Monday, February 23, 2009

Workplace Violence Prevention in Health Care Settings Works

Annals of Epidemiology Volume 19, Issue 2, February 2009, Pages 125-133

Hospital Employee Assault Rates Before and After Enactment of the California Hospital Safety and Security Act
Carri Casteel PhDa, b, , , Corinne Peek-Asa PhDc, d, Maryalice NoceraMSNb, Jamie B. Smith MAb, James Blando PhDe, Suzi Goldmacher MSN, Emily O'Hagan MPHe, David Valiante PhDe and Robert Harrison PhDf
aDepartment of Epidemiology, University of North Carolina at Chapel Hill
bUniversity of North Carolina Injury Prevention Research Center, Chapel Hill
cDepartment of Occupational and Environmental Health, University of Iowa, Iowa City, IA
dUniversity of Iowa Injury Prevention Research Center, Iowa City, IA
eNew Jersey Department of Health and Senior Services, Trenton, NJ
fUniversity of California, San Francisco

This study examines changes in violent event rates to hospital employees before and after enactment of the California Hospital Safety and Security Act in 1995.
We compared pre- and post-initiative employee assault rates in California (n = 116) emergency departments and psychiatric units with those in New Jersey (n = 50), where statewide workplace violence initiatives do not exist. Poisson regression with generalized estimating equations was used to compare assault rates between a 3-year pre-enactment period (1993–1995) and a 6-year post-enactment period (1996–2001) using New Jersey hospitals as a temporal control.
Assault rates among emergency department employees decreased 48% in California post-enactment, compared with emergency department employee assault rates in New Jersey (rate ratio [RR] = 0.52, 95% confidence interval [CI]: 0.31, 0.90). Emergency department employee assault rates decreased in smaller facilities (RR = 0.46, 95% CI: 0.21, 0.96) and for-profit-controlled hospitals (RR = 0.39, 95% CI: 0.19, 0.79) post-enactment. Among psychiatric units, for-profit-controlled hospitals (RR = 0.41, 95% CI: 0.19, 0.85) and hospitals located in smaller communities (RR = 0.44, 95% CI: 0.21, 0.92) experienced decreased assault rates post-enactment.
Policy may be an effective method to increase safety to health care workers.
BrooklynDodger(s) comment: The Dodger(s) couldn't get the full text to find the most interesting findings, which would have been the actual rates rather than the ratios, were New Jersey and California different, were emergency rooms and psychiatric facilities different? (The Dodger(s) suspect higher rates of assault in custodial facilities.) The reviewers get a demerit for not making the authors put that in the abstract. Injury control research is difficult, but this is a meager data base

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