Page 161 - HA Convention 2015

Parallel Sessions

PS1.1 System and Practices on Prevention/Management of Workplace 09:00 Theatre 2
Violence

Identification of Workplace Violence Risk Factors and Management Practices in Healthcare Settings Tuesday, 19 May
Gerberich SG
Division of Environmental Health Sciences, School of Public Health, University of Minnesota, USA

Introduction

Work-related violence in healthcare settings and surrounding environment is recognised as a major problem, globally.
Hospital and healthcare workers are at high risk for violence, particularly nonfatal violence. Violence against nurses,
specifically, is a major occupational health problem. Such violence includes physical assault, threats, harassment, verbal
abuse, and bullying. Consequences of workplace violence affect not only the victim but, also, may affect employers and
result in damage to the healthcare organisations’ resources or capabilities. Few analytical studies have been conducted,
whereby comparisons of exposures have been made between victims and non-victims of violence — studies that enable
identification of risk or protective factors and, in turn, serve as a basis for prevention.

Objectives

The purpose of this presentation is to identify risk and protective factors for work-related violence within the healthcare
industry, based on specific analytic efforts, including one focused on a cohort of registered and licensed practical nurses
that examined the relation between physical assault and various exposures: (1) personal exposures; (2) environmental
situations/exposures in the work environment; and (3) characteristics of others in the environment (other workers, patients,
visitors).

Methodology

There is great variation in definitions and methodologies utilised in the few analytic efforts conducted to date, thus, limiting
comparisons. Among the studies, one included a random selection of 6,300 nurses, licensed in one state in the United
States, to identify work-related violence experience in the past year. Subsequently, using a case-control design, data were
collected on work-related exposures for relevant one-month periods from cases (n=475) and randomly selected controls
(n=1,425). This enabled comparison of exposures between each group to identify specific risk factors to be used as a basis
for prevention and control efforts. Logistic regression was used to model the dependence of physical assault on each
exposure of interest and associated confounders; adjustments were included for unknown eligibility and non-response.

Results and Outcomes

Among studies conducted, increased risks were identified for working in: long term care facilities; emergency and
psychiatric/behavioural departments; environments with illumination less than “bright as daylight”; and working evening,
night, and rotating day and evening shifts. Decreased risks were identified for: working with young populations, carrying
cell phones/personal portable alarms, and working in home/public heath agencies, outpatient facilities and clinics/health
provider offices. Comprehensive prevention programmes embraced by employers and personnel include rigorous attention
to relevant: policies; reporting/recordkeeping; training; counseling; assault deterrents; and environmental interventions,
including security design and applications, that will optimise safety for all.

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