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J Nurs Manag. 2013 Apr;21(3):491-8. doi: 10.1111/j.1365-2834.2012.01416.x. Epub 2012 Jul 10.

Impact of hospital security programmes and workplace aggression on nurse perceptions of safety.

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School of Community and Environmental Health College of Health Sciences, Old Dominion University, Norfolk, VA 23529, USA.



To assess how nurses' perception of their safety and risk of violence was affected by their work environment and whether this perception correlated with their actual risk.


The work environment has an impact on nurses' perception of their risk of violence and this perception affects worker productivity, quality, employee retention, worker satisfaction and their actual safety.


A cross-sectional survey was conducted in person of 314 emergency department nurses and 143 psychiatric nurses, and assault data was collected from injury logs.


This study found that nurses in the emergency and psychiatric units differed in their perception of violence and safety. The workplace elements that led to a perception of lower risk of violence were not correlated with a lower rate of injury from violent acts. The nurses' beliefs about the adequacy of security equipment, security guards and the frequency of verbal abuse were strongly correlated with perceived safety.


Several factors that influence nurses' perception of their risk of violence are not well correlated with their actual risk.


Managers must address workplace elements that affect nurse perceptions because this has an impact on quality and employee retention. They must also address factors that have an impact on the actual risk of violence because this study showed, for the first time, that these may differ from perceptions.

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