Workplace Violence Prevention in Forensic Psychiatric Nursing: A Five-Year Qualitative Content Analysis of Incident Reports From a Finnish Forensic Psychiatric Hospital.

introductionForensic psychiatric nursing staff are exposed to workplace violence, which harms well-being and may undermine safe care. AIM/QUESTION: To identify preventive factors for workplace violence on forensic psychiatric wards as reported in incident reports by nursing staff and nurse managers.

methodQualitative inductive content analysis of workplace violence incident reports over 5 years at one Finnish forensic psychiatric hospital, focusing on prevention-oriented free-text fields. Categories were descriptively quantified as the number (%) of reports containing each category.

resultsIncident reports portrayed workplace violence prevention as a layered entity covering clinical stabilisation, staffing and work organisation, anticipatory routines, therapeutic interaction and de-escalation, environmental and technological safety measures, restrictions and external-risk control, and information flow, debriefing and organisational learning. DISCUSSION: Clinical, organisational and environmental factors were intertwined in prevention. Incident report narratives and measures may provide a qualitative source for examining prevention-related practices and follow-up actions in forensic psychiatric care. LIMITATIONS: Single-hospital data, possible underreporting and a nursing-only focus limit transferability. IMPLICATIONS FOR PRACTICE: Following recommendations emerging from incident reports, such as ensuring adequate staffing, providing training and maintaining safe work environments, may support workplace violence prevention. RECOMMENDATIONS: Forensic psychiatric inpatient services may benefit from strengthening layered prevention strategies and from using incident report narratives to inform local policy and practice. RELEVANCE STATEMENT: Workplace violence is a persistent occupational hazard in forensic psychiatric nursing, yet little is known about how prevention is described in workplace violence incident reports. This study analyses prevention-oriented incident report entries from a Finnish forensic psychiatric hospital to examine how nursing staff and nurse managers describe workplace violence prevention. Prevention was described as a layered entity involving clinical stabilisation, staffing and competence, anticipatory practices, therapeutic interaction, environmental and safety measures, restrictions and external-risk control, and post-incident information flow, debriefing and follow-up actions. These findings may inform use of incident reports and prevention planning in similar secure forensic inpatient settings.