Gramling Joshua J, McGovern Patricia M, Church Timothy R, Nachreiner Nancy M, Gaugler Joseph E
Minneapolis, MN.
Minneapolis, MN.
J Emerg Nurs. 2018 May;44(3):249-257. doi: 10.1016/j.jen.2017.06.008. Epub 2017 Jul 28.
Health care workers suffer higher rates of violence-related injuries than workers in other industries, with hospital security officers and ED personnel at particularly high risk for injury. Arming hospital security workers with conducted electrical weapons, such as tasers, has been suggested as an intervention to decrease violence-related injuries in the hospital.
A retrospective cohort of all security and ED nursing staff at an urban level 1 trauma center was identified from human resources data for the period 4 years before and 7 years after security workers were armed with conducted electrical weapons. A violence-related rate of injury was calculated as all violence-related injuries incurred by each employee for the numerator and the productive hours worked by each person during the study period as the denominator.
The hospital employed approximately 30 security staff and 200 nursing staff at the time, with a total of 98 security officers and 468 nursing staff members over the 11 years of study. During the total nursing study period, 98 security officers contributed 452,901 hours; 265 registered nurses from the emergency department contributed 1,535,044 hours; and 203 health care assistants contributed 624,805 hours. Security officers' violence-related rate of injury was 13 times higher than that of the nursing staff. The risk ratio was 1.0 (95% confidence interval [CI] 0.7-1.4) between the 2 examination periods for security officers, with similar results for nurses. However, among security workers, the cost of the injuries decreased in the period after implementation.
Carrying conducted electrical weapons by hospital security staff appears to have limited capacity to decrease overall rates of violence-related injury but may decrease the severity of violence-related injuries. The latter could decease costs to health care organizations as well as morbidity of injured staff. Contribution to Emergency Nursing Practice.
医护人员遭受与暴力相关伤害的比例高于其他行业的工作人员，医院保安人员和急诊科工作人员受伤风险尤其高。有人建议为医院保安人员配备电击武器（如泰瑟枪）作为一种干预措施，以减少医院内与暴力相关的伤害。
从人力资源数据中确定了一家城市一级创伤中心所有保安和急诊科护理人员的回顾性队列，数据涵盖保安人员配备电击武器之前4年和之后7年的时间段。将与暴力相关的伤害发生率计算为：分子为每名员工发生的所有与暴力相关的伤害，分母为每个人在研究期间的工作时长。
当时该医院雇用了约30名保安人员和200名护理人员，在11年的研究期间共有98名保安人员和468名护理人员。在整个护理研究期间，98名保安人员贡献了452,901小时；急诊科的265名注册护士贡献了1,535,044小时；203名医护助理贡献了624,805小时。保安人员与暴力相关的伤害发生率比护理人员高13倍。保安人员在两个检查期之间的风险比为1.0（95%置信区间[CI] 0.7 - 1.4），护士的结果相似。然而，在保安人员中，实施电击武器配备后的受伤成本有所下降。
医院保安人员携带电击武器似乎在降低与暴力相关伤害的总体发生率方面能力有限，但可能会降低与暴力相关伤害的严重程度。后者可以降低医疗机构的成本以及受伤工作人员的发病率。对急诊护理实践的贡献。
