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The source of these physical assaults against nurses have been found to be predominantly patients, accounting for 64%, with a further 30% being carried out by the family or friends of patients and the remaining 11% is lateral violence from nurses, physicians or staff (Spector et al. The proportions experiencing violence in geriatric wards (45.9%), emergency departments (49.5%), and psychiatric departments are substantially higher than those in a general sample of nurses (23.4%) (Spector et al. Globally, nurses working in some departments face much higher levels of violence than those in others. One quarter of assaults are reported in acute wards and 69% in those for mental health problems and learning disability. Nurses are four times more likely to experience assaults than any other NHS worker, with student nurses and those in psychiatric and learning disability areas at highest risk (Wells and Bowers 2002).

According to NHS Protect figures, a total of 70,555 physical assaults on NHS staff were reported in the year 2015–2016 resulting in 1740 criminal sanctions this represents an increase in total assaults of 4% from 67,864 in the year 2014–2015 and an increase of 17% from a total of 60,385 in the year 2004–2005 (NHS Protect 2017a). Such assaults against NHS staff have increased. In a 2010 survey, between 5 and 8% of frontline National Health Service (NHS) staff reported being physically assaulted by patients or other service users in the previous 12 months (Ipsos MORI 2010). An international review found that a third of nurses have been assaulted and injured (Spector et al. Violence against healthcare staff is a major problem. In relation to findings relating to any given intervention, EMMIE refers to effects produced, mechanisms activated to produce the effects, moderators or contexts relevant to the activation of mechanisms, implementation issues that arise, and economic costs and benefits. Given this complexity and diversity, prior to field trials EMMIE orientated efficacy trials are recommended to try to establish whether alarms can be introduced and operated in ways that can contribute to reducing assaults in specific high-risk settings. Alarm systems form one of a range of measures, which may interact with one another, that are used to reduce the risks of assault. Healthcare workers in emergency departments, psychiatric units and geriatric facilities face much higher risks of assault than those in other healthcare settings.

Four reported associations of personal alarms (and other variables) with risks of assault in healthcare settings. No studies were found that met all inclusion criteria.

Secondary outcomes included increased confidence or self-efficacy in violence prevention (recorded or self-reported). The primary outcome was physical assaults (recorded or self-reported).

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Full text reports for all potentially relevant studies were obtained and independently assessed for final inclusion. Search results were screened by title, abstracts and keywords for possible inclusion. fall alarms for the elderly, domestic violence prevention) were excluded. Workplace violence between colleagues (lateral violence and bullying) and other uses of personal alarms (e.g.

including staff working in confined spaces such as hospitals and also field personnel such as community health workers). Searches were undertaken for studies of healthcare staff in all settings (i.e.

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Study designs eligible for inclusion were randomised controlled trials, interrupted time series and controlled before-after studies that assessed the impact of personal security alarms on assaults.

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MethodsĮlectronic databases, including Cochrane Library, Ovid MEDLINE(R) CINAHL Plus (EBSCO) PubMed PsycINFO (OvidSP) PsycEXTRA Applied Social Sciences Index and Abstracts (ProQuest) (1987 to current) Criminal Justice Abstracts (EBSCOhost) Psychology and Behavioural Science Collection (EBSCOhost) Social Policy and Practice (OvidSP) Sociological Abstracts ProQuest theses and dissertations, were searched. This systematic review focused on the effect of alarms in reducing the incidence and/or severity of assaults. Personal security alarms have been used to try to reduce violence against healthcare staff, some of whose members face relatively high risks of assault.