“I’d say the first three years on the trauma and orthopaedic ward I was subject to multiple times a week aggression and violence. I was punched on that ward and threatened with scissors…Then for the next four years in ED I would easily say daily aggression/violence… I became almost numb to it…”

– Anonymous Victorian Nurse

Unfortunately for healthcare workers, violent, aggressive, abusive, or threatening behaviour from patients or their loved ones has become an expected part of the job.

In an effort to address the escalating issue of OVA in healthcare settings, ISCRR conducted an Environmental Scan to identify effective interventions, risk controls, and frameworks that have been implemented and evaluated in acute health services to prevent and manage OVA. The ultimate goal was to find the most effective ways to prevent and manage OVA incidents, both within hospitals and during home-based care.

Employing a mixed-methods approach, the investigation included a rapid systematic review that focused on research published since 2020, and interviews conducted with key healthcare staff. Sixteen staff members from eleven different health services in Victoria were interviewed or engaged in focus groups.

A significant portion of the literature explored interventions that showcased positive outcomes for healthcare staff. However, the healthcare staff interviewed emphasised the complexities of OVA prevention and management, and although they are trialling numerous strategies, there is limited evidence available to confirm the success of their efforts.

Effective OVA committees credited their success to the unwavering support of management and leadership who championed the cause. This top-down approach has initiated a cultural shift within the organisations aiming to address the underlying issues related to OVA. Interestingly, regardless of location and size, healthcare services encountered similar challenges throughout their OVA prevention and management journey.

All health services identified de-escalation as a critical component of OVA prevention and management.

“We would really benefit from de-escalation training in relation to somebody’s condition rather than how do I get people’s hands off me sort of restraint type of education.”

– Health Service #5

With the hope of implementing evidence-based interventions and fostering a culture of prevention, these findings mark a significant step forward in the ongoing battle against OVA in acute health services.


1. Grant, S. L., Hartanto, S., Sivasubramaniam, D., & Heritage, K. (2022). Occupational violence and aggression in urgent and critical care in rural health service settings: A systematic review of mixed studies. Health & Social Care in the Community, 30(6), e3696. https://doi.org/10.1111/hsc.14039


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