1 Barbara E. Lakatos, DNP, PMHCNS-BC, APRN, Brigham and Women's Hospital, Boston, MA, USA.
2 Monique T. Mitchell, MS, PMHCNS-BC, APRN, Brigham and Women's Hospital, Boston, MA, USA.
J Am Psychiatr Nurses Assoc. 2019 Jul/Aug;25(4):280-288. doi: 10.1177/1078390318788944. Epub 2018 Jul 16.
Workplace violence is a major public health concern. According to the U.S. Bureau of Labor Statistics, from 2002 to 2013, incidents of serious workplace violence (those requiring days off) were four times more common in health care than in private industry. An interprofessional committee developed, implemented, and evaluated a quality improvement project from 2012 to 2016 to reduce workplace violence and prevent staff injury. The initiative termed S.A.F.E. Response stands for pot a threat, ssess the risk, ormulate a safe response, valuate the outcome. An institutional review board-approved quality improvement survey was implemented and evaluated. The data were analyzed using descriptive statistics. An interprofessional committee developed and implemented a comprehensive program to prevent injury, which included (a) a mandatory eLearning educational training, (b) a S.A.F.E. Response with standardized interventions for the clinical conditions affecting safety, and (c) a clinical debriefing process. A reduction in nursing staff assault incidence rates was identified as a success. Nursing staff injury rates decreased an average of 40%. A reduction in nursing staff assault incidence rates was notable. Clinicians equipped with knowledge, skills, and resources can identify and defuse unsafe situations to prevent violence. This clinical approach shifts the focus from crisis intervention to crisis prevention, which reduces injury.
工作场所暴力是一个主要的公共卫生关注点。根据美国劳工统计局的数据,从 2002 年到 2013 年,严重的工作场所暴力事件(需要休假的事件)在医疗保健行业比私营行业常见四倍。一个跨专业委员会制定、实施和评估了一个质量改进项目,从 2012 年到 2016 年减少工作场所暴力和预防员工受伤。该倡议被称为 S.A.F.E. 反应,代表识别威胁、评估风险、制定安全反应、评估结果。实施并评估了一个机构审查委员会批准的质量改进调查。使用描述性统计数据对数据进行了分析。一个跨专业委员会制定并实施了一项综合计划,以预防伤害,其中包括 (a) 强制性的电子学习教育培训,(b) 针对影响安全的临床情况的 S.A.F.E. 反应和标准化干预,以及 (c) 临床汇报过程。护理人员攻击发生率的降低被认为是成功的。护理人员受伤率平均降低了 40%。护理人员攻击发生率的降低是显著的。具备知识、技能和资源的临床医生可以识别和化解不安全情况,以预防暴力。这种临床方法将重点从危机干预转移到危机预防,从而减少伤害。