Hospital workers bypass traditional occupational injury reporting systems when reporting patient and visitor perpetrated (type II) violence.

BACKGROUND: Under-reporting of type II (patient/visitor-on-worker) violence by workers has been attributed to a lack of essential event details needed to inform prevention strategies. METHODS: Mixed methods including surveys and focus groups were used to examine patterns of reporting type II violent events among ∼11,000 workers at six U.S. hospitals. RESULTS: Of the 2,098 workers who experienced a type II violent event, 75% indicated they reported. Reporting patterns were disparate including reports to managers, co-workers, security, and patients' medical records-with only 9% reporting into occupational injury/safety reporting systems. Workers were unclear about when and where to report, and relied on their own "threshold" of when to report based on event circumstances. CONCLUSIONS: Our findings contradict prior findings that workers significantly under-report violent events. Coordinated surveillance efforts across departments are needed to capture workers' reports, including the use of a designated violence reporting system that is supported by reporting policies. Am. J. Ind. Med. 59:853-865, 2016. © 2016 Wiley Periodicals, Inc.

The Duration of Self-Selected Music Needed to Reduce Preoperative Anxiety.

PURPOSE: Preoperative anxiety affects patients both physically and psychologically. It may also influence the patient's perioperative experience and result in reduced patient satisfaction with care and potentially delayed recovery. Previous research indicates that patients who listen to music in the perioperative setting experience less anxiety than patients who do not listen to music. Research does not address the duration of music required to effectively reduce anxiety in this population. DESIGN: A randomized control trial was used. METHODS: Two intervention groups (15-minute music and 30-minute music) and one control group (no music) were compared. FINDINGS: Patients (n = 133) demonstrated less anxiety after listening to either 15 or 30 minutes of music (P < .0001). Patients (n = 47) who listened to 15 minutes of music demonstrated less anxiety than those who did not listen to music (P = .005), whereas patients (n = 41) who listened to 30 minutes of music demonstrated less anxiety than those who did not listen to music (P < .001). CONCLUSIONS: Listening to as little as 15 minutes of music preoperatively is an effective method to reduce anxiety in patients who are about to have surgery.

An urgent need to understand and address the safety and well-being of hospital "sitters".

BACKGROUND: Hospital sitters provide continuous observation of patients at risk of harming themselves or others. Little is known about sitters' occupational safety and well-being, including experiences with patient/visitor-perpetrated violence (type II). METHODS: Data from surveys, focus groups, individual interviews at six U.S. hospitals were used to characterize the prevalence of and circumstance surrounding type II violence against sitters, as well as broader issues related to sitter use. RESULTS: Sitter respondents had a high 12-month prevalence of physical assault, physical threat, and verbal abuse compared to other workers in the hospital setting. Sitters and other staff indicated the need for clarification of sitters' roles regarding patient care and sitter well-being (e.g., calling for assistance, taking lunch/restroom breaks), training of sitters in personal safety and de-escalation, methods to communicate patient/visitor behaviors, and unit-level support. CONCLUSIONS: The burden of type II violence against hospital sitters is concerning. Policies surrounding sitters' roles and violence prevention training are urgently needed.

Physical assault, physical threat, and verbal abuse perpetrated against hospital workers by patients or visitors in six U.S. hospitals.

BACKGROUND: An elevated risk of patient/visitor perpetrated violence (type II) against hospital nurses and physicians have been reported, while little is known about type II violence among other hospital workers, and circumstances surrounding these events. METHODS: Hospital workers (n = 11,000) in different geographic areas were invited to participate in an anonymous survey. RESULTS: Twelve-month prevalence of type II violence was 39%; 2,098 of 5,385 workers experienced 1,180 physical assaults, 2,260 physical threats, and 5,576 incidents of verbal abuse. Direct care providers were at significant risk, as well as some workers that do not provide direct care. Perpetrator circumstances attributed to violent events included altered mental status, behavioral issues, pain/medication withdrawal, dissatisfaction with care. Fear for safety was common among worker victims (38%). Only 19% of events were reported into official reporting systems. CONCLUSIONS: This pervasive occupational safety issue is of great concern and likely extends to patients for whom these workers care for.