Violence Exposure Predicts Adverse Child Behavior: Use of Item Response Theory to Characterize Violence Experience

Healthcare work is associated with a high risk of violent incidents usually as a result of interactions with patients and the public.The purpose of this study was to assess the effect of an intervention on incidents of patient violence towards healthcare workers in a large acute care hospital in British Columbia.The Alert system is a tool used by nursing personnel to identify hospital patients with an increased risk of violence based on patient characteristics such as a prior history of violence.The intent is that workers can take precautionary measures to prevent incidents while caring for high-risk patients.All employee occupational incident reports for patient violence were identified in the study hospital from January 2002 to May 2003 and rates calculated per 100,000 hours worked for all hospital personnel.During the study period, we observed an average rate of 1.48 incidents/100,000 hours worked across all nursing units in the hospital (range 0.82-2.82incidents/100,000 hours worked).Prior to the implementation of the Alert System (Jan-March), the average rate was 1.87 incidents/100,000 hours worked.During the implementation phase, the average rate was 1.72 (April) and 3.99 (May) incidents/100,000 hours worked (data is currently being collected on the post implementation phase).This data suggests an increase in reporting of violent incidents due to worker education about the Alert system.Further, longer-term investigation is needed to assess the full impact of the Alert system.