Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R01-OH-007953, 2009 Nov; :1-48
Workplace violence, including workplace intimate partner violence, has major long-term health and employment outcomes and affects nursing personnel in significant numbers. By affecting productivity, absenteeism and job satisfaction workplace violence also may significantly affect nursing personnel retention and therefore the nursing shortage. The overall purpose of this investigation was to identify individual, environmental and organizational risk and protective factors for negative health and employment outcomes from all forms of workplace violence, including intimate partner workplace violence, among nursing personnel. The study population was derived from a large medical institution, consisting of three hospitals, an inner city medical center, Johns Hopkins Hospital, a metropolitan Baltimore community hospital, Johns Hopkins Bayview, and a suburban medical center, Howard County General Hospital. The three hospitals, known as the Johns Hopkins Medical Institutions (JHMI), employ approximately 4164 nursing personnel. A confidential online survey of workplace violence was used to obtain responses from 2166 (52% response rate) nurses (76%) and nursing personnel (24%) from one large urban, one medium sized community and one small suburban hospital. Cases who experienced WPV in the past year (N = 652) were prospectively followed and compared with a random sample of controls who had never experienced workplace violence (N = 1038). Participants completed follow-up questionnaires at 3 consecutive 6-month intervals; of the 1690 participants selected for follow-up, 1355 (80%) completed the Round 2 questionnaire, 1267 (75%) completed Round 3, and 1179 (70%) completed Round 4. Prevalence and descriptions of the episodes of workplace violence were obtained, including type (physical, sexual, emotional, harassment, stalking, witnessed violence), injury, reporting, organizational response, and any interventions received. Case and control groups were compared in terms of health (injury, physical and mental health symptoms and medical records), and employment outcomes (productivity, job satisfaction, burnout, lost work time, intent to stay in employment, and return to work), controlling for lifetime trauma and prior health and employment status. Multivariate logistic regression was utilized to determine the risk factors for physical and psychological WPV. Those experiencing intimate partner violence (IPV) at the workplace (including stalking) were also compared with other workplace violence survivors, survivors of IPV outside of the workplace, and those who have never experienced either IPV or workplace violence. At baseline, 30.3% of the participants reported experiencing physical (19.8%) and/or psychological (20%) WPV in the past 12 months. Approximately 10% of those physically assaulted were injured. At the first follow-up period the response rate was 81.3% (n=1378). 37% of follow-up participants reported experiencing physical (23.9%) and/or psychological (24.5%) violence in the approximately 6 months between baseline and follow-up surveys. Of those who reported experiencing WPV at follow-up, 21.8% had not reported experiencing WPV at Baseline. Nurses and nursing personnel working in the emergency department were found to be at greatest risk for experiencing WPV compared to those working in other hospital sites. Additional risk factors included male gender, younger age, and experiences of childhood abuse or intimate partner violence.
Jacquelyn Campbell, PhD, RN, FAAN, Johns Hopkins University School of Nursing, 525 N. Wolfe Street/Room 436, Baltimore, MD 21205