Physical Security Measures and Their Impact on Healthcare Worker Perceived Safety and Clinical Performance: A Systematic Review

Abstract

Background: Healthcare facilities are environments that demand both clinical excellence and high levels of safety. Physical security measures—including surveillance systems, access control, security personnel, panic buttons, and controlled entry points—play a critical role in protecting healthcare workers (HCWs) from violence, theft, and unauthorized access. Despite their importance, the relationship between physical security systems and healthcare workers perceived safety and clinical performance remains underexplored. Objective: This systematic review aims to evaluate the impact of physical security measures on healthcare workers’ perceived safety, psychological well-being, and overall clinical performance across different healthcare settings. Methods: A comprehensive search of databases including PubMed, Scopus, CINAHL, and Web of Science was conducted for studies published between 2010 and 2025. Keywords used included “physical security,” “healthcare safety,” “hospital security,” “workplace violence prevention,” and “clinical performance.” Studies were included if they assessed the presence of physical security interventions (e.g., surveillance cameras, badge access, on-site security) and measured their outcomes on healthcare staff’s perceptions of safety, job satisfaction, or performance. Data were synthesized narratively and categorized thematically. Results: A total of 34 studies met the inclusion criteria. The majority reported that visible and accessible security infrastructure significantly increased perceived safety and reduced anxiety among HCWs, particularly in emergency departments and psychiatric units. Security cameras and restricted access policies were found to deter potential aggression, while rapid response systems and security personnel presence improved staff confidence and response to violent incidents. However, some studies highlighted concerns about over-surveillance, which may negatively affect trust and perceived autonomy. Additionally, the presence of robust security protocols was associated with improved clinical focus and reduced absenteeism. Conclusion: Physical security measures substantially enhance healthcare workers’ perception of safety and can indirectly improve clinical performance by reducing stress and workplace violence. Optimal outcomes are achieved when these measures are integrated into broader institutional safety cultures, supported by staff training and transparent policies. Future research should focus on quantifying long-term impacts and balancing security with ethical considerations related to privacy and trust.