Impact of medical center complexity on Veterans Health Administration nursing staff incidence rates for reported assaults

Abstract

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.

Second-Level Nurses’ Experiences of Workplace Violence: A Scoping Review

“…Tabulation of extracted data of study characteristics was utilised, and key study fndings were compared [44]. [47,50,53,56,[58][59][60][61]; three had qualitative designs [48,49,55]; two were case-control studies [54,57], and there was one each of quantitative [45], phenomenological [46], quasi-experimental [51], cohort [52], and retrospective prevalence studies [62]. Workplace locations of reported WPV included emergency, medical-surgical, acute care, mental health [46,48,[54][55][56][57][58][59], nursing homes, and residential care facilities [45-48, 54, 56-59, 61].…”

“…In addition, stress and suicidal ideation [48,50], fatigue, diffculty concentrating, tiredness, lack of energy [57,61], depression [57], fashbacks, nightmares, and hallucinations [54,57,61] were explored in the studies. Physical impacts include physical injury, disability, reduced quality of life [54], generalised body pains [54,61,62], and headache/head pressure [57,61].…”

“…Tree studies also explored the fnancial impacts of WPV, including reduced productivity and lost employee work hours [54,62], increased turnover, decreased retention, and nursing shortage [54,56], salary replacement dollars for overtime and agency staf [62], counselling cost [54], potential organisational ramifcations from lawsuits, and negative publicity with potential negative impact on staf recruitment and retention [62].…”

Workplace Violence Prevention: Improving Front-Line Health-Care Worker and Patient Safety

“…Other front-line health-care workers, such as nursing assistants, environmental service workers, and ward clerks, have been the focus of many fewer studies. Those studied include workers in home care [29][30][31], long-term care [32], the Veterans Health Administration (VHA) health system [1,33] and in one major midwestern health-care system [34]. In the absence of research focused on these worker populations, extrapolation of known risk factors from nurses may inform prevention and policy across disciplines within health care.…”

“…Welch et al reported on eight years of standardized assault incidence data among nursing staff working across VHA health-care facilities. They found that female nursing assistants and practical nurses experienced assaults at a rate WORKPLACE VIOLENCE PREVENTION / 301 6.0 and 2.3 times higher risk than registered nurses; male nursing assistants and practical nurses also were at increased risk [33]. Findorff [34] conducted a mail survey of current and former employees of a major midwestern health-care system.…”