title: The impact of patient aggression on community pharmacists: a critical incident study.
abstract: BACKGROUND
  The impact of patient aggression on healthcare staff has been an important research topic over the past decade. However, the majority of that research has focused primarily on hospital staff, with only a minority of studies examining staff in primary care settings such as pharmacies or doctors' surgeries. Moreover, whilst there is an indication that patient aggression can impact the quality of patient care, no research has been conducted to examine how the impact of aggression on staff could affect patient safety.
  
  
  OBJECTIVE
  The aim of the current study was to examine the impact of aggression on community pharmacists in Scotland. Three main aspects were examined: the cause of patient aggression, the impact of aggression on pharmacist job performance and pharmacist behaviours in response to aggression.
  
  
  METHODS
  A sample of 18 community pharmacists were interviewed using the critical incident technique. In total, 37 incidents involving aggressive patients were transcribed.
  
  
  RESULTS
  Aggression was considered by the majority of participants to be based on a lack of understanding about the role of a pharmacist. More worrying were the reports of near misses and dispensing errors occurring after an aggressive incident had taken place, indicating an adverse effect on patient safety. Pharmacists described using non-technical skills, including leadership, task management, situational awareness and decision-making, in response to aggressive behaviour.
  
  
  CONCLUSIONS
  Patient aggression may have a significant impact on patient safety. This could be addressed through training in non-technical skills but further research is required to clarify those skills in pharmacy staff.
authors.affiliation: Industrial Psychology Research Centre, School of Psychology, University of Aberdeen, Aberdeen AB24 2UB, Scotland, UK. a.irwin@abdn.ac.uk
authors.forename: Amy
authors.initials: A
authors.lastname: Irwin
authors.forename: Christianne
authors.initials: C
authors.lastname: Laing
authors.forename: Kathryn
authors.initials: K
authors.lastname: Mearns
mesh_terms: D000223:Adaptation, Psychological; D000374:Aggression / Q000523:psychology*; D003157:Community Pharmacy Services / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data; D061214:Patient Safety; D010361:Patients / Q000523:psychology*; D010595:Pharmacists / Q000523:psychology*; D012606:Scotland; D011795:Surveys and Questionnaires