Critical Care Aggression and Violence Events (CAVE) Against Nurses in the ICU: Epidemiology and Risk Factors for Recurrence
Authors' conclusion
Violence in the ICU is frequent and almost always caused by patients. Recurring violence was independently associated with longer ICU stay, initial aggression, and verbal violence. Staff harm was rare, but incidents were frequently associated with complications in patients.
Study context
- Population
- Nurses in a tertiary medical-surgical ICU (up to 35 beds), University Hospital Basel, 2023–20242,190 shifts
- Outcome
- Incidence and characteristics of aggression and violence against ICU nurses
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Aggressive or violent incidents
- Incidents reported during 2190 shifts
- 308
- Shifts with an incident
- 14%
- Occurred during late shifts
- 37%
- Occurred during night shifts
- 34%
- Involved violence
- 75%
- Violence physical
- 79%
- Violence verbal
- 43%
- Violence sexual
- 3%
- Caused by patients
- 97%
- Patients male
- 71%
- Patients median age
- 67
- Patients emergency admissions
- 90%
- Psychiatric comorbidities, drug and alcohol abuse
- 20-33%
Observational data: associations, not effects.
Secondary outcomes
Recurrent aggression/violence (episodes ≥24 h apart)
- Recurrence
- 27%
- Longer ICU stay, aOR per additional hour
- 1.05
- Aggression as first incident, aOR
- 6.9
- Verbal violence as first incident, aOR
- 4.3
- Multivariable analysis
Safety
Harm to staff and complications in patients
- Nurses documenting harm
- 1.3%
- Incidents with patient complications (mainly oversedation, physical harm from restraints)
- 60%
Original publication
Critical Care Aggression and Violence Events (CAVE) Against Nurses in the ICU: Epidemiology and Risk Factors for Recurrence. Crit Care Med. Published 24 July 2026. doi:10.
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