Workplace violence as a predictor of missed nursing care in emergency departments: Findings from an analytical cross-sectional study.

BACKGROUND: Workplace violence is a common and significant issue in healthcare settings, particularly against emergency nurses, which compromises the quality of nursing care and can lead to the omission or delay of patient care tasks in the emergency department. Therefore, this study was conducted to examine the relationship between workplace violence and missed nursing care among emergency department nurses. METHODS: A cross-sectional correlational study was conducted with 221 nurses from emergency departments of Tabriz University of Medical Sciences, selected via stratified random sampling. Data were collected using a three-part questionnaire comprising demographic information, the MISSCARE questionnaire (Part A), and the Workplace Violence in the Health Sector questionnaire. Descriptive statistics, Pearson's correlation, and multiple regression were used to analyze the data. RESULTS: Among 221 emergency nurses, 76.0% experienced verbal violence, 32.1% experienced physical violence, and 24.9% reported threatening behaviors during the previous six months. The most frequently missed nursing care activities were patient and family education (67.9%), monitoring patients' emotional status (57.0%), and assisting with patient mobility (52.9%). Pearson correlation analysis demonstrated significant positive associations between verbal violence (r = 0.52, p < 0.001), physical violence (r = 0.38, p < 0.001), and total workplace violence (r = 0.61, p < 0.001) and missed nursing care. In the multivariable regression model, total workplace violence (B = 0.536, standardized β = 0.580, p < 0.001), work experience (B = 0.284, standardized β = 0.197, p = 0.031), and working time (B = 0.327, standardized β = 0.229, p = 0.004) were significant positive predictors of missed nursing care. The model explained 48% of the variance in missed nursing care (R² = 0.48). CONCLUSIONS: WPV is significantly associated with increased missed nursing care in emergency departments, with verbal and physical violence contributing to higher care omissions. Interventions to reduce WPV, such as violence prevention protocols and support systems, are essential to improve nursing care quality and patient safety.