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Weapons screening programs (WSPs) in hospitals show no evidence of reducing workplace violence (WPV). Current literature does not support WSPs

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Area of Science:

  • Public Health
  • Healthcare Management
  • Criminology

Background:

  • Rising rates of hospital workplace violence (WPV) prompt healthcare organizations to implement weapons screening programs (WSPs), such as metal detectors.
  • Existing literature on WSPs' effectiveness in reducing hospital WPV requires critical analysis based on public health principles.

Purpose of the Study:

  • To identify, analyze, and report on the evidence supporting the ability of weapons screening programs (WSPs) to reduce hospital workplace violence (WPV).
  • To evaluate WSPs' efficacy in lowering absolute rates of hospital WPV according to established public health principles.

Main Methods:

  • A comprehensive literature search was conducted across six databases from July 2023 to December 2024 for original research on WSPs at US hospital public entrances.
  • Study quality and robustness were rigorously assessed using the Mixed Methods Appraisal Tool and the 2010 Melnyk and Fineout-Overholt hierarchy of evidence.

Main Results:

  • Twenty-nine nonexperimental studies, predominantly quantitative descriptive, were included, all from academic institutions with moderate quality scores.
  • Only two studies directly measured WPV rates before and after WSP implementation, with neither showing a statistically significant reduction.
  • Conclusions on WSP efficacy in reducing armed WPV were often based on flawed assumptions, conflating weapons presence with assault prevalence and weapons removal with violence reduction.

Conclusions:

  • No direct evidence supports the claim that weapons screening programs (WSPs) effectively reduce absolute rates of hospital workplace violence (WPV).
  • WSPs do not address the majority of non-armed hospital violence and may divert resources from clinical factors driving WPV.
  • While armed WPV is a serious concern, its low baseline prevalence means WSPs are unlikely to significantly impact overall hospital violence rates.