This retrospective population-based study assessed the long-term risk of repeat reported occupational injury or illness incidents among Veterans Health Administration (VHA) nursing employees. Using fiscal year (FY) 2002 as the start date for the longitudinal surveillance of incidents, descriptive analyses included all VHA nursing employees ( N = 25,697) who reported an initial (index) incident that occurred between FY 2002 and FY 2005. Adjusted for total administrative loss rates (e.g., attrition, disability, retirements), approximately half of the “surviving” index cases reported repeat incidents during an ensuing 3-year period. This total increased to approximately two thirds during a 6-year period. Compared to their nurse counterparts, practical nurses and nursing assistants had higher cumulative probabilities of multiple reported repeat occupational injury or illness incidents. Study findings suggest that reported levels of repeat occupational injury or illness incidents represent a complex interplay between environmental factors (e.g., location) and nursing staff demographics (e.g., level of education).
OBJECTIVE: Ascertain whether Veterans Health Administration administrative medical center complexity ratings could be used to help identify potential sites for targeted nursing staff workplace violence intervention activities. PARTICIPANTS: VHA field nursing staff, classified among the nurse, practical nurse, and nursing assistant series, who administratively reported a grand total of 9,964 occupational assault incidents that occurred between October 1, 2003 and September 30, 2011. METHODS: Outcome measures were population-based standardized assault incidence rates, as differentiated by fiscal year, medical facility complexity level, gender, and nursing staff occupation. Subgroup measures included age, highest educational attainment level, location of injury, body part most affected, day of week, and time of day. RESULTS: Across eight fiscal years, standardized incidence rates for reported assaults among females were 6.0 and 2.3 times higher for nursing assistants and practical nurses, respectively, as compared with nurses; for males, the corresponding rates for nursing assistants and practical nurses were 3.5 and 1.5 times higher, respectively. Across occupation and gender, standardized incidence rates for assaults were consistently higher among medium-and low-level facility complexity levels. Findings suggest that more attention is needed for ascertaining the potential role and functioning of facility-specific staff training for preventing assaultive behavior on VHA nursing staff.
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