Staff survey results and characteristics that predict assault and injury to personnel working in mental health facilities

Abstract

The purpose of this study was to complete a mental health staff opinion survey to identify patient and staff characteristics associated with staff assault and injury in psychiatric treatment settings and to develop a model of prediction for staff assault and injury utilizing these survey variables. The data consisted of opinion surveys sent to staff of 15 child, adolescent, and adult psychiatry inpatient units in the United States. Multivariate logistic regression was used to determine the level of assault and staffreported injury prediction that could be obtained from the staff-completed opinion survey. Responses indicated a high prevalence of reported aggression, with 62.3% of staff endorsing verbal and physical aggression, property destruction, and self-injurious behavior as being prevalent at their site, whereas only 4.1% rated none of these as prevalent. Staff working with children and adolescents in settings with high rates of psychiatric diagnoses reported increased frequency of assault and injury compared with those working with adults. Younger, less experienced staff reported higher rates of assault and injury. Staff working with female patients reported similar rates of assault and injury to those working with males. A logistic regression analysis using staff-reported survey results of both staff and patient characteristics predicted assault correctly 73.7% of the time and injury 66.1% of the time. Resources for violence prevention and staff training programs in violence prevention are needed in child and adolescent psychiatry wards. Results are consistent with theories emphasizing the importance of negative emotions and affects, impulsivity, and frustration in goal-directed activities in human aggression.

Psychiatric nurses' attitudes towards inpatient aggression: preliminary report of the development of attitude towards aggression scale (ATAS)

“…In a study by Carmel and Hunter [1989], male nursing staff were almost twice as likely as female staff to be injured and nearly three times as likely to receive containment-related injuries. In contrast, in two other studies no differences were found between male and female nurses and their assault rate [Whittington, 1994;Cunningham et al, 2003]. …”

“…The impact of education was considered, and a low level of qualification was found to be associated with higher rates of assault [Whittington and Wykes, 1994;Cunningham et al, 2003]. In several studies it was found that the more inexperienced the staff were, the more they were exposed to assaults [Hodgkinson et al, 1985;Cunningham et al, 2003].…”

“…In several studies it was found that the more inexperienced the staff were, the more they were exposed to assaults [Hodgkinson et al, 1985;Cunningham et al, 2003]. Cunningham et al [2003] found that an increased number of hours of contact between nurses and patients resulted in more injuries being sustained.…”

Cross-Cultural Differences in Psychiatric Nurses' Attitudes to Inpatient Aggression

“…In a study by Carmel and Hunter (1989), male nursing staff were almost twice as likely as female staff to be injured and nearly three times as likely to receive containment-related injuries. In contrast, in two other studies, no differences were found between male and female nurses and their assault rate (Cunningham, Connor, Miller, & Melloni, 2003;Whittington, 1994). In several studies, it was found that more inexperienced staff were more likely to be exposed to assaults (Cunningham et al, 2003;Hodgkinson, Mcivor, & Philips, 1985;Whittington, Shuttleworth, & Hill, 1996).…”

“…In contrast, in two other studies, no differences were found between male and female nurses and their assault rate (Cunningham, Connor, Miller, & Melloni, 2003;Whittington, 1994). In several studies, it was found that more inexperienced staff were more likely to be exposed to assaults (Cunningham et al, 2003;Hodgkinson, Mcivor, & Philips, 1985;Whittington, Shuttleworth, & Hill, 1996). Studies on the relationship between time of day and increase in aggression show that most incidents take place in the daytime, followed by the evening, and with the lowest rate found during the night.…”