Health documents, INAIL reports, WHO/ILO guidance and legislation. Systematic reviews, meta-analyses, observational studies, institutional reports, legal documents and prevention guidelines were included. Due to heterogeneity in definitions, settings and outcome measures, a narrative synthesis was performed.
Results: The evidence shows that healthcare workers experience high exposure to workplace violence, particularly verbal aggression, threats and physical violence. International meta-analyses estimate that more than 60% of healthcare workers may experience at least one form of workplace violence, while physical violence affects approximately one in five professionals annually. Emergency departments are among the highest-risk settings, with high exposure to verbal abuse and frequent involvement of patients, relatives and caregivers. Key risk factors include overcrowding, long waiting times, communication failures, understaffing, emotional distress, psychiatric or cognitive impairment, substance abuse, poor environmental design, lack of security and weak reporting culture.
Conclusions: Aggression against healthcare professionals should be considered a preventable occupational adverse event and a threat to healthcare quality, workforce retention and patient safety. Effective prevention requires integrated strategies combining organizational redesign, staff training, risk assessment, incident reporting, environmental safety, security support, communication protocols, legal protection and post-event psychological support.