Affiliation:
1. Wellstar Kennestone Hospital, Marietta, Georgia
2. Yale New Haven Children’s Hospital, New Haven, Connecticut
3. Department of Pediatrics, Seattle Children’s Hospital, Seattle, Washington
4. Departments of Psychiatry
5. University of Iowa Stead Family Children’s Hospital, Iowa City, Iowa
6. Pediatrics, Yale School of Medicine, New Haven, Connecticut
Abstract
OBJECTIVE
Mistreatment of health care providers (HCPs) is associated with burnout and lower-quality patient care, but mistreatment by patients and family members is underreported. We hypothesized that an organizational strategy that includes training, safety incident reporting, and a response protocol would increase HCP knowledge, self-efficacy, and reporting of mistreatment.
METHODS
In this single-center, serial, cross-sectional study, we sent an anonymous survey to HCPs before and after the intervention at a 213-bed tertiary care university children’s hospital between 2018 and 2019. We used multivariable logistic regression to examine the effect of training on the outcomes of interest and whether this association was moderated by staff role.
RESULTS
We received 309 baseline surveys from 72 faculty, 191 nurses, and 46 residents, representing 39.1%, 27.1%, and 59.7%, respectively, of eligible HCPs. Verbal threats from patients or family members were reported by 214 (69.5%) HCPs. Offensive behavior was most commonly based on provider age (85, 28.5%), gender (85, 28.5%), ethnicity or race (55, 18.5%), and appearance (43, 14.6%) but varied by role. HCPs who received training had a higher odds of reporting knowledge, self-efficacy, and experiencing offensive behavior. Incident reporting of mistreatment increased threefold after the intervention.
CONCLUSIONS
We report an effective organizational approach to address mistreatment of HCPs by patients and family members. Our approach capitalizes on existing patient safety culture and systems that can be adopted by other institutions to address all forms of mistreatment, including those committed by other HCPs.
Publisher
American Academy of Pediatrics (AAP)
Subject
Pediatrics,General Medicine,Pediatrics, Perinatology and Child Health
Reference39 articles.
1. Association of American Medical Colleges. Addressing and eliminating racism and the AAMC and beyond. Available at: https://www.aamc.org/addressing-and-eliminating-racism-aamc-and-beyond. Accessed December 5, 2020
2. Children’s Hospital Association. Children’s Hospital Association statement on racism and child health. Available at: https://www.childrenshospitals.org/Newsroom/Press-Releases/2020/CHA-Statement-on-Racism-and-Child-Health. Accessed December 5, 2020
3. Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: a quantitative review;Spector;Int J Nurs Stud,2014
4. Learning about medical student mistreatment from responses to the medical school graduation questionnaire;Mavis;Acad Med,2014
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献