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Prospective study of violence against ED workers.

Authors
Kowalenko-T; Gates-D; Gillespie-GL; Succop-P; Mentzel-TK
Source
Am J Emerg Med 2013 Jan; 31(1):197-205
NIOSHTIC No.
20045212
Abstract
Background: Health care support occupations have an assault-injury rate nearly 10 times the general sector. Emergency departments (EDs) are at greatest risk of such events. Objective: The objective was to describe the incidence of violence in ED health care workers (HCWs) over 9 months. Specific aims were to (1) identify demographic, occupational, and perpetrator factors related to violent events (VEs) and (2) identify predictors of acute stress in victims and predictors of loss of productivity. Methods: A longitudinal, repeated-methods design was used to collect monthly survey data from ED HCWs at 6 hospitals. Surveys assessed number and type of VEs, and feelings of safety and confidence. Victims also completed specific VE surveys. Descriptive statistics and a repeated-measure linear regression model were used. Results: Two hundred thirteen ED HCWs completed 1795 monthly surveys and 827 VEs were reported. Average VE rate per person per 9 months was 4.15. Six hundred one eventswere physical threats (PTs) (3.01 per person). Two hundred twenty six events were assaults (1.13 per person). Five hundred one VE surveys were completed, describing 341 PTs and 160 assaults. Men perpetrated 63% of PTs and 52% of assaults. Significant differences in VEs were reported between registered nurses (RNs) and medical doctors (MDs) (P = .0017) and patient care assistants (P < .05). The RNs felt less safe than the MDs (P = .0041). The MDs felt more confident than the RNs in dealing with violent patients (P = .013). The RNs were more likely to experience acute stress than the MDs (P < .001). Acute stress reduced productivity (P < .001). Conclusion: Emergency department HCWs are frequent victims of violence perpetrated by visitors and patients. This results in injuries, acute stress, and lost productivity. Acute stress has negative consequences on workers' ability to perform their duties.
Keywords
Violence-prevention; Force; Health-care-facilities; Health-care; Medical-facilities; Health-care-personnel; Statistical-analysis; Epidemiology; Emergency-care; Stress; Physical-stress; Psychological-stress; Demographic-characteristics; Injuries; Medical-personnel; Nurses; Physicians
Contact
Terry Kowalenko MD, University of Michigan, Ann Arbor, MI 48109
CODEN
AJEMEN
Publication Date
20130101
Document Type
Journal Article
Email Address
terryk@med.umich.edu
Funding Type
Grant
Fiscal Year
2013
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-009544
Issue of Publication
1
ISSN
0735-6757
Source Name
The American Journal of Emergency Medicine
State
OH
Performing Organization
University of Cincinnati
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