Violence Against Healthcare Workers: Key Characteristics of the Phenomenon in the Marche Region in 2025

Abstract

Introduction

Workplace violence (WPV) in healthcare settings is a growing social and structural problem. However, the lack of adequate methods for active monitoring and surveillance, based on systematic incident reporting, makes it difficult to quantify the extent of the problem and assess the effectiveness of measures aimed at preventing it.

Aim

The aim of this study was to estimate the risk of violent incidents against healthcare workers in health care services in the Marche Region and evaluate its association with professional and socio-demographic variables.

Methods

In this cross-sectional study, we used questionnaires from personnel of Regional Health System involved in the program monitoring violent incidents in the healthcare setting as required by Ministry of Health and collected by Regional Centre for Health Risk Management and Patient Safety of the Marche region in 2025. The survey form for incidents of violence was developed by the National Observatory on the Safety of Healthcare and Social-Health Professions (ONSEPS). Workers’ demographic and professional characteristics as well as the types of incidents were summarized using absolute and percentage frequencies. The overall and by professional role (Physicians, Nurses, and non-clinical support staff) risk of violent incidents (per 1000 workers), with 95% CI, were estimated as the ratio between the number of workers reporting at least one WPV incidents and the total number of workers in service during 2025. The total number of employees in the Regional Health System in 2025 was derived from the Annual Staff Report of the Marche Region by the New Health Information System. The RRs, with 95% CI, were calculated for comparing the violent incidents across the professional role. All data were processed in compliance with the European (GDPR, EU 2016/679) and national privacy laws (D.lgs. 196/2003 and subsequent amendments).   

Results

In 2025, 397 healthcare workers reported violence, of whom 69.5% were women, 31.0% aged 50-59 years, and 71.8% nurses. Violence was more frequently verbal (71.0%), more frequently involved patient-on staff violence (66.9%) and occurred more frequently in the Emergency Department (25.1%).

The WPV overall risk was 17.9 ‰ (95% CI 16.2 - 19.7), 11.9 ‰ (95% CI 8.2 - 15.5) for doctors and 30.3 ‰ (95% CI 26.8 - 33.8) for nurses. Nurses had 2.6 times higher risk of experiencing violence than doctors (RR = 2.6, 95% CI 2.5 - 2.7) and more than four times higher than non-clinical support staff (RR = 4.1, 95% CI 4.0 - 4.3), while doctors were 60% more likely to experience violence than non-clinical support staff (RR = 1.6, 95% CI 1.6 - 1.7).

Conclusion

Our findings are consistent with the latest ONSEPS report, based on data collected in 2022–23. According to that data, the Marche Region has the lowest risk rates compared to those recorded in the northern and central regions but has not yet implemented specific systems for identifying or recording cases. It is necessary to continue implementing prevention and management strategies aimed at countering the belief among workers that such accidents constitute an inevitable “occupational hazard”.