Occupational violence in health care: Final Report

EXECUTIVE SUMMARY
This review examines the literature related to occupational violence in health care. Occupational violence in health care is prevalent, with up to 95% of health care workers reporting experiencing violence. In health care, patients, family and visitors of patients are the primary source of violence and aggression, and therefore client-initiated violence is the focus of this review.

Prevalence
Occupational violence occurs in a wide variety of health care settings. The common types of violence experienced by health care workers are verbal and physical abuse. There are many negative consequences of violence in healthcare, including increased incidents of depression, sleep and anxiety disorders, drug and alcohol problems, Post Traumatic Stress Disorder (PTSD), and reduced staff retention. Risk factors linked to occupational violence in health care include patient characteristics, staff characteristics, organisational factors, and physical design of the workplace and setting.

Interventions
A number of interventions have been introduced to reduce occupational violence in health care. These interventions can be broadly grouped under the following headings: education, patient risk assessment, environmental factors, organisational policy (including zero tolerance), and restraint. There is a paucity of data evaluating the effectiveness of these interventions.

Reporting
There are low reporting rates for occupational violence with estimates only 20% of events are reported. Reasons for under-reporting include worker tolerance of violence, violence is perceived as just part of the job, lack of co-worker and manager support, and lack of management action. The systems for reporting occupational violence include RiskMan, risk assessment tools, integrated IT systems and paper based incident reports. There is limited evaluation of the reporting systems.

Conclusion
The review is presented in three sections; i) prevalence of occupational violence in health care (including risk factors, and sources of violence), ii) interventions aimed at reducing occupational violence in health care, and iii) surveillance or reporting of occupational violence in health care.