The magnitude and consequences of work-related violence: the Minnesota Nurses Study.
Gerberich-S; McGovern-P; Church-T; Hansen-H; Nachreiner-N; Geisser-M
AHSRHP Annual Meeting, June 23-25, 2002, Washington, DC. Washington, DC: Academy for Health Services Research and Health Policy, 2002 Jun; :2
Research Objective: Identify the incidence and outcomes of work related violence among nurses. Study Design: In this retrospective cohort study, work-related violence was defined as the intentional use of physical force or emotional abuse that resulted in physical or non-physical violence (including, threat, sexual harassment and verbal abuse). A mailed survey addressed work history, demographics, violence, and factors associated with violence, e.g., environmental and event characteristics, health and work consequences. Logistic regression analyses were conducted to estimate odds ratios for potential risk factors and confounders; re-weighting adjusted for unknown eligibility and non-response Population Studied: 57,388 Registered Nurses (RNs) and 21,740 Licensed Practical Nurses (LPNs) licensed in Minnesota as of October 1, 1998; a random sample of 6,300 nurses working in Minnesota was selected. Principal Findings: The estimated response rate was 78%. The average nurse was female, and 46 years old. The adjusted physical assault rate per 100 person years was 16 for LPNs and 12 for RNs. Regression results revealed the odds ratios for a physical assault decreased with age (0.985/year) and increased for: men (1.5); work at a long term care (2.4) or rehabilitation facility (1.8) compared with an inpatient hospital; assignment to an emergency (2.1) or psychiatric department (1.9) compared with medical/surgical; and care of geriatric patients (2.0) compared with adults. Injuries included bruises/contusions (34%), temporary discolorations/slap marks (22%) and lacerations/scratches (18%). Emotional outcomes included frustration (47%), anger (33%), and fear/stress (26%); 8% reported persistent problems. Over 5% of nurses reported work restrictions and 2% quit or transferred voluntarily. The non-physical violence rate (including threat, harassment and verbal abuse) per 100 persons per year was 39.7 for LPNs and 38.5 for RNs. Regression results revealed the odds ratios for non-physical violence decreased with age (0.98/year) and increased for: work at a rehabilitation (3.5) or long term care facility (1.4) compared with inpatient hospital; assignment to a psychiatric (3.4), emergency (2.7) or intensive care (1.4) department compared with medical/surgical; and care of geriatric patients (1.2) compared with adults. Emotional outcomes included frustration (61%), anger (60%), and fear/ stress (40%), irritability (27%), sadness (21%) and fatigue (20%); 13% of nurses reported persistent problems. Work restrictions resulted for nearly 9% of the nurses and 9% quit or transferred voluntarily. Conclusions: The incidence of non-physical violence (including threat, harassment and verbal abuse) was nearly three times greater than physical violence. Common risk factors were environmental (e.g., primary work in a long term care or rehabilitation facility; assignment to an emergency or psychiatric department; caring for geriatric patients). Emotional sequelae were important repercussions for physical and non-physical violence, and surprisingly, more common for non-physical violence. Implications for Policy, Delivery or Practice: Voluntary guidelines to prevent work-related violence among health workers have been available through the Occupational Safety and Health Administration since 1996; yet, these nurses reported significant violence. Given the nursing shortage, health care administrators would benefit by working collaboratively with nursing staff, occupational health and safety professionals, and supervisors to identify high-risk environments and associated prevention and control measures to enhance working conditions.
Occupational-hazards; Injuries; Injury-prevention; Nurses; Nursing; Health-care-personnel; Humans; Epidemiology; Statistical-analysis
Patricia McGovern, Ph.D., M.P.H., Associate Professor, Division of Environmental and Occupational Health, University of Minnesota School of Public Health, Mayo Bldg, MMC 807, 420 Delaware St. SE, Minneapolis, MN 55455
Conference/Symposia Proceedings; Abstract
Disease and Injury: Traumatic Injuries
Academy for Health Services Research and Health Policy Annual Meeting, June 23-25, 2002, Washington, DC
University of Minnesota, School of Public Health, Division of Environmental and Occupational Health, Minneapolis, Minnesota