Multi-Site Intervention to Reduce Violence in Hospital Emergency Departments.

摘要

In 2006, the Bureau of Labor reported that 60% of workplace assaults occurred in healthcare, and most of the assaults were committed by patients. Healthcare support occupations had an injury rate of 20.4 per 10,000 workers due to assaults, and healthcare practitioners had a rate of 6.1per 10,000; this compares to the general sector rate of only 2.1 per 10,000. As significant as these numbers are the actual number of incidents is much higher due to the gross underreporting in healthcare that is related to the perception that assaults are part of the job. Recent evidence indicates that nurses and other direct care providers who work in emergency departments (EDs) are at greater risk of violence than other providers. Although there are numerous epidemiological studies that have emphasized that ED violence is a prevalent and serious problem, there are no published accounts of interventions to reduce this alarming trend. The purpose of this intervention study is to partner with six hospitals to test a multi-dimensional intervention to prevent assaults against ED workers and reduce the related negative consequences. Primary study aims are to test the effectiveness of an intervention to: (1) reduce assaults against ED workers from patients and visitors, (2) decrease acute stress disorder symptoms, absences, and loss of productivity after assaults and physical threats, and (3) increase employees' feelings of safety and self-confidence in managing aggressive patients and visitors. Secondary study aims are to: (1) develop and implement processes and procedures for ensuring the intervention is planned with stakeholder input and involvement, and (2) develop and implement processes that increase the capacity of the EDs to sustain the intervention.