{
  "abstract": "Importance: Workplace violence is common in high-risk health care settings, with consequences for clinician well-being and care delivery. Less is known about multilevel work-system factors associated with workplace violence in emergency department (ED) nurses.\n\nObjective: To characterize workplace violence among ED nurses and identify multilevel work-system factors associated with workplace violence.\n\nDesign, Setting, and Participants: This cross-sectional study used nurse survey data combined with administrative and electronic medical record data collected in 2023 from nurses working in 11 EDs in a multisite health system in the southeastern US.\n\nExposure: Multilevel work-system factors, with primary exposures of interest including overtime, shift type, and ED type (freestanding vs in-hospital); additional covariates included individual, team, and ED-level characteristics.\n\nMain Outcomes and Measures: Any self-reported workplace violence in the prior month (threats, physical violence, verbal abuse, unwanted sexual attention, or bullying) from patients, visitors, and/or coworkers. Associations were estimated using mixed-effects logistic regression with a random intercept for emergency department site and factor selection using cross-validated least absolute shrinkage and selectrion operator regression. Nurses in the supplemental staffing team were excluded from this analysis.\n\nResults: Among 337 ED nurses (mean [SD] age, 34.9 [9.5] years; 289 [85.8%] female; 287 [85.2% white; mean [SD] nursing experience, 9.0 [8.2] years), 296 (87.8%) reported workplace violence in the prior month. Incidents of WPV involved patients or visitors (292 of 296 [98.6%]) and coworkers (60 of 296 [20.3%]). In adjusted mixed-effects models (n = 299), overtime was associated with higher odds of workplace violence (OR, 3.21; 95% CI, 1.30-7.93), while night shift (OR, 0.28; 95% CI, 0.10-0.78) and employment in a freestanding ED (OR, 0.25; 95% CI, 0.09-0.76) were associated with lower odds.\n\nConclusions and Relevance: In this cross-sectional study of ED nurses, workplace violence was common and was associated with overtime and ED context. These findings support further evaluation of work-hour practices and context-specific approaches to workplace violence prevention.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Implementation Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina",
    "Department of Emergency Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina",
    "Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina",
    "Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston-Salem, North Carolina",
    "Center for Advanced Practice, Atrium Health, Charlotte, North Carolina",
    "School of Nursing, University of North Carolina, Chapel Hill",
    "Public Safety, Advocate Health, Charlotte, North Carolina"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Lindsay Thompson Munn"
    },
    {
      "affs": [
        2
      ],
      "name": "Nathaniel Sean O’Connell"
    },
    {
      "affs": [
        0,
        3
      ],
      "name": "Carolyn S. Huffman"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Esita Patel"
    },
    {
      "affs": [
        0
      ],
      "name": "Kristie L. Foley"
    },
    {
      "affs": [
        5
      ],
      "name": "Cheryl B. Jones"
    },
    {
      "affs": [
        0,
        1,
        6
      ],
      "name": "Jason P. Stopyra"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ddy485mbgdw0h.bib",
  "cited_by": 1,
  "doi": "10.1001/jamanetworkopen.2026.44016",
  "fulltext_url": null,
  "id": "ddy485mbgdw0h",
  "issns": [
    "2574-3805"
  ],
  "landing_url": "https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2856635",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-13",
  "publisher": "American Medical Association (AMA)",
  "ris": "https://research.draconitic.com/paper/ddy485mbgdw0h.ris",
  "sources": [
    {
      "first_seen": "2026-11-14T00:21:02Z",
      "native_id": "10.1001/jamanetworkopen.2026.44016",
      "source": "crossref",
      "url": "https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2856635"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2574-3805",
      "subfield": "general"
    }
  ],
  "title": "Work Hours, Emergency Department Context, and Workplace Violence Among Nurses",
  "title_text": "Work Hours, Emergency Department Context, and Workplace Violence Among Nurses",
  "type": "peer-reviewed",
  "updated_at": "2026-11-15T00:21:29Z",
  "url": "https://research.draconitic.com/paper/ddy485mbgdw0h",
  "venue": "JAMA Network Open",
  "versions": []
}