Prevalence of assault and perception of risk of assault in urban public service employment settings

Difference in Work-Related Violence by Nurse License Type

Nurses are at considerable risk for work-related violence. This study compared the experiences of work-related violence among registered nurses (RNs) and licensed practical nurses (LPNs) to quantify differences in risks and exposures and to gain insight into possible interventions. A random sample (n = 6,300) of licensed Minnesota nurses was surveyed regarding the previous 12-month period. Nurses self-reported violent events and demographic information. After adjustment for potential confounders and nonresponse, LPNs had an increased risk for both physical assault (odds ratio = 1.4; 95% confidence interval = 1.1-1.9) and nonphysical violence (odds ratio = 1.2; 95% confidence interval = 1.0-1.5) compared to RNs. Some exposures resulted in increased risks for both types of violence for RNs and LPNs: working primarily in psychiatric departments and long-term care facilities. In contrast, working in clinics resulted in decreased risks for both license types. Some risks varied by license type. Risk of physical assault was increased for LPNs working with neonatal/pediatric patients, whereas RNs' risk was decreased. RNs' risk of physical violence increased while providing care, whereas LPNs' risk increased while supervising care. A better understanding of how this problem varies by license type and work setting will assist in designing efficacious interventions.

Violence toward health care workers in emergency departments in west Turkey

The aims of this study were to describe the epidemiology of violence in Turkish emergency departments (EDs), and to provide a more specific focus on violence. This study was conducted in 18 EDs in west Turkey for 3 months. Emergency staff in the EDs were asked to recall experiences of violence directed at them at work over the previous year. We then put these experiences into five categories: verbal abuse, specific threats, physical action with or without injury, sexual violence, and the last category, acts not falling in the other four categories. The data were analyzed using chi-square test and percent ratios. Of the 195 respondents answering the questions regarding violence against them, 72.3% (141/195) had experienced some form of violence. Most of the respondents stated that they had experienced verbal/emotional abuse (69.5%), followed by specific threats (53.2%), and physical action (8.5%). Groups experiencing the highest percentage of any type of violence during the previous year were as follows: 30-39-year-olds (82.1%), nurses and physicians (80.8% and 78.0%, respectively), public hospital health care staff (81.0%), staff working for 61-120 months (82.8%), those working between 8:00 a.m. and 5:00 p.m. (81.8%), and those working in low deprivation practices (79.6%). Most of the aggressors were patients' relatives (89%) as compared with patients' themselves (52%). Half of those experiencing physical action (50% [6/12]) during the course of the last year received support and inability reports due to minor injuries. There were no major injuries such as lacerations or fractures. We recommend that training to deal with violence in the workplace be specifically targeted at members of staff who are most likely to be at risk of threats of violence and actual physical aggression.

Workplace health and safety concerns in service organizations in the inner city

There is little known about occupational health and safety concerns or programs in workplaces in the inner city. This work was part of a needs assessment for development of occupational health and safety programs for workplaces in the inner city. Its key objective was to identify inner-city worker concerns regarding specific hazards. The work involved two phases. The first sampled workers in an inner-city hospital and church, and the second involved both paid and volunteer workers in inner-city community outreach programs. The key concerns raised by inner-city workers were infectious disease and personal safety and violence. Occupational health and safety programs need to address infectious disease and personal safety issues in this environment. Further research is needed regarding workplace health and safety in inner-city workplaces, both regarding hazards particular to the inner city and occupational health programs for the workers, both paid and volunteer, who work there.

An epidemiological study of the magnitude and consequences of work related violence: the Minnesota Nurses' Study

AIMS

To identify the magnitude of and potential risk factors for violence within a major occupational population.

METHODS

Comprehensive surveys were sent to 6300 Minnesota licensed registered (RNs) and practical (LPNs) nurses to collect data on physical and non-physical violence for the prior 12 months. Re-weighting enabled adjustment for potential biases associated with non-response, accounting for unknown eligibility.

RESULTS

From the 78% responding, combined with non-response rate information, respective adjusted rates per 100 persons per year (95% CI) for physical and non-physical violence were 13.2 (12.2 to 14.3) and 38.8 (37.4 to 40.4); assault rates were increased, respectively, for LPNs versus RNs (16.4 and 12.0) and males versus females (19.4 and 12.9). Perpetrators of physical and non-physical events were patients/clients (97% and 67%, respectively). Consequences appeared greater for non-physical than physical violence. Multivariate modelling identified increased rates for both physical and non-physical violence for working: in a nursing home/long term care facility; in intensive care, psychiatric/behavioural or emergency departments; and with geriatric patients.

CONCLUSIONS

Results show that non-fatal physical assault and non-physical forms of violence, and relevant consequences, are frequent among both RNs and LPNs; such violence is mostly perpetrated by patients or clients; and certain environmental factors appear to affect the risk of violence. This serves as the basis for further analytical studies that can enable the development of appropriate prevention and control efforts.

Multiple Risk Factors for Violence to Seven Occupational Groups in the Swedish Caring Sector

Violence towards health-care personnel represent an increasing problem, but little is known in terms of how different occupational groups are affected. A questionnaire was sent to a stratified sample of 2,800 of 173,000 employees in the Swedish municipal health and welfare sector. Seven major groups working with the elderly or persons with developmental disabilities were considered: administrators, nursing specialists, supervisors, direct carers, nursing auxiliaries, assistant nurses, and personal assistants. The response rate was 85 percent. Fifty-one percent of respondents reported exposure to violence or threats of violence over one year. The most vulnerable groups were assistant nurses and direct carers (usually of the developmentally disabled). Individual characteristics, such as age and organizational tenure, were related to exposure. Work-related characteristics, such as type of workplace, working full-time with clients, organizational downsizing, and high workload, were also associated with risk. Greater knowledge of impacts on different professional groups and relevant prevention are required.

The reproductive and occupational health of women street vendors in Johannesburg, South Africa

While the informal sector is rapidly emerging as the major source of employment in poor countries, little attention has been paid to the health hazards encountered by workers in this sector. Women, the majority of informal sector workers in most parts of the world, are particularly at risk. This paper reports on 422 women street vendors trading in 323 city blocks in Johannesburg, South Africa. The median age was 29 years, 66% were single, 29% had primary education and 58% had secondary schooling. Foreign-born women accounted for 15% of the sample and a further 59% of the women were not born in Johannesburg. More than a third of the women did not work for themselves and 48% earned <115 US dollars per month. Fertility was positively related to age and inversely related to education, while reported infertility was related to gynaecological disease. More than half the women used, mainly injectable, contraceptives and only 5% reportedly had PAP smears taken. Most of the women sold food and clothing, 51% lifted heavy weights and a small proportion of the women worked with fire. Over half of the women (54%), mainly those over 40 years and the self-employed, complained of a work-related illness or injury, mainly burns, cuts, headaches and musculoskeletal problems. The type of health problem was related to age and 32% had received treatment. More than half (52%) of the respondents reported that they were not comfortable with the working environment, for reasons ranging from lack of shelter and dirt (34%), noise (26%) and having to clean the area themselves (24%). While only 2% reported that they felt unsafe, violence and abuse was ever present. Approximately one in four women reported some form of abuse, either verbal or physical, while 7% reported that they had been sexually harassed. A substantial proportion (29%) of the women reported that they had been robbed of money or goods while trading in the streets. The implications of these findings are discussed.