Study aimed at reducing health care violence

From MSU Today

Violence toward health care workers is an occupational hazard of epidemic proportion, but a new study by a Michigan State University College of Human Medicine researcher found that it can be reduced with a structured program.

Violence against health care workers “is much more common than what the ordinary person would think,” said Judith Arnetz, a professor and associate chair for research in the Department of Family Medicine. “What we see in our studies is that violence (in medical facilities) is grossly underreported.”

Arnetz has been researching violence in hospitals and other medical facilities since the 1990s. Her latest study, published in the January issue of the Journal of Occupational and Environmental Medicine, found that the level of violence can be curtailed if health care workers develop action plans based on data specific to their hospital units.

In the first, large-scale study of its kind, Arnetz and her colleagues randomly assigned 41 units in the Detroit Medical Center to a group, identified as an intervention group, that received three years of violence data specific to their units and another group, known as a control group, that received no data.

Based on the data, the units were able to take such steps as changing policies, training staff and installing panic buttons and better lighting to reduce violence against the hospital employees.

The research team supplied the data and a checklist of possible prevention strategies, but each intervention unit was responsible for devising its own action plan.

After six months, the rate of violent events in the units that had received data was about half the rate of the units that had not. After two years, the rate of violence-related injuries was about 60 percent lower in the intervention group than in the control group.

But that did not mean the number of violent incidents had decreased in those units that had developed action plans, only that it had not increased at the same rate as in the other units.

During the study period, rates of violence increased generally, according to the Bureau of Labor Statistics. The reason for the increase in violence is unclear, Arnetz said.

According to the U.S. Occupational Safety and Health Administration, health care facilities can be dangerous places. The organization has reported that in 2013, the rate of violent attacks against health care workers was 16.2 cases per 10,000 full-time employees, nearly four times the rate of other private sector workers.

Patients in emergency rooms and psychiatric units are particularly prone to violence, Arnetz said. Those who are in pain or discomfort, are cognitively impaired, are restrained or afraid of needles sometimes lash out, she said, as do patients and family members frustrated with long waits.

Such violent incidents are “disturbing,” Arnetz said, “and it can affect your ability to work and be productive. Health care workers say, ‘I can’t do this anymore. I just can’t do it.’”

Violence threatens not only worker well-being and safety, but the quality of patient care as well. It is imperative that hospitals take steps to reduce the violence, she said.

“Based on our data, the intervention was effective,” Arnetz said. “Ours is the first randomized-controlled study shown to successfully lower the risks of workplace violence in hospitals using a systematic program. I would like to see this methodology get implemented and evaluated on a wider scale.”