Hospital workers at high risk for violent attacks
NIOSH says nurses and aides most likely victims
A new publication from the Centers for Disease Control’s National Institute for Occupational Safety and Health (NIOSH) paints a disturbing picture of the risk of violent attack faced by hospital employees. In fact, says the publication, Violence: Occupational Hazards in Hospitals, recent data indicate that hospital workers are at high risk for experiencing violence in the workplace.
"According to estimates of the Bureau of Labor Statistics (BLS), 2,637 nonfatal assaults on hospital workers occurred in 1999 — a rate of 8.3 assaults per 10,000 workers. This rate is much higher than the rate of nonfatal assaults for all private-sector industries, which is two per 10,000 workers," claims NIOSH.
Examples of violence can be placed in three major categories:
• Threats: Expressions of intent to cause harm, including verbal threats, threatening body language, and written threats.
• Physical assaults: Attacks ranging from slapping and beating to rape, homicide, and the use of weapons such as firearms, bombs, or knives.
• Muggings: Aggravated assaults, usually conducted by surprise and with intent to rob.
Although anyone who works in a hospital can become a victim of violence, nurses and aides who have the most direct contact with patients are at higher risk. Others at increased risk are emergency response personnel, hospital safety officers and all health care providers. Violence occurs most frequently in psychiatric wards, emergency rooms, waiting rooms and geriatric units.
Violence is a significant issue for occupation health professionals, says NIOSH, not just because of the physical injuries that can occur. "Violence may also have negative organizational outcomes such as low worker morale, increased job stress, increased worker turnover, reduced trust of management and co-workers, and a hostile working environment."
There are many things you can do to prevent or minimize the likelihood of violence in your hospital, says NIOSH. Your facility should develop a safety and health program that includes management commitment, employee participation, hazard identification, safety and health training, and hazard prevention, control, and reporting.
Prevention strategies recommended
Here are a number of prevention strategies recommended by NIOSH:
• Design staffing patterns to prevent personnel from working alone and to minimize patient waiting time;
• Restrict the movement of the public in hospitals by card-controlled access;
• Develop a system for alerting security personnel when violence is threatened;
• Provide all workers with training in recognizing and managing assaults, resolving conflicts and maintaining hazard awareness;
• Design the triage area and other public areas to minimize the risk of assault. This includes providing staff restrooms and emergency exits; installing closed nurses’ stations; installing deep service counters or bullet-resistant and shatterproof glass enclosures in reception areas; and arranging furniture and other objects to minimize their use as weapons.
• Provide security escorts to the parking lots at night;
• Install security devices such as metal detectors, cameras and good lighting in hallways;
• Develop emergency signaling, alarms and monitoring systems.
Prevention strategies work
NIOSH cites several instances where the employment of these strategies has helped prevent violence. For example, a security screening system in a Detroit hospital included stationary metal detectors supplemented by hand-held units. The system prevented the entry of 33 handguns, 1,324 knives, and 97 mace-type sprays during a six-month period.
A system restricting movement of visitors in a New York City hospital used identification badges and color-coded passes to limit each visitor to a specific floor. The hospital also enforced the limit of two visitors at a time per patient. Over 18 months, these actions reduced the number of reported violent crimes by 65%.
[To receive a copy of "Violence: Occupational Hazards in Hospitals," or to request additional information, contact: NIOSH — Publications Dissemination, 4676 Columbia Parkway, Cincinnati, OH 452261998. Telephone: (800) 356-4674. Fax: (513) 533-8573. E-mail: [email protected]. Or, visit the NIOSH web site at: www.cdc.gov/niosh.]
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