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Authors: Jordan Van Godwin (Cardiff University), Megan Hamilton (Cardiff University), Graham Moore (Cardiff University), David O'Reilly (Cardiff and Vale Health Board), Simon Moore (Cardiff University)
Background: Hospital-based violence programmes (HVIPs) are an increasingly popular method to identify and support patients attending Emergency Departments (EDs) due to violence. However, research on HVIP implementation remains limited. The Violence Prevention Teams (VPTs) are novel nurse-led HVIPs situated in two emergency departments in Wales, UK. This abstract presents the factors influencing the implementation of the two VPTs.
Methods: Semi-structured interviews with professional stakeholders (N=49),and documentary analysis (N=46) were conducted. Qualitative data was analysed thematically using NVivo 12.
Results: Barriers and facilitators for implementation were identified across both sites. Barriers included: the need to establish and maintain new patient referral pathways and information sharing processes with multi-agency partners; VPT and wider service operating hours; resource limitations across services including staff shortages, turnover, workload and burden; the short-term funding of VPTs and need to continually seek funding; the changing physical locations of VPTs and increased burden on ED staff through VPT practice (e.g. the referral process). Facilitators included: positive professional perceptions of the VPTs and violence prevention; the VPTs ability to identify patients; VPT staff experience and existing professional relationships, skillset, personality and ability to work in an agile manner; adaptation of the delivery model by VPT staff to improve support for patients and staff; continued engagement and awareness raising with hospital staff; the physical visibility and presence of the VPT staff in the EDs.
Discussion: Factors that supported and constrained the implementation of the novel nurse-led VPTs were identified. VPTs need time to raise awareness of their service and establish multi-agency patient pathways and professional relationships. VPT staff experience, skillset and existing professional networks were key. Similarly, the ability of VPT staff to develop and adapt the service for their local context including, patient and staff need, were vital for implementation. Findings can support ongoing and future HVIP implementation.
| Conflict of interest | The authors declare no conflicts of interest. |
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