Patient and visitor violence (PVV) is increasingly recognised as being widespread in General hospital setting, more so in medical wards. Recent International studies showed that it's a worldwide problem. There is little data available detailing prevalence of PVV in UK. The national NHS annual violence data only focuses on physical assaults on staff.

To measure PVV with parameters of verbal abuse, threats and physical assaults over a four week period.

The aim of the study is to identify the prevalence of PVV in high risk medical wards in North Wales

A cross sectional study was conducted with a validated tool (abbreviated SOVES) in six high PPV risk medical wards in three North Wales General District Hospitals.

Of the 158 staff responded 83% were subjected to verbal abuse in the preceding four weeks. 50% reported being threatened and 63% reported being physically assaulted. 56% of those assaulted sustained an injury with three needed medical assessment and/or treatment.

Nurses and Health care support Workers reported being subjected to all forms of PVV more than other staff groups. Direct patient contact correlated more to overall incidence of PVV. Our study could not find any correlation between amount of training received by staff in the management of aggression and the experience of PVV.

PVV is a significant problem in medical wards inspite of regular staff training programmes. Means to communicate risk should be considered by all staff working in high risk medical wards.