Incidence and risk factors of workplace violence on psychiatric staff

Abstract

BACKGROUND A study by Hesketh et al. found that 20% of psychiatric nurses were physically assaulted, 43% were threatened with physical assault, and 55% were verbally assaulted at least once during the equivalent of a single work week. From 2005 through 2009, the U.S. Department of Justice reported that mental health occupations had the second highest average annual rate of workplace violence, 21 violent crimes per 1,000 employed persons aged 16 or older. OBJECTIVE An evaluation of risk factors associated with patient aggression towards nursing staff at eight locked psychiatric units. PARTICIPANTS Two-hundred eighty-four nurses in eight acute locked psychiatric units of the Veterans Health Administration throughout the United States between September 2007 and September 2010. METHODS Rates were calculated by dividing the number of incidents by the total number of hours worked by all nurses, then multiplying by 40 (units of incidents per nurse per 40-hour work week). Risk factors associated with these rates were analyzed using generalized estimating equations with a Poisson model. RESULTS Combining the data across all hospitals and weeks, the overall rate was 0.60 for verbal aggression incidents and 0.19 for physical aggression, per nurse per week. For physical incidents, the evening shift (3 pm – 11 pm) demonstrated a significantly higher rate of aggression than the day shift (7 am – 3 pm). Weeks that had a case-mix with a higher percentage of patients with personality disorders were significantly associated with a higher risk of verbal and physical aggression. CONCLUSION Healthcare workers in psychiatric settings are at high risk for aggression from patients.

The Effects of Biofeedback Training and Smartphone-Delivered Biofeedback Training on Resilience, Occupational Stress, and Depressive Symptoms among Abused Psychiatric Nurses

“…One study found that up to 99% of psychiatric ward (PW) healthcare providers reported that they had experienced verbal violence from patients or their families, and approximately 70% had been physically assaulted by patients in the past 12 months [4]. A similar study showed that PW nurses experienced an average incidence of verbal and physical violence of 0.6 and 0.19 times per nurse per week, respectively [5]. One study reported that physical and psychological violence were experienced annually by 55.7% and 82.1% of the PW nurses in Taiwan, respectively [6].…”

Violence committed against nursing staff by patients in psychiatric outpatient settings

“…Ridenour et al . () found no differences between days of the week with regard to violent occurrences. However, working the day shift increased the risk of exposure to verbal violence, and working the evening shift increased the risk of exposure to physical violence.…”

“…Also, patient restriction, physical assistance, and medication were reasons for violent behaviour especially in inpatient settings (Ridenour et al . ). Ose et al .…”

“…Ridenour et al . () found that staff members employed at their current job for over a year experienced violence more frequently than those with less work experience. Also, Terkelsen and Larsen () found that causes of violence in inpatient settings are most often related to gender, atmosphere, environment, and nursing staff members’ stereotypical thinking.…”

“…Ridenour et al . () examined the risk factors of workplace violence and concluded that patients’ personality disorders are related to increased risk of violent behaviour. Also, patient restriction, physical assistance, and medication were reasons for violent behaviour especially in inpatient settings (Ridenour et al .…”