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Testing the Feasibility of a Smartphone Application for Collecting Data on Occupational Violence Exposure Among Nurses and Midwives

Duff, J.; Chataway, M.; Xu, G.; Fox, A.; Johnston, S.

2026-09-21 health systems and quality improvement
10.64898/2026.09.14.26363061 medRxiv
Show abstract

Background: Nurses are disproportionately affected by occupational violence, yet conventional incident reporting and retrospective surveys underestimate its extent and miss its context. Ecological momentary assessment (EMA) offers a way to capture violence in near-real time. Aim: To evaluate the feasibility of a smartphone EMA application for capturing the incidence, characteristics, and reporting of occupational violence among hospital nurses and midwives. Methods: In a prospective, single-site feasibility study at a large public hospital, nurses and midwives used a commercially available EMA application (MetricWire) to report occupational violence in two-hourly blocks across their shifts over a three-week period. Incidence, incident characteristics, reporting, and usability were analysed descriptively. Findings: Of 108 enrolled participants, 69 contributed 607 momentary assessments, recording 111 incidents. Violence was reported in 18.6% of assessments, and 62% of participants reported at least one incident. Most incidents were verbal (69%) and patient-perpetrated (86%); 59% involved witnessing violence against a colleague. Although 57% of incidents were reported to someone, only 6% reached the formal incident management system. Respondents (n = 16) found the application easy to use and acceptable. Conclusion: Smartphone-based EMA feasibly and acceptably captures contextually rich, near-real-time data on occupational violence, including the witnessed exposure and under-reporting that conventional systems miss.

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