A study of patient assault -related injuries in state psychiatric hospitals

We surveyed nurses and mental health workers (MHWs) working in six state psychiatric hospitals to identify factors that predict the risk of patient assault-related injuries to staff. We assessed workers\u27 perceptions of ward performance, ward safety climate, and recall of patient assault-related injuries over a one-year period. Fifteen percent of participants experienced a major to severe patient assault. The results suggested that for a worker in a ward with low safety climate supervisory actions, the odds of experiencing a patient assault-related injury are 5 times greater than for workers in a ward with high safety climate supervisory actions (OR = .2, 95% CI = .0 - .8, p = .02). No effect on the odds of patient assault-related injury was found for ward performance. Other important factors that increased the odds of experiencing a patient assault-related injury included: being a MHW, working the day shift, and working in a particular hospital. Another significant finding was that the odds of experiencing a patient assault-related injury was 2.5 times greater for respondents who believed that patient seclusion and restraint was not beneficial to use with patients than for respondents who held favorable beliefs about using seclusion and restraint (OR = .4, CI = .2 - .8, p \u3c .001). The implications of our study are that a high level of safety climate is protective for experiencing patient assault-related injuries. This finding demonstrates the importance of ward supervisors providing feedback about workers\u27 safety conduct, which in turn, can decrease the risk of staff injuries in psychiatric wards. Considering the Centers for Medicare and Medicaid\u27s rule about minimizing the use of patient seclusion and restraint, we support that these containment strategies remain an important option for staff self-protection in psychiatric wards