Development and Evaluation of a Hospital Violence Surveillance System

Details

• Personal Author:
  Conway SH ; Dement, John M. ; Lipscomb HJ ; Pompeii LA ; Schoenfisch AL ; Smith C
• Description:
  Specific Aims: Violence against workers in the hospital setting, including both physical and verbal assaults, has become a growing public health concern. Recent studies have demonstrated a 12-month prevalence of reported workplace violent assaults experienced by nursing staff and physicians ranging from 24% to 74%, with verbal assaults ranging from 23% to 80%. These estimates are considered conservative as several studies have observed significant underreporting of violent episodes experienced by hospital workers. Violence perpetrated by patients and visitors is the most common type of violence reported in this setting. The lack of standardized surveillance methodology to capture incident cases of workplace violence, as well as details about the circumstances surrounding these in the hospital setting means that preventive policy development is often made on an ad hoc basis or triggered by sentinel events. We propose to design and implement a comprehensive violence surveillance system that effectively captures episodes of workplace violence inflicted on hospital workers by patients and visitors. This system will record circumstances surrounding these violent episodes and generate information that will be used to inform more detailed etiologic analyses and violence prevention efforts by hospital stakeholders. The work will take place in two large medical systems which include two tertiary care hospitals and four community hospitals located in Texas and North Carolina. We will partner with key stakeholders at the study hospitals to develop an enhanced online mechanism for capturing incident cases of workplace violence, as well as develop supporting policies and procedures that detail the mechanisms in place for reporting these events. We will conduct a preliminary assessment of the level of integration of the workplace violence surveillance system and their corresponding policies in each hospital. This research study addresses NIOSH's strategic goal for promoting effective occupational health surveillance conducted by employers. AIM 1. Conduct a baseline needs assessment that will: (1) examine the types of violent events captured through existing surveillance and reporting methods in place at all study hospitals; and, (2) identify the magnitude and nature of under-reporting. In this process, we will also assess workers' knowledge about the violence reporting policies and procedures in place within each hospital and work unit by means of survey and focus group methods. Attention will be paid to identifying both the formal and informal reporting structures for violent episodes in order to determine deficiencies in reporting that need to be addressed with the enhanced surveillance system. This process will allow us to determine if we need to expand our study definition of workplace violence in order to capture appropriate events as the surveillance system is more clearly defined and improved. AIM 2. Conduct baseline and ongoing analyses of existing administrative data for purposes of characterizing the frequency and type of reported episodes of workplace violence among hospital workers. Through rate-based analyses of workers' compensation and first report of injury data, we will describe reported violent events by hospital and work unit, as well as explore factors associated with violent episodes that are reported based on worker, job, unit and perpetrator characteristics. AIM 3. Develop and implement the enhanced workplace violence surveillance system that includes both an online mechanism for reporting violent events and reporting policies and procedures that support this system. Using data from the baseline needs assessment, we will collaborate with occupational safety and security personnel (who manage the hospitals' online first report of injury programs) to develop and implement the Enhanced Online First Report of Injury form. Simultaneously, we will collaborate with key hospital stakeholders to update/develop new violence policies and procedures that detail the mechanisms for reporting violent events through the enhanced surveillance system. We will partner with these hospitals to promote this new system through an official "roll-out" through promoting and educating workers about the system. AIM 4. Conduct a preliminary evaluation of the integration of the enhanced violence surveillance system, as well as the integration of unit level violence reporting policies and procedures. These findings will be provided to hospital stakeholders for purposes of continued refinement of both the surveillance system and reporting policies and procedures. [Description provided by NIOSH]
• Subjects:
  Behavior Environmental Exposure Health Personnel Mental Disorders Mental Health Occupational Exposure Occupational Health Risk Assessment Risk Factors Safety Stress, Psychological Surveys And Questionnaires Violence Workplace

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• Keywords:
  Behavioral-disorders Employee Exposure Exposure Levels Health-care-personnel Health-surveys Injuries Injury-prevention Medical Personnel Nurses Physical-reactions Protective Measures Psychological-factors Psychological-stress Recording Systems Recordkeeping Risk Assessment Risk Factors Sentinel Health Events Statistical Analysis Surveillance Violence-prevention Work Environment Worker-health Workers Workplace Violence

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• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Final Grant Report
• Place as Subject:
  North Carolina ; OSHA Region 4 ; OSHA Region 6 ; Texas
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-147
• NIOSHTIC Number:
  nn:20052096
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R01-OH-009697, 2016 Oct; :1-147
• Federal Fiscal Year:
  2017
• Performing Organization:
  University of Texas, Health Science Center - Houston
• Peer Reviewed:
  False
• Start Date:
  20100701
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20150630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:aad89704db0de028ad116aa6fe8477b99c4d1f36986c79f46854d1c5b2b6fd269c131ab1779a04326ac22b300061abf1a586a94bc15bdff5c71fe45958c8d3ab
• Download URL:
  https://stacks.cdc.gov/view/cdc/218689/cdc_218689_DS1.pdf
• File Type:
  [PDF - 3.18 MB ]