The phenomenon of assaults on health personnel

Assaults against doctors, nurses and health and social workers are a growing problem in Italian hospitals, particularly in emergency rooms. According to the Report of the National Observatory on the Safety of Health Personnel (published on 12 March 2025), in 2024 there were more than 18,000 incidents of violence against health workers throughout the country with a total of approximately 22,000 workers involved in reported assaults (each assault may also involve more than one worker).

The data collected by the Regional Centres for the Health Risk Management, on voluntary reporting by professionals in public and accredited private facilities, confirm that for the 2023, 2/3 of all assaults were reported by women (beyond the 60%). The most affected are nurses, doctors and OSSs and the most risky places are hospitals, emergency rooms and outpatient clinics. In 70% it is about verbal assaults and the 67% of the attackers are users/patients.

This problem does not only concern Italy, but is spread internationally. Recent surveys indicate that in 2024, assaults on health personnel increased by 32% in Europe and the 39% in the world compared to the previous year. Countries such as the United States (+40%) and the United Kingdom (+35%) show significant increases. Moreover, in Europe, a European Day of Awareness against violence against healthcare workers (celebrated on 12 March in Italy) was established in 2020, recognising that many states, e.g. Spain and Belgium, were experiencing a worrying increase in assaults similar to the Italian case.

The causes of this phenomenon are complex. Observers point out that at the root are often patients' tensions and frustrations due to organisational problems: overcrowded emergency rooms, long waiting lists, chronic staff shortages and weakened territorial healthcare. These critical issues in the healthcare system, exacerbated during and after the pandemic, have raised the stress level of users and operators. As the CEOM (European Council of Associations of Physicians), many citizens unload the tensions generated by inefficiencies in the service on health care workers, and today's higher expectations lead to conflicts especially in emergency-urgency. However, there are anti-aggression systems that can limit these unpleasant situations.

Institutional Initiatives

Violence towards health personnel is now recognised as a real national emergency. In addition to anti-aggression systems, the central initiatives of Italian institutions, including the Law 14 August 2020, n. 113, designed to protect those working in the health and social care sector. This regulation, in addition to the National Day against Violence against Health Workers, introduced:

the National Observatory on the Safety of Health Professionals (ONSEPS)

• Established in 2022 at the Ministry of Health (Art. 2 of the law)
• Composed of representatives of institutions, professional orders, trade unions, AGENAS, INAIL, etc.
• Purpose: to monitor incidents of violence, propose preventive measures and submit an annual report to Parliament

the tightening of penalties

• Amendment of the criminal code with the introduction of a specific aggravating circumstance
• New offence of injury against medical personnel in the exercise of their duties
• Ex officio prosecution for injuries and beatings: the victim's complaint is no longer required
• Aim: to make the criminal response faster and more severe

the protocol with the police

• Article 7 of the law requires healthcare facilities to include measures agreed with the police in their security plans
• Local protocols signed between health authorities, prefectures and police headquarters

In parallel, Regions e healthcare companies have implemented further measures: regional observatories, guidelines and technical tables. In addition, institutions also promote prevention and training activities in this regard. These interventions aim to reduce triggers and prepare personnel to handle critical situations, increasing risk awareness without increasing fear.

Anti-aggression systems: TWIG devices

In response to an increasingly critical issue in healthcare settings, the anti-aggression systems are essential tools for the protection of personnel. They are generally small electronic devices equipped with an SOS button and motion sensors, capable of sending help requests via the mobile phone network or other channels by communicating the position of the worker in danger.

These include TWIG Neo, a compact and robust wearable device designed for the safety of healthcare personnel. The device allows manual alarms, via the SOS button, but also sends automatic alerts via the fall and immobility sensors.

The main features include:

• SOS alarmmanually activated, also in silent mode, with calls and SMS to predefined numbers
• Man down“ alert”Automatic activation in the event of a fall, impact or immobility, even if the operator cannot intervene
• Two-way voice communicationhands-free active for talking
• GPS localisationPosition tracking via GPS, Wi-Fi and BLE beacons, even in areas without cellular coverage
• Advanced connectivity: supports GSM/4G, Wi-Fi, BLE and SRD radio
• IP67 certified ruggedness, resistance to shocks and harsh conditions
• Autonomy of several days: notifications in case of low battery or malfunctions
• Compact and customisable designwearable with clip, lanyard, strap or badge holder
• Integration with IrTrack software: Irbema provides, in combination with TWIG devices, software that allows monitoring of alarms sent by devices on a map

There are various scalable solutions of TWIG anti-aggression systems:

• La most immediate solution consists of the use of personal devices such as TWIG Neo, wearable in various ways (around the neck, belt or pocket) and capable of sending manual or automatic alarms in the event of an emergency. The alarm activates a two-way audio channel with a central unit, enabling environmental listening and rapid response, even with activation of external devices such as sirens or flashing lights.

• A higher level includes integration with a localisation software platform, IrTrack, which allows the location of the operator to be pinpointed during the alarm, even inside buildings via Wi-Fi or beacons. This solution respects the GDPRposition is only transmitted in the event of a real emergency.

• La third option introduces advanced wearable devices such as the TWIG Eon D, similar to an analogue watch, but equipped with anti-aggression technology, fall detection, GNSS geolocation, display messaging and silent mode. It is also ideal in isolated and high-risk environments.

All these solutions can be integrated with existing systems, such as automated gates, video surveillance, sirens, notifications on DECT/IP phones or smartphones, creating a complete and customisable ecosystem for personnel protection.

Want to know more about anti-aggression systems?

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