Instituting a series of proactive steps can go a long way towards minimizing the possibility of aggressive acts in a healthcare setting, says Barbara J. Youngberg, consultant to the Beecher Carlson national healthcare practice.
geriatric units. The US Department of Labor, Bureau of Labor Statistics (BLS) showed that 48 percent of all non-fatal injuries from workplace assaults and violent acts occurred in healthcare and social services settings, the majority of which occur in the emergency department. However, other areas of the hospital are not immune.
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towards patients. According to the Department of Justice data, nurses are most likely to be assaulted among healthcare workers. They are 57 percent more likely to be assaulted than are physicians.
More than half of emergency nurses say they’ve been “spat on”, “hit”, “pushed or shoved”, “scratched” or “kicked” while on the job according to a national online survey by the Emergency Nurses Association titled Violence against Nurses Working in US Emergency Departments. According to the survey of 3,465 emergency nurses, one in four reported that they had been been verbally abused more than 200 times during the same period.
Nearly one-third of violent acts against nurses are committed by family members of patients, visitors and other healthcare providers, including physicians. Perpetrators are commonly impaired males (fortunately pediatric emergency departments report the lowest amount of violence).
The highest incidents of violence occur during night shifts and on
weekends. Common causes of assault by family members of patients are related to the patient’s situation or condition, long wait times or the healthcare system, physicians or nurses, in general.
WHY THE ESCALATION OF VIOLENCE? Hospitals are vulnerable to the stresses of the modern world. Many
iolence in hospitals has been reported in the news with increasing frequency. It no longer occurs just in the emergency departments, but is happening in waiting areas and patient treatment rooms, particularly in critical care, psychiatric and
or brought in by police as victims or perpetrators of violence. The economic downturn, unemployment, loss of medical insurance, crime and increased substance abuse also serve to fuel a feeling of hopelessness and anger among some individuals that may result in them expressing their frustrations or concerns aggressively. Violence is not isolated to the
increasingly violent society. There is more reported domestic abuse, easier insurance, increased usage of emergency departments as primary care, longer wait times in unpleasant waiting conditions and increased use of emergency departments for psychiatric treatment and clearance and it is easy to see why violence in all types of healthcare settings is on the rise.
THE JOINT COMMISSION WEIGHS IN The Joint Commission has studied the factors that lead to violence in healthcare through analysis of sentinel events. According to its data, between 1995 and 2010, hospitals and healthcare facilities experienced 256 assaults, rapes or homicides with 110 of those occurring since 2007.
Among many local reasons and individual institutional factors, the
• Lack of appropriate or updated policies and procedures. • Inconsistent implementation of policies and procedures. • Inconsistent use of screening and monitoring tools. • and competencies.
• the public leaving them highly vulnerable to adverse events. There security safeguards.
• patients. Inadequate psychiatric resources lead to increased use of emergency departments.
• caregivers and family members is usually noted to be one of the main reasons for adverse events. Lack of appropriate communication can
PROACTIVELY ADDRESSING THE PROBLEM To prevent violence in healthcare facilities, The Joint Commission’s Sentinel Event Alert newsletter issue #45 suggests that facilities take a
1. Work with the security department to audit your facility’s of violence. Evaluate environmental and administrative controls
risk Annual 2014 | HEALTHCARE RISK MANAGEMENT REVIEW | 45
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SHUTTERSTOCK.COM
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