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，对医护人员的暴力是一种严重的职业危险，威胁到员工的安全、健康、工作效率、留任和护理质量。NIOSH制定了战略目标，旨在总体上减少不健康的工作环境，特别是在保健和社会援助部门的1700万雇员中减少工作场所暴力。[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。迫切需要标准化工作场所暴力数据收集、流行病风险分析，并将收集的数据转化为有效的暴力预防工作。]这项建议的长期目标是制定工作场所暴力监测、风险评估和预防的标准化方法。该项目的具体目标是：(1)开发和评价由医院安全、职业健康、护理、安保、人力资源[和劳工]代表按照最终用户规格编制的标准化、数据库生成的暴力事件报告；(2)[使用CDC/NIOSH危险风险矩阵]制定和实施战略，[研究数据库数据并]帮助医院管理[和劳工]确定[暴力干预工作地点]的优先次序；以及(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]来前瞻性地评估[工作场所走访]干预的效果。这项工作将在一个拥有14,500名员工的多地点大都市医院系统内进行。在之前与医院系统的[独特的]数据库的工作中，这个研究小组开发了计算[工作场所]暴力的发生率和风险因素的方法。拟议的参与性行动研究项目将在这一方法的基础上进一步发展，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、安保、人力资源和劳工专业人员积极合作。利用焦点小组讨论，我们将根据这些[关键医院系统利益相关者]的规范，开发用户[改编]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，将使用危险风险矩阵作为评估分配暴力预防工作的优先事项的框架，研究这些工作场所暴力报告。根据该小组的分析，将使用[随机]设计实施和评估[工作场所走访形式的暴力干预]。这项研究的结果可能成为工作场所暴力监测、风险评估和预防的标准化方法的基础，可以用于全国的医院系统[以改善工人的健康和安全]。 公共卫生相关性：工作场所对医护人员的暴力是一种流行比例的职业危害，严重威胁着1700万名员工的健康和安全。[管理]这一公共卫生问题的一个关键障碍是缺乏有效的方法来收集、分析和[利用][医院中]暴力事件的数据。[如果成功，该项目将提供一个适用于全国医院的标准化暴力监测和工作场所适应干预的集成系统。]

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.]