Online Program

Evaluation of an intervention to reduce hospital worker injury from patient violence

Monday, November 2, 2015

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
Lydia Hamblin, BA, Department of Family Medicine and Public Health Sciences; Department of Psychology - Industrial/Organizational, Wayne State University, Detroit, MI
Joel Ager, PhD, School of Medicine, Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI
Mark Upfal, MD, MPH, Occupational Health Services, Detroit Medical Center, Detroit, MI
Mark Luborsky, PhD, Institute of Gerontology; Dept. of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Sweden, Wayne State University, Detroit, MI
Jim Russell, Occupational Health Services, Detroit Medical Center, Detroit, MI
Lynnette Essenmacher, MPH, Occupational Health Services, Detroit Medical Center, Detroit, MI
Background and Objectives:Hospital employees are at increased risk of injury from violence compared to workers in other industries. Violence towards hospital workers is most often perpetrated by patients. The objective of this study was to evaluate an intervention aimed at reducing violence-related injury by prospectively tracking population-based incidence rates of patient-to-worker (Type II) violence and resultant injury.

 Methods: The study was conducted within a multi-site hospital system with a system-wide electronic database for reporting workplace violence events and related injuries. 42 hospital units identified as being at high risk for violence were stratified by type of care and randomized into intervention (n=21) and control (n=21) groups. The intervention, a worksite visit, was conducted on the intervention units in 2013. Unit supervisors were presented with workplace violence data for their unit compared to corresponding data for the entire hospital system. Based on the data presented, units developed an “Action Plan” for reducing violence. Weighted mixed models were used to compare groups over time based on incidence rates of violence and rates of violence-related and other occupational injury.

Results: Nine months post-intervention, the rate of reported Type II violence in the intervention group decreased from 8.16 per 100 fulltime equivalents (FTEs) to 7.66/100 FTEs, but increased in the control group from 8.05 to 12.45 (p <0.05).  There was no significant change in injury rates over time in either group.

Conclusions: This randomized controlled intervention was associated with reduced patient-to-worker violence, but did not appear to impact rates of hospital worker injury.

Learning Areas:

Occupational health and safety

Learning Objectives:
Discuss the importance of designing workplace violence interventions that are unit-based and data-driven. Explain why workplace interventions may impact violence incidence rates but not necessarily injury rates.

Keyword(s): Violence & Injury Prevention, Occupational Health and Safety

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been involved with data management and data analysis for over 20 years and am currently the Senior Data Analyst with this project.
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.