Carrie Sona, BSN, CCNS, CCRN, MSN
Clinical Nurse Specialist
Barnes Jewish Hospital
Saint Louis, MO
Disclosure information not submitted.
Beth Taylor, DCN, RD-AP,FCCM
Research Scientist
Barnes-Jewish Hospital
Maryville, Illinois
Disclosure information not submitted.
Donna Prentice, PhD, RN, CNS, FCCM
Research Scientist
Barnes-Jewish Hospital
Saint Louis, Missouri, United States
Disclosure information not submitted.
.jpg "Marilyn Schallom, CCNS, PhD, FCCM photo")
Marilyn Schallom, CCNS, PhD, FCCM
Research Scientist
Barnes-Jewish Hospital
Saint Louis, MO
Disclosure information not submitted.
Erin schepis, MSN, RN
Clinical Nurse Manager
Barnes Jewish Hospital, United States
Disclosure information not submitted.
Stephanie Banaszynski, MSN, RN
Registered Nurse
Barnes Jewish Hospital, United States
Disclosure information not submitted.
Anna Wyman, BSN, RN
Registered Nurse
Barnes Jewish Hospital, United States
Disclosure information not submitted.
Ramonda George, BSN, RN
RN
Barnes Jewish Hospital, United States
Disclosure information not submitted.
Angela Seley, BSN, RN
Assistant Nurse Manager
Barnes Jewish Hospital, United States
Disclosure information not submitted.
gail willmann, BSN, RN
Assistant Nurse Manager
Barnes Jewish Hospital, United States
Disclosure information not submitted.
Title: Workplace Violence Pilot Study: Response Algorithms and other Measures for Staff Safety
Introduction/Hypothesis: Workplace violence (WPV) toward healthcare workers (HCW) leads to physical and mental health issues impacting absenteeism, productivity, quality of work and employee turnover. WPV events are underreported. The stressful intensive care unit (ICU) environment increases HCW exposure to WPV. The purpose of this pilot was to examine the impact of WPV prevention training and response strategy bundles on ICU staff comfort/consistency in assessing and managing events and frequency and severity of events.
Methods: Process improvement (PI) project of surgical ICU staff. Training included definition of WPV, Crisis Prevention Intervention (CPI), Therapeutic Communication (TC), Aggressive Behavior Risk Assessment Tool, Response Algorithms and Occupational (OH) online reporting tool. WPV Response Algorithms were available for clinicians and leadership response to three levels: level 3– non-responsive escalating behaviors; level 2 – verbal abuse; and level 1- physical abuse. A pre/post survey design was used for staff input. Pre/Post intervention compared count of type and level of WPV injury events report to OH. An independent sample T test was completed on the survey.
Results: 125 pre and 55 post-surveys were completed. Most were bedside nurses, followed by patient care techs and providers, majority were female (78%). Significant findings were improvement in staff confidence (mean 7.5 to 8.45, p< .001), ability to respond to WPV (mean 6.72 to 8.05, p < .001), and easier dealing with aggressive behavior (4.43 to 5.63, p =.002). Most WPV involved nurses with no reported injury from event. Contributing factors were cognitive and mental health concerns. Top 3 care activities at the time of WPV were general assessment, mobility, and airway care. Total number of events for 3 months prior to the pilot (July – September 2020) was 12 for an average of 4/month. October 2020 showed an increase in reported WPV events at initiation of the project. The WPV events post, November 2020 through June 2021, were 29 (3.6/month).
Conclusions: Staff found education and response algorithms useful when responding to a WPV event. Simulation training provides opportunity to practice new skills. Initial increase in events is expected as reporting understanding improves. Ongoing PI to reduce frequency and severity is needed.