Insights of nurses about assault in hospital-based emergency departments.

PURPOSE: To explore contributing factors, consequences, and solutions to the assault of nurses working in U.S. hospital emergency departments. This preliminary study targeted emergency nurses whose risk for assault was significantly greater than many other workers. Exploring nurses' opinions about factors they believe contribute to assault provides important information for designing acceptable preventive measures. DESIGN: In this descriptive study, an ecological, occupational-health framework was used which integrates personal, organizational, and societal influences. The six components of the framework were personal factors, workplace factors, environmental factors, assault injuries, solutions, and effects of workplace violence. METHOD: Four focus groups were used comprised of 22 RNs employed in emergency departments in one large metropolitan area in the United States. Half the nurses had been physically assaulted at work. FINDINGS: Fourteen themes emerged: nurse attitude, vulnerability, security, administrative issues, assault reporting, safety training, beyond control, societal changes, types of patients, geographic location, pervasiveness of anger, previous assault experiences, effects and possible solutions. Personal, workplace, and environmental factors all contribute to assault. Verbal and physical assaults are common and affect nurses' personal and professional lives. CONCLUSIONS: Assault-related injuries are preventable. Only physical injuries are treated; all employees who have been verbally or physically assaulted should be referred for post-incident debriefing. Hospital managers should implement violence-prevention programs. The ecological, occupational health framework is useful for identifying factors that contribute to assault.

Workplace violence: female occupational homicides in metropolitan Chicago.

Homicide is the leading cause of fatal occupational injuries for women and accounts for 39% of all fatal injuries for women at work. Using medical examiner and coroner reports, this study analyzed female workplace homicides in three counties within metropolitan Chicago from 1984 to 1990. These workplace homicides were compared to non-workplace homicides of women. There were 1,354 female homicides; of the 17 workplace homicides, all occurred in Cook County. The annual rate of female occupational homicides was higher (1.5/10(5)) for Cook County, while for the metropolitan Chicago area (Cook, DuPage, and Lake counties) it was 1.19/10(5). Black women experienced a higher workplace homicide rate (2.3/10(5)) than white women (1.2/10(5)). Most of these occupational homicides occurred in retail trade, predominately in eating and drinking establishments; robbery was a frequent occurrence, and the women often worked alone. Only three medical examiner reports cited a known assailant. The leading cause of death was from gunshot wounds. Workplace homicides were similar to non-workplace homicides in relation to age, race, and cause of death. Identified risk factors associated with workplace homicides, as well as non-fatal assaults, should be used to develop effective preventive measures. A national standard for general workplace security also is needed.

Health hazards of nursing: identifying workplace hazards and reducing risks.

Nurses often work in settings in which they may be exposed to a wide array of psychosocial, chemical, biological, and physical hazards. The authors outline several ways in which occupational exposures occur and the general process for reducing or preventing workplace hazards. Several commonly encountered workplace hazards and their potential health risks are identified and discussed. Specific health hazards that are addressed include the chemical hazards of antineoplastic and antiviral drugs; the biological hazards of human immunodeficiency virus, hepatitis B, herpes viruses, rubella, and tuberculosis; and the physical hazards of noise and ionizing and nonionizing radiation. The authors suggest specific preventive measures that nurses can take to make their workplaces safer.

Female workplace homicides: an integrative research review.

1. Between 1980 and 1985, murder on the job was the leading cause of fatal injuries for women compared to being the third leading cause for men. The annual female homicide rate per 100,000 women ranged from 0.05 to 0.7. 2. Risk factors that were identified included age 65 and over, black, and work involving the exchange of money. The primary cause of death was gunshot wounds. 3. Suggested prevention strategies were environmental controls, training, policy, and research. 4. Occupational health nurses need to recognize homicide as an occupational hazard, determine high risk employees and situations, and implement programs to reduce violence related stress.