Page 587 - Encyclopedia of Nursing Research

554 n WORKPLACe VIOLenCe

in 2009. Between 2004 and 2008, an average of 68 per 1,000 workers compared with an over-
564 workers per year died as a result of work- all rate of 12 per 1,000 workers. nurses had
W–Z place violence (BLS, 2010). By comparison, an incidence rate of 22 per 1,000 workers, the
the Department of Justice’s national Crime highest rate in the “medical” category. Rates
Victimization Survey (nCVS), estimates that for other nurse specialties or units were not
1.9 million incidents of nonfatal workplace available, but it is well recognized that emer-
violence occurred in the workplace each year gency department personnel face a signifi-
from 1992 to 1996 (Warchol, 1998). Twelve cant risk of injury from assaults by patients
percent of all victims reported physical inju- or their families; with weapon-carrying pre-
ries, 6% of the workplace crimes resulted in senting the opportunity for severe or fatal
injury that required medical treatment, and injuries. A recent survey of 69 u.S. emer-
only 44% of all incidents were reported to the gency departments found that 20% reported
police. A more recent report from a nationally that guns or knives were brought to their
representative study found that 41.4% of all emergency departments on a daily or weekly
workers reported incidents of psychological basis (Kansagra et al., 2008).
aggression, whereas 6% reported incidents of Violence in mental health has an exten-
physical aggression at work (Schat, Frone, & sive history, with the first documented case
Kelloway, 2006). of a patient fatally assaulting a psychiatrist in
Workplace violence (Type II) is a docu- 1849 (Bernstein, 1981). until the 1990s, most
mented occupational hazard in the health studies that examined the risk of violence to
care and service sectors (Centers for Disease psychiatrists and other therapists focused on
Control and Prevention/national Institute the victim’s role, the assaultive patient’s char-
of Occupational Safety and health, 2009; acteristics, and contextual factors surround-
Lipscomb & Love, 1992; Warchol, 1998). In ing the assault. Since that time, research has
the united States, the health care sector included the inquiry of organizational and
leads all other industry sectors in the inci- environmental risk factors; with nurses and
dence of nonfatal workplace assaults. From aides a focus of study.
1994 to 2005, nursing, psychiatric, and home Bensley et al. (1997) compared the num-
health aides were victims of nearly 30% of ber of workers’ compensation claims from
workplace assaults resulting in lost work- a Washington State psychiatric hospital,
days, which was the highest proportion of formal incident reports, and the number of
assault injury by broad occupational group- incidents of assault reported on a survey
ing in the united States (BLS, 2006). In 2005, measuring attitudes and experiences related
the BLS rate of nonfatal assaults among to assaults. She found that 73% of staff sur-
health care workers was 8.8 cases per 10,000, veyed reported at least a minor injury related
which was nearly four times higher than in to a patient assault in the past year. Only
the overall private sector workforce. Among 43% of those reporting moderate, severe, or
these assault victims, 30% were government disabling injuries related to assault filed a
employees, even though they make up only worker’s compensation claim. The survey
18% of the workforce. found an assault incidence rate of 437 per
The more sensitive nCVS, a population- 100 employees per year, a rate that underesti-
based household survey, provides rates of mated incident reports of assaults by a factor
violent crimes by occupation. In 12% of the of more than five (Bensley et al., 1997).
1.7 million episodes of workplace-related environmental and organizational fac-
violence annually in the united States, the tors associated with patient assaults include:
victim was a health care or mental health understaffing, workplace security, shift,
care worker. According to the nCVS, mental unres tricted access to movement, and
health professionals had an incidence rate of transporting patients (Centers for Disease