Assault and abuse of health care workers in a large teaching hospital

Abstract

Objectives: To determine the nature, extent and costs of injuries to health care workers caused by physical abuse.

Design: Retrospective study.

Setting: Large acute and tertiary care teaching hospital in Winnipeg.

Participants: All health care workers at the hospital who filed reports of abuse-related injuries and of verbal abuse and threatening behaviour from Apr. 1, 1991, to Mar. 31, 1993.

Outcome measures: Frequency of physical and verbal abuse of hospital personnel according to job category, type of injury, hours of staff time lost and estimates of costs compensated for abuse-related injuries.

Results: Of the 242 reported abuse-related injuries 194 (80.2%) occurred among the nursing personnel. The nurses in the medical units filed most (33.1%) of the reports. Although the psychiatric nurses filed fewer reports (35 [14.5%]) they had the highest rate of injuries per 100,000 paid hours among the nursing staff. Not surprisingly, the security officers were at highest risk, 53.5% having reported an abuse-related injury for a rate of 16.8 such injuries per 100,000 paid hours. Male staff members had a higher injury rate than their female counterparts in all occupational groups. Bruising or crushing was the most frequent type of injury (in 126 cases); the next most frequent were cuts and lacerations (in 47) and human bites and exposures to blood or body fluids (in 23). However, the 36 sprains and strains resulted in the largest amount of time lost. In all, over 8000 hours were lost due to abuse-related injuries, and over $76,000 was paid in workers' compensation benefits. Concurrently, 646 incidents of verbal abuse and threatening behaviour were reported. Only three abuse-related injuries and two incidents of verbal abuse were reported by physicians.

Conclusions: Abuse-related injuries to health care workers in an urban hospital are prevalent, serious and can be costly in terms of time off work and compensation. Underreporting is likely, especially among physicians.