Using a System-Wide Database to Reduce Workplace Violence in Hospitals

描述（由申请人提供）：在普通医院环境中对医护人员的暴力行为是一种重大的职业危害，威胁到员工的安全、健康、工作效率、留任和护理质量。国家职业健康与健康协会制定了战略目标，旨在减少保健和社会援助部门1 700万雇员的心理不健康的工作环境，特别是工作场所暴力。[然而，医院缺乏实用和可持续的工作场所暴力风险评估和预防系统。目前迫切需要标准化工作场所暴力数据收集、流行病学风险分析以及将收集到的数据转化为有效的暴力预防工作。本提案的长期目标是制定工作场所暴力监督、风险评估和预防的标准化方法。该项目的具体目标是：(1)编写和评价由医院安全、职业健康、护理、安保、人力资源[和劳工]方面的代表编写的符合最终用户规范的标准化数据库生成的暴力事件记录报告；(2)[使用疾病预防控制中心/NIOSH危害风险矩阵]制定和实施战略，以[研究数据库数据并]帮助医院管理[和劳工]优先考虑[工作场所]进行暴力干预；(3)通过比较[随机]干预和对照工作场所的暴力发生率和伤害率、工作满意度和员工感知的工作安全文化]，前瞻性地评估[现场演练]干预的效果。这项工作将在一个拥有14,500名员工的多站点大都市医院系统内进行。在先前与医院系统的[独特]数据库的合作中，该研究小组开发了计算[工作场所]暴力发生率和危险因素的方法。拟议的参与性行动研究项目将进一步以这种方法为基础，利用现有的电子数据收集系统和数据库，并与医院系统内的职业健康、安全、护理、保障、人力资源和劳工专业人员积极合作。通过焦点小组讨论，我们将根据这些[医院系统关键利益相关者]的具体要求，编制用户[适应的]、标准化的、计算机生成的工作场所暴力发生率和风险因素报告。在下一阶段，将使用危害风险矩阵作为评估分配预防暴力工作优先事项的框架，对这些工作场所暴力报告进行研究。根据小组的分析，将采用[随机]设计实施和评估[以工地巡视形式进行的暴力干预]。这项研究的结果可能会成为工作场所暴力监控、风险评估和预防的标准化方法的基础，这种方法可以在全国的医院系统中使用[以改善工人的健康和安全]。

DESCRIPTION (provided by applicant): Violence towards health care workers in general hospital environments is a significant occupational hazard that threatens employee safety, health, work productivity, retention, and the quality of care. NIOSH has established strategic goals aimed at the reduction of psychologically unhealthy work environments generally, and workplace violence specifically, among the 17 million employees within the Health Care and Social Assistance sector. [However, hospitals lack practical and sustainable systems for workplace violence risk assessment and prevention. There is a pressing need for standardization of workplace violence data collection, epidemiological risk analysis, and translation of collected data into effective violence prevention efforts.] The long-term objective of this proposal is to develop standardized methodology for workplace violence surveillance, risk assessment, and prevention. The specific aims of this project are to: (1) Develop and evaluate standardized, database-generated reports of documented violent incidents attuned to end-user specifications by representatives of hospital safety, occupational health, nursing, security, human resources, [and labor]; (2) Develop and implement strategies [using the CDC/NIOSH Hazard Risk Matrix] for [studying database data and] helping hospital management [and labor] to prioritize [worksites for] violence interventions; and (3) Prospectively evaluate the effect of [a worksite walkthrough] intervention by comparing [violence incidence and injury rates, work satisfaction, and staff-perceived work safety culture at [randomized] intervention and control worksites]. This work will be carried out within a multi-site metropolitan hospital system with 14,500 employees. In previous work with the hospital system's [unique] database, this research team has developed methodology for calculating incidence rates and risk factors for [workplace] violence. The proposed participatory action research project will build further on that methodology, utilizing the existing electronic data collection system and database, and working in active collaboration with occupational health, safety, nursing, security, human resource and labor professionals within the hospital system. Using focus group discussions, we will develop user-[adapted], standardized, computer-generated reports of workplace violence incidence rates and risk factors based on the specifications of these [key hospital system stakeholders]. In the next phase, these workplace violence reports will be studied using the Hazard Risk Matrix as a framework for assessing priorities for allocation of violence prevention efforts. Based on the group's analysis, [a violence intervention in the form of a worksite walkthrough] will be implemented and evaluated, using a [randomized] design. Results from this research could potentially be the foundation for a standardized methodology for workplace violence surveillance, risk assessment and prevention that could be used in hospital systems nationwide [to improve worker health and safety]. PUBLIC HEALTH RELEVANCE: Workplace violence towards health care workers is an occupational hazard of epidemic proportion, significantly threatening the health and safety of 17 million employees. A critical barrier to [managing] this public health problem is a lack of effective methods for collecting, analyzing and [utilizing] data on violent events [in hospitals]. [If successful, this project will deliver an integrated system for standardized violence surveillance and worksite-adapted intervention with applicability for hospitals nationwide.]