Workplace violence against healthcare workers: a scoping review of reporting practices, barriers to reporting and institutional responses (2020–2025)

Violence against healthcare workers (HCWs) is a widespread global problem that has gained increasing attention due to its substantial impact on HCWs well-being and the quality of care they provide. This scoping review aimed to identify current reporting practices, institutional and organisational barriers to reporting violent incidents against HCWs, and critical research gaps in this area, integrating global evidence with a specific focus on Portugal. Following the methodological framework of Arksey and O’Malley (2005), refined by Levac et al. (2010), and reported per PRISMA-ScR (2018) guidelines, a comprehensive search was conducted in PubMed, Scopus, and Web of Science (January 2020–June 2025). Studies in English, Portuguese, or Spanish addressing reporting practices, barriers to reporting, digital platforms, or policies regarding WPV against HCWs were included. Two reviewers independently screened and extracted data using a structured matrix, resolving discrepancies by consensus. Results were summarized narratively with frequency analysis. From the initial 232 records, 35 studies met inclusion criteria, from 19 geographic areas across 5 continents. Most studies originated from Asia and Europe. Verbal violence was the most frequently reported form (20–91%), and over half reported underreporting rates exceeding 50%. The most frequently reported individual barrier was the belief that reporting is ineffective (60%), while the most cited systemic barrier was ineffective reporting systems (63%). National digital platforms reporting included the WVIRS system (California), the Synergic system (Sweden), the White Code system (Turkey), and the NOTIFICA, SAGRIS and HER+ systems (Portugal). Effective strategies to reporting combined staff training with awareness campaigns, supported by leadership engagement and policy frameworks. The COVID-19 pandemic intensified workplace tensions and may have influenced both the occurrence and reporting of violent incidents. Underreporting of workplace violence persists despite the existence of policies and reporting platforms. This review highlights persistent barriers to reporting workplace violence among HCWs and emphasizes the need for user-friendly and supportive reporting systems. Findings call for institutional accountability, better feedback mechanisms, and targeted policies to foster a culture of safety and transparency, both globally and in Portugal.