Background Type II (customer-on-worker) workplace violence (WPV) against nurses and its underreporting are ongoing safety and health challenges in health care. The COVID-19 pandemic has strained patients and nurses and, in turn, may have increased WPV. The purpose of this cross-sectional study was to describe and compare a sample of nurses’ reported prevalence of Type II WPV and their reporting of these events during the pandemic. Methods Data from an online survey of registered nurses ( N = 373) working in hospitals were included. Prevalence was calculated for physical violence and verbal abuse, and their reporting of these events, including the experience of violence between nurses who did and did not care for patients with COVID-19. Findings Overall, 44.4% and 67.8% of the nurses reported experiencing physical violence and verbal abuse, respectively, between February and May/June 2020. Nurses who provided care for patients with COVID-19 experienced more physical violence (adjusted odds ratio [aOR] = 2.18, 95% confidence interval [CI] = [1.30, 3.67]) and verbal abuse (aOR = 2.10, 95% CI = [1.22, 3.61]) than nurses who did not care for these patients. One in 10 nurses felt reporting the incident was more difficult during the pandemic. Conclusion/Application to Practice A significant proportion of nurses who cared for patients with COVID-19 experienced more physical violence and verbal abuse, and more difficulty in reporting to management. As the pandemic continues, health care organizations need to recognize that workers may be at an elevated risk for experiencing WPV and may be less likely to report, resulting in an urgent need for prevention efforts on their part.

Shelter staff and veterinarians routinely make subjective dog breed identification based on appearance, but their accuracy regarding pit bull-type breeds is unknown. The purpose of this study was to measure agreement among shelter staff in assigning pit bull-type breed designations to shelter dogs and to compare breed assignments with DNA breed signatures. In this prospective cross-sectional study, four staff members at each of four different shelters recorded their suspected breed(s) for 30 dogs; there was a total of 16 breed assessors and 120 dogs. The terms American pit bull terrier, American Staffordshire terrier, Staffordshire bull terrier, pit bull, and their mixes were included in the study definition of 'pit bull-type breeds.' Using visual identification only, the median inter-observer agreements and kappa values in pair-wise comparisons of each of the staff breed assignments for pit bull-type breed vs. not pit bull-type breed ranged from 76% to 83% and from 0.44 to 0.52 (moderate agreement), respectively. Whole blood was submitted to a commercial DNA testing laboratory for breed identification. Whereas DNA breed signatures identified only 25 dogs (21%) as pit bull-type, shelter staff collectively identified 62 (52%) dogs as pit bull-type. Agreement between visual and DNA-based breed assignments varied among individuals, with sensitivity for pit bull-type identification ranging from 33% to 75% and specificity ranging from 52% to 100%. The median kappa value for inter-observer agreement with DNA results at each shelter ranged from 0.1 to 0.48 (poor to moderate). Lack of consistency among shelter staff indicated that visual identification of pit bull-type dogs was unreliable.

Background Home healthcare workers (HHWs) provide medical and nonmedical services to home‐bound patients. They are at great risk of experiencing violence perpetrated by patients (type II violence). Establishing the reliable prevalence of such violence and identifying vulnerable subgroups are essential in enhancing HHWs’ safety. We, therefore, conducted meta‐analyses to synthesize the evidence for prevalence and identify vulnerable subgroups. Methods Five electronic databases were searched for journal articles published between 1 January 2005 and 20 March 2019. A total of 21 studies were identified for this study. Meta‐analyses of prevalence were conducted to obtain pooled estimates. Meta‐regression was performed to compare the prevalence between professionals and paraprofessionals. Results Prevalence estimates for HHWs were 0.223 for 12 months and 0.302 for over the career for combined violence types, 0.102 and 0.171, respectively, for physical violence, and 0.364 and 0.418, respectively, for nonphysical violence. The prevalence of nonphysical violence was higher than that of physical violence for professionals in 12 months (0.515 vs 0.135) and over the career (0.498 vs 0.224) and for paraprofessionals in 12 months (0.248 vs 0.086) and over the career (0.349 vs 0.113). Professionals reported significantly higher nonphysical violence for 12‐month prevalence than paraprofessionals did (0.515 vs 0.248, P = .015). Conclusion A considerable percentage of HHWs experience type II violence with higher prevalence among professionals. Further studies need to explore factors that can explain the differences in the prevalence between professionals and paraprofessionals. The findings provide support for the need for greater recognition of the violence hazard in the home healthcare workplace.

Background: Home health care nurses (HHNs) work alone in patients’ homes. They experience high rates of Type II (client/patient-on-worker) workplace violence (WPV); however, little is known about the extent and factors of their reporting. Methods: A convenience sample of employees aged 18 years and older and working as an HHN or management staff were recruited from a U.S. nonprofit home health care agency. To describe the extent of reporting of WPV events, an HHN survey was conducted. To identify the barriers and facilitators to reporting, two HHN focus groups were conducted, and management key informant interviews were employed. Findings: We recruited 18 HHNs and five management staff into the study. Almost all HHNs reported to management the most serious forms of violence they experienced, and that HHNs reported WPV when they perceived that reporting was beneficial (alerting other nurses and management) and supported by management staff. However, they were unwilling to report when it was perceived as disadvantageous (reliving the trauma), discouraged (by a norm that experiencing violence is a part of the job), unachievable (unstandardized reporting process), and ambiguous (uncertain of what is reportable). Management staff perceived a lack of standardized reporting processes as a barrier when responding to HHNs’ reporting. Conclusion/Application to Practice: High reporting was related to strong support from management. Policies and procedures should clearly define WPV, the threshold for reporting, how to report, and how management will respond to the reports.