260778 Workplace violence in nursing homes: Association to employee well-being and resident safety

Wednesday, October 31, 2012

Judith Arnetz, PhD, MPH , Department of Family Medicine & Public Health Sciences, Division of Occupational & Environmental Health; Dept. of Public Health and Caring Sciences, Uppsala Sweden, Wayne State University, Detroit, MI
Peter Lichtenberg, PhD , Institute of Gerontology, Wayne State University, Detroit, MI
Mark Luborsky, PhD , Institute of Gerontology; Dept. of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Sweden, Wayne State University, Detroit, MI
Bengt Arnetz, MD, PhD, MPH, MscEp , Dept.. Family Med. & Public Health Sci., Div. Occup. & Env. Health / Dept. of Public Health & Caring Sci., Uppsala Univ.Sweden, Wayne State University, Detroit, MI
Yoasif Rofa, MD, MPH , Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI
Background and Objectives: Nursing home employees are at increased risk for violence and aggression, especially from nursing home residents. However, no studies have considered the implications of violence for the nursing home safety culture. This study examined the association between workplace violence and employee perceptions of nursing home resident safety.

Methods: Questionnaires among employees at 4 nursing homes (N=312) assessed work-related exhaustion, mental energy, work stress, work climate, violence exposure, intention to leave, and resident safety culture. T-tests were used to compare group differences for safety culture ratings between employees exposed to violence and those not exposed. Hierarchical linear regression was used to determine individual and organizational predictors of overall perceptions of resident safety.

Results: Approximately 22% of respondents had been victims of violence in the past year, with nurses' aides at increased risk (OR 4.14, CI 2.3-7.3) compared to other staff. Ratings for safety culture domains were significantly lower among staff victims of violence compared to non-victims. Predictors of overall resident safety were nursing home (= -0.33, p<.001, CI= -24.87- -11.81); working on a dementia unit (=0.12, p<.05, CI=.56 - 15.58) or skilled nursing unit (= 0.20, p<.01, CI=4.24 - 15.19); work stress (= -0.19, p<.01, CI=-.26 - -.05); work climate (=0.20, p<.01, CI=.06 - .26) and exposure to violence (= -0.15, p<.01, CI= -.11.5 - -1.97).

Conclusions: Workplace violence is a significant inverse predictor of nursing home resident safety. Reducing violence and stress in high-risk environments would likely improve employee working conditions as well as resident safety.

Learning Areas:
Occupational health and safety

Learning Objectives:
1. Identify significant work-related predictors of nursing home resident safety. 2. Formulate the association between workplace violence and employee perceptions of nursing home safety culture.

Keywords: Violence, Health Care Workers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principal investigator on this project on organizational climate and resident safety culture in nursing homes
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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