This study examined the use and effectiveness of the Alert assessment form. The form is part of the Alert system, used by one large acute care hospital to identify patients with a propensity for violence. All reported incidents of patient violence from August 1, 2003, through December 31, 2004, were included in patient charts. One hundred seventeen violent patient charts were reviewed and compared with 161 non-violent patient charts, randomly chosen from the same time period. Overall use of the Alert assessment form for violent and non-violent patients was 75.7% and 35.4%, respectively. The assessment form was found to have moderate sensitivity (71%) and high specificity (94%). It is reasonably effective in identifying potentially violent or aggressive patients when it is used according to protocol. Efforts to improve the tool are warranted, as is evaluation of its benefit in settings with low prevalence of violence. Also, greater effort must be taken to prevent violence once an aggressive patient has been identified.

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Technological change is a constant in today's workplace, especially the modern health care workplace. The introduction of electronic health records changes workloads, job demands, interactions with other health care professionals, and work roles-all elements that have previously been noted to increase work stress and impact health. Despite the significant changes that accompany computerization, it is seldom studied as a source of stress. Also, the health effects of computerization within health care have not been extensively studied. This article summarizes the potential environmental impact of computerization on workers, with special reference to health care workers, and suggests ways occupational health nurses can monitor the health consequences of new technology and intervene in case of adverse health impact. In many health care organizations, high work pressure and staff shortages make it impractical, and perhaps impossible, to use standard in-depth research methods to investigate this issue. Therefore, several less obtrusive methods that can be triangulated are suggested as an alternative. A s Coovert and Thompson (2002) note, "it is nearly impossible to reflect on occupational health and well-being without considering the implications of technology in the workplace" (p. 221). A National Institute for Occupational Safety and Health (NIOSH) report noted that "revolutionary changes in the organization of work have far outpaced our knowledge about the implications of these changes to the quality of working life and for safety and health on the job" (Sauter et al., 2002, p. v). Considering this, Griffiths, Mackey, and Adamson (2007) concluded in a recent review that management of occupational health risks is more effective when risk factors, generated by a changing work environment and work organization, are recognized, measured, and controlled to minimize the incidence of work-related musculoskeletal disorders. Technological change is a constant feature of today's

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