Abstract
Introduction
Workplace violence against nurses is a serious problem. Nurses from a US urban/community
hospital system employing more than 5,000 nurses researched the incidence of workplace
violence against nurses perpetrated by patients or visitors in their hospital system.
Methods
Survey research and retrospective database review methods were used. Nurse participants
(all system-employed nurse types) completed a 34-item validated survey in electronic
format. Retrospective database review provided annual nurse workplace violence injury
treatment and indemnity charges. Institutional review board approval was received.
Results
Survey research participants (N = 762) were primarily white female registered nurses,
aged 26 to 64 years, with more than 10 years of experience. Over the past year, 76.0%
experienced violence (verbal abuse by patients, 54.2%; physical abuse by patients,
29.9%; verbal abuse by visitors, 32.9%; and physical by visitors, 3.5%), such as shouting
or yelling (60.0% by patients and 35.8% by visitors), swearing or cursing (53.5% by
patients and 24.9% by visitors), grabbing (37.8% by patients and 1.1% by visitors),
and scratching or kicking (27.4% by patients and 0.8% by visitors). Emergency nurses
(12.1%) experienced a significantly greater number of incidents (P < .001). Nurses noted more than 50 verbal (24.3%) and physical (7.3%) patient/visitor
violence incidents over their careers. Most serious career violence incidents (n =
595, 78.1%) were physical (63.7%) (60.8% by patients and 2.9% by visitors), verbal
(25.4%) (18.3% by patients and 7.1% by visitors), and threatened physical assault
(10.9%) (6.9% by patients and 4.0% by visitors). Perpetrators were primarily white
male patients, aged 26 to 35 years, who were confused or influenced by alcohol or
drugs. Per database review, annual workplace violence charges for the 2.1% of nurses
reporting injuries were $94,156 ($78,924 for treatment and $15,232 for indemnity).
Discussion
Nurses are too commonly exposed to workplace violence. Hospitals should enhance programs
for training and incident reporting, particularly for nurses at higher risk of exposure,
caring for patients with dementia or Alzheimer disease, patients with drug-seeking
behavior, or drug- or alcohol-influenced patients.
Key words
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References
- National crime victimization survey: violence in the workplace, 1993-2009.(Available at:) (Published 2011. Accessed January 7, 2012)
- Strategies and tools to reduce workplace violence.AAOHN J. 2008; 56: 449-454
- Violence against nurses working in US emergency departments.J Nurs Adm. 2009; 39: 340-349
- Workplace violence experienced by registered nurses: a concept analysis.Nurs Prax NZ. 2009; 25: 37-50
- Development of a violence tool in the emergency hospital setting.Nurse Res. 2010; 17: 70-82
- Workplace violence.Adv Emerg Nurs J. 2009; 31: 94-100
- Reduce ED violence with training, diligent reporting.Healthcare Benchmarks Qual Improv. 2008; 18: 90-91
- Violence in the emergency department: a national survey of emergency medicine residents and attending physicians.J Emerg Med. 2011; 40: 565-579
- Violence towards emergency department nurses by patients.Accid Emerg Nurs. 2004; 12: 67-73
- Innocent or culpable? Meanings that emergency department nurses ascribe to individual acts of violence.J Clin Nurs. 2007; 17: 1071-1078
- OSHA fact sheet. Workplace violence.(Available at:) (Published 2002. Accessed January 7, 2012)
- National crime victimization survey: violence in the workplace, 1993-99.(Available at:) (Published 2001. Accessed January 7, 2012)
- Survey Sampling. John Wiley & Sons, New York1965
Biography
Karen Gabel Speroni is Nursing Research Scientist, Inova Loudoun Hospital, Leesburg, VA.
Biography
Tammy Fitch, Member, Metropolitan Baltimore Chapter, is Direct Care Nurse, Emergency Department, Inova Loudoun Hospital, Leesburg, VA.
Biography
Elaine Dawson is Employee Health & Safety, Inova Loudoun Hospital, Leesburg, VA.
Biography
Lisa Dugan, Member, Northern Virginia Chapter, is Chief Nurse Officer, Inova Loudoun Hospital, Leesburg, VA.
Biography
Martin Atherton is Statistician, Inova Loudoun Hospital, Leesburg, VA.
Article info
Publication history
Published online: September 19, 2013
Accepted:
May 25,
2013
Received in revised form:
April 19,
2013
Received:
February 21,
2013
Footnotes
Earn Up to 9.5 CE Hours. See page 295.
Partial funding for this research was received from the Emergency Nurses Association Foundation (industry-supported 2011 research grant sponsored by Stryker) and from the Epsilon Zeta Chapter of Sigma Theta Tau International.
Identification
Copyright
© 2014 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
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- Incidence and Cost of Workplace ViolenceJournal of Emergency NursingVol. 41Issue 1
- PreviewI wanted to comment on the article “Incidence and Cost of Nurse Workplace Violence Perpetrated by Hospital Patients or Patient Visitors.”1 I have spent 26 years as a paramedic and nurse in the emergency department. I am very familiar with workplace violence (WPV). Statistics from the 2011 US Bureau of Justice indicated that the rate of nurse WPV was 3.9%. The estimated cost associated with WPV was $4.2 billion. I believe that both of these numbers are woefully lower than the actual numbers. I agree with the reported precipitating factors for WPV in the emergency department, such as large volumes of patients, along with drug-seeking behavior, alcohol intoxication, and drug use.
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