Faculty of Health, University of Technology, Sydney, NSW, Australia.
Int J Older People Nurs. 2014 Dec;9(4):317-23. doi: 10.1111/opn.12051. Epub 2014 May 24.
Workplace violence is one of the most complex and significant occupational hazards experienced by nurses in healthcare settings. Verbal abuse and physical violence are particularly prevalent in older person assessment wards, owing to the prevalence of illnesses involving cognitive dysfunction; the high frequency and nature of contact with staff; and the frustration caused by high levels of disability.
To determine the frequency, kinds and cues of violence displayed by patients towards nurses in an acute older person assessment ward environment using a structured observational tool - the Violence Assessment Tool (VAT).
Observational study.
Non-participant structured observations of behavioural cues for violence towards nurses in an acute older person hospital ward were gathered and analysed.
One hundred and twelve hours of observations were undertaken, resulting in 95 behavioural cues for violence in 19 patients. Four of these patients subsequently escalated to physical violence. Pacing around the bed was the only commonality in the behavioural cues of patients who became violent. All patients who became violent had previously demonstrated showing.
To date, the assessment of potentially violent older patients has not been adequately addressed. The VAT may be one way of addressing this challenge through early identification of the more subtle behavioural cues that could indicate potential for violence. Further research on the VAT using a larger data set could determine its predictability for physically violent acts displayed by older people.
工作场所暴力是医疗环境中护士面临的最复杂和最严重的职业危害之一。由于涉及认知功能障碍的疾病普遍存在、与工作人员接触的频率高且性质特殊，以及残疾程度高导致的挫败感，言语虐待和身体暴力在老年人评估病房中尤为普遍。
使用结构化观察工具——暴力评估工具（VAT），确定急性老年人评估病房环境中患者对护士表现出的暴力的频率、种类和线索。
观察性研究。
对急性老年医院病房中针对护士的暴力行为的行为线索进行非参与式结构化观察，并进行分析。
共进行了 112 小时的观察，在 19 名患者中发现了 95 个暴力行为线索。其中 4 名患者随后升级为身体暴力。在变得暴力的患者的行为线索中，只有在床边踱步是唯一的共同点。所有变得暴力的患者之前都表现出过这种行为。
迄今为止，对潜在暴力老年患者的评估尚未得到充分解决。VAT 可能是通过早期识别可能表明暴力倾向的更微妙行为线索来应对这一挑战的一种方法。使用更大的数据集对 VAT 进行进一步研究，可以确定其对老年人表现出的身体暴力行为的可预测性。
