An Interdisciplinary Clinical Approach for Workplace Violence Prevention and Injury Reduction in the General Hospital Setting: S.A.F.E. Response

Author:

Lakatos Barbara E.1ORCID,Mitchell Monique T.2,Askari Reza3,Etheredge Mary Lou4,Hopcia Karen5,DeLisle Leslie6,Smith Christine7,Fagan Maureen8,Mulloy Deborah9,Lewis-O’Connor Annie10,Higgins Margaret11,Shellman Andrea12

Affiliation:

1. Barbara E. Lakatos, DNP, PMHCNS-BC, APRN, Brigham and Women’s Hospital, Boston, MA, USA

2. Monique T. Mitchell, MS, PMHCNS-BC, APRN, Brigham and Women’s Hospital, Boston, MA, USA

3. Reza Askari, MD, Brigham and Women’s Hospital, Boston, MA, USA

4. Mary Lou Etheredge, MS, PMHCNS-BC, APRN, Brigham and Women’s Hospital, Boston, MA, USA

5. Karen Hopcia, ScD, CNP, ANP-BC, COHN-S, FAAOHN, Brigham and Women’s Hospital, Boston, MA, USA

6. Leslie DeLisle, MS, PMHCNS-BC, APRN, Brigham and Women’s Hospital, Boston, MA, USA

7. Christine Smith, RN, MSN, Brigham and Women’s Hospital, Boston, MA, USA

8. Maureen Fagan, DNP, FNP-BC, FAAN, Brigham and Women’s Hospital, Boston, MA, USA

9. Deborah Mulloy, PhD, RN, CNOR, Brigham and Women’s Hospital, Boston, MA, USA

10. Annie Lewis-O’Connor, NP-BC, MPH, PhD, Brigham and Women’s Hospital, Boston, MA, USA

11. Margaret Higgins, MSN, RN, Brigham and Women’s Hospital, Boston, MA, USA

12. Andrea Shellman, MHSA, CPPS, Brigham and Women’s Hospital, Boston, MA, USA

Abstract

BACKGROUND: Workplace violence is a major public health concern. According to the U.S. Bureau of Labor Statistics, from 2002 to 2013, incidents of serious workplace violence (those requiring days off) were four times more common in health care than in private industry. AIMS: An interprofessional committee developed, implemented, and evaluated a quality improvement project from 2012 to 2016 to reduce workplace violence and prevent staff injury. The initiative termed S.A.F.E. Response stands for Spot a threat, Assess the risk, Formulate a safe response, Evaluate the outcome. METHOD: An institutional review board–approved quality improvement survey was implemented and evaluated. The data were analyzed using descriptive statistics. An interprofessional committee developed and implemented a comprehensive program to prevent injury, which included (a) a mandatory eLearning educational training, (b) a S.A.F.E. Response with standardized interventions for the clinical conditions affecting safety, and (c) a clinical debriefing process. A reduction in nursing staff assault incidence rates was identified as a success. RESULTS: Nursing staff injury rates decreased an average of 40%. CONCLUSIONS: A reduction in nursing staff assault incidence rates was notable. Clinicians equipped with knowledge, skills, and resources can identify and defuse unsafe situations to prevent violence. This clinical approach shifts the focus from crisis intervention to crisis prevention, which reduces injury.

Publisher

SAGE Publications

Subject

Phychiatric Mental Health

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