By: Lisbeth Votruba, MSN, RN, is Vice President of Clinical Quality and Innovation at AvaSure
Workplace violence is a well-understood fact of the daily lives of nurses, who are subject to a growing amount of abuse from patients and visitors. And yet, despite all of the research and debate on the topic, it is estimated that fewer than a third of all incidents are reported by nurses to their supervisors. There seems to be a cultural belief that abuse is just part of the job; many staff don’t report it because they don’t believe anything will be done about it. Only a few states have enacted legislation creating a process for reporting such data.
AvaSure’s initial uses were for fall prevention and sitter reduction. However, we soon heard anecdotal reports of nurses using the solution to keep caregivers safe. Following the lead of customers, AvaSure designed and released a new software version in 2016 that allowed monitoring staff to document witnessed physical or verbal abuse events, as well as “near miss” incidents where they believed they prevented an injury to bedside caregivers.
In 2018 there were 71 hospitals that documented abuse events. Abusive behavior may occur between patient and caregiver, visitor to caregiver, patient to visitor, or visitor to patient.
AvaSure adviser Patricia A. Quigley, Jill Kaminski, our Clinical Data and Systems Analyst, and I co-authored an article analyzing these events, which will be published in American Nurse Today later this year. Major findings include:
- Nursing judgment alone is not that sensitive or specific for identifying which patients will be violent – most of the patients that perpetrated violence on caregivers were being monitored for fall prevention
- 11% of the verbal abuse reported was a threat to kill the caregiver
- For every abuse event reported, monitoring staff reported avoiding 40 events mainly through verbally redirecting patients
Based on our results, we can suggest that AvaSure program managers:
- Review their hospital’s observation policy to place patients who are aggressive/violent on the TeleSitter. Many of these patients present in the emergency department, and video monitoring can provide staff safety for not only the clinical staff but ancillary staff as well.
- Train monitoring staff to recognize escalating aggressive behavior to proactively identify issues before they lead to a violent event.
- If a patient’s aggressive behavior requires a one-on-one observation, consider utilizing a monitoring device in the room as a backup to provide safety for the sitter.
As more and more hospitals adopt AvaSure and take advantage of the software to track abuse of staff, we hope to shed new light on this issue and spur action to keep frontline staff safe.