University of Michigan, Ann Arbor, MI 48109, USA.
Am J Emerg Med. 2013 Jan;31(1):197-205. doi: 10.1016/j.ajem.2012.07.010. Epub 2012 Sep 20.
Health care support occupations have an assault-injury rate nearly 10 times the general sector. Emergency departments (EDs) are at greatest risk of such events.
The objective was to describe the incidence of violence in ED health care workers (HCWs) over 9 months. Specific aims were to (1) identify demographic, occupational, and perpetrator factors related to violent events (VEs) and (2) identify predictors of acute stress in victims and predictors of loss of productivity.
A longitudinal, repeated-methods design was used to collect monthly survey data from ED HCWs at 6 hospitals. Surveys assessed number and type of VEs, and feelings of safety and confidence. Victims also completed specific VE surveys. Descriptive statistics and a repeated-measure linear regression model were used.
Two hundred thirteen ED HCWs completed 1795 monthly surveys and 827 VEs were reported. Average VE rate per person per 9 months was 4.15. Six hundred one events were physical threats (PTs) (3.01 per person). Two hundred twenty six events were assaults (1.13 per person). Five hundred one VE surveys were completed, describing 341 PTs and 160 assaults. Men perpetrated 63% of PTs and 52% of assaults. Significant differences in VEs were reported between registered nurses (RNs) and medical doctors (MDs) (P = .0017) and patient care assistants (P < .05). The RNs felt less safe than the MDs (P = .0041). The MDs felt more confident than the RNs in dealing with violent patients (P = .013). The RNs were more likely to experience acute stress than the MDs (P < .001). Acute stress reduced productivity (P < .001).
Emergency department HCWs are frequent victims of violence perpetrated by visitors and patients. This results in injuries, acute stress, and lost productivity. Acute stress has negative consequences on workers' ability to perform their duties.
医疗支持职业的袭击伤害率接近一般行业的 10 倍。急诊科（ED）是此类事件风险最高的地方。
本研究旨在描述急诊科医护人员（HCWs）在 9 个月内遭受暴力的发生率。具体目标是：（1）确定与暴力事件（VE）相关的人口统计学、职业和犯罪者因素；（2）确定受害者急性应激的预测因素和生产力损失的预测因素。
采用纵向、重复方法设计，在 6 家医院的急诊科 HCWs 中每月收集一次调查数据。调查评估 VE 的数量和类型，以及安全感和信心。受害者还完成了专门的 VE 调查。采用描述性统计和重复测量线性回归模型。
213 名 ED HCWs 完成了 1795 次每月调查，报告了 827 起 VE。9 个月内人均 VE 发生率为 4.15。601 起事件为身体威胁（PT）（人均 3.01）。226 起事件为袭击（人均 1.13）。完成了 510 份 VE 调查报告，描述了 341 起 PT 和 160 起袭击事件。男性实施了 63%的 PT 和 52%的袭击。注册护士（RN）和医生（MD）之间报告的 VE 存在显著差异（P=0.0017）和病人护理助理（P<.05）。RN 比 MD 感到更不安全（P=0.0041）。MD 比 RN 更有信心处理暴力病人（P=0.013）。RN 比 MD 更有可能经历急性应激（P<.001）。急性应激会降低生产力（P<.001）。
急诊科 HCWs 经常成为访客和患者暴力行为的受害者。这会导致受伤、急性应激和生产力损失。急性应激对工人履行职责的能力产生负面影响。
