Healthcare Workplace Violence Injuries Up From 2012-2014

Laurie Barclay, MD

April 23, 2015

From 2012 to 2014, workplace violence injury rates increased for all healthcare job classifications and nearly doubled for nurse assistants and nurses, according to data from the Occupational Health Safety Network (OHSN).

"The health care and social assistance sector accounts for the greatest proportion (20.7%) of private industry nonfatal occupational injuries among all sectors," write Ahmed E. Gomaa, MD, from the Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, and colleagues in an article published in the April 24 issue of the Morbidity and Mortality Weekly Report. "The most common injuries are due to patient handling; slips, trips, and falls; and workplace violence."

To help target and measure the effect of prevention measures toward US healthcare personnel workers, departments, and activities at highest risk for injury, the web-based OHSN portal collects and reports near real-time data regarding injuries. OHSN reporting is voluntary.

From January 1, 2012, to September 30, 2014, the 112 US facilities studied reported 10,680 Occupational Safety and Health Administration–recordable injuries. There were 4674 patient handling and movement injuries; 3972 slips, trips, and falls; and 2034 workplace violence injuries. The overall rate for injuries was 11.3 per 10,000 worker-months for patient-handling injuries; 9.6 for slips, trips, and falls; and 4.9 for workplace violence.

More than half of the injuries (57%) involved nurses (38%) and nursing assistants (19%). Whereas nurses and nursing assistants had the highest rates of patient handling and workplace violence injuries, non-patient-care staff, as well as nursing staff, had high rates of slip, trip, and fall injuries. In contrast, physicians, dentists, interns, and residents had low injury rates.

The authors note that 62% of the patient-handling injury reports included information on use of lifting equipment. Of those, 82% occurred when lifting equipment was not used.

During the study period, all job classifications had an increase in workplace violence injury rates, and these rates nearly doubled for nurse assistants and nurses.

"Injury prevention interventions mitigating high-risk aspects of nurse and nurse assistant duties are needed," the report authors write. "Safety cultures that emphasize continuous improvement and support resources such as routine use of lifting equipment, as well as safe patient-handling training and lifting teams, might prevent many of the musculoskeletal disorders from patient handling and the associated costs of diagnosis, treatment, and disability."

Limitations of this report include participation of only 112 US health care facilities from 19 states, a considerable proportion of OHSN injury data categorized as "unspecified" regarding risk factors, and possible participation, reporting, and recording biases.

"Future improvements to OHSN include plans to develop a module to systematically collect detailed information on occupational injuries from needles, scalpels, and other sharp objects, and blood and body fluid exposures among health care personnel to assist in creating prevention strategies for those hazards," the report authors conclude.

The report authors have disclosed no relevant financial relationships.

Morb Mortal Wkly Rep. 2015;64:405-410. Full text

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