Barriers to Reporting Workplace Violence Among Emergency Nursing Staff: A Systematic Review and Meta-Analysis.

BACKGROUND

Workplace violence (WPV) is highly prevalent in emergency departments and frequently remains unreported, compromising nurse safety and institutional accountability.

PURPOSE: The purpose of this study was to identify barriers to emergency departments nurses reporting WPV incidents and the frequency of unreported WPV incidents.

METHODS

A systematic review and meta-analysis was conducted, with 4 databases searched through April 2025. Cross-sectional and cohort studies examining reporting behaviors among emergency nurses were included. Random-effects models were applied to estimate pooled prevalence and odds ratios.

RESULTS

Ten studies comprising 5812 emergency nurses met inclusion criteria. The pooled prevalence of unreported WPV was 64% (95% CI: 0.57-0.72). Verbal violence was significantly more likely to remain unreported than physical violence (OR 2.51, 95% CI: 1.40-4.49, P =.0019). Major barriers included perceptions of reporting futility, peer pressure, inadequate institutional support, and absence of clear reporting procedures.

CONCLUSION

Underreporting of WPV among emergency nurses is substantial and driven by systemic and perceptual barriers, warranting structured institutional reforms to promote safer reporting environments.