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

J Psychiatr Ment Health Nurs. 2026 May 22. doi: 10.1111/jpm.70152. Online ahead of print.

ABSTRACT

INTRODUCTION: Forensic 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.

METHOD: Qualitative 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.

RESULTS: Incident 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.

PMID:42171501 | DOI:10.1111/jpm.70152