Preventing Patient-to-Worker Violence in Hospitals

Abstract

Objective To evaluate the effects of a randomized controlled intervention on the incidence of patient-to-worker (Type II) violence and related injury in hospitals. Methods Forty-one units across 7 hospitals were randomized into intervention (n=21) and control (n=20) groups. Intervention units received unit-level violence data to facilitate development of an action plan for violence prevention; no data were presented to control units. Main outcomes were rates of violent events and injuries across study groups over time. Results Six months post-intervention, incident rate ratios of violent events were significantly lower on intervention units compared to controls (IRR 0.48, 95% CI 0.29-0.80). At 24 months, the risk for violence-related injury was lower on intervention units, compared to controls (IRR 0.37, 95% CI 0.17-0.83). Conclusion This data-driven, worksite-based intervention was effective in decreasing risks of patient-to-worker violence and related injury.

Worksite Walkthrough Intervention

“…Evaluation of this intervention provided evidence that it was effective against Type II workplace violence incidence and violence-related injuries over time. 8 The majority of the 21 intervention unit supervisors returned their Action Plan documents with specific strategies they planned to implement on their unit. Questionnaire responses from supervisors and staff were favorable regarding the methods used for the intervention and most expressed wanting to continue using the walkthrough meetings in the future.…”

“…Contamination of intervention strategies between intervention and control groups may have occurred. Several of the intervention and control units were located within the same hospitals, 8 and members of these units may have interacted in hospital-level meetings. However, this would have decreased the likelihood of detecting the significant differences between groups that were previously reported.…”

“…Evaluation of this intervention has provided evidence that it is an effective tool for reducing the risks of workplace violence events and related injuries. 8 The development, implementation, and fidelity of this intervention are described in this paper.…”

“…17,18 Third, the authors focused only on rates of assault without consideration of change in assault severity, which may have improved over time. The current study describes an intervention that used unit-specific data, examining rates of both incidence and severity of workplace violence over time, 8 and planning data-driven, setting-specific prevention strategies to target relevant factors behind that unit’s violent events.…”

“…Results revealed significantly lower risks of patient-to-worker violent events and violence-related injuries on intervention units post-intervention compared to controls. 8 The intervention incorporated some of the positive elements of previous interventions (e.g., participatory components, walkthrough methodology), while improving upon prior methods by using a setting-specific, data-driven design based on actual incidents.…”