A preliminary investigation into patterns of aggression in an Australian forensic psychiatric hospital

Daffern, Michael; Mayer, Maggie M; Martin, Trish

doi:10.1080/1478994031000074306

Cited by 52 publications

(72 citation statements)

References 31 publications

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“…[30][31][32] A few studies have explored workplace abuse among mental health professionals who were practising in forensic facilities. 30,33 It is not clear, however, whether the high risk of inmate initiated abuse among correctional officers is similarly high in correctional health professionals.…”

Section: Introductionmentioning

confidence: 99%

Workplace abuse among correctional health professionals in New South Wales, Australia

Cashmore

Indig²,

Hampton³

et al. 2012

Aust. Health Review

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Objective. Studies have found that health workers are at elevated risk of being abused while at work. Little is known, however, about workplace abuse among correctional health professionals. We implemented a cross-sectional study to investigate the prevalence, sources and consequences of workplace abuse among correctional health professionals in New South Wales, Australia.Methods. All employees of Justice Health (a statutory health corporation) were invited to complete a self-administered survey, which was delivered via the internet. Among nurses, medical doctors and allied health professionals, 299 usable surveys were returned; a response rate of 42%.Results. In the preceding 3 months, 76% of participants had personally experienced some form of abuse in their workplace, all but one of whom recalled verbal abuse. Only 16% reported physical abuse. Seventy per cent reported feeling safe in their workplace. Patients were identified as the main perpetrators of abuse, followed by fellow health staff. Participants felt that incidents of workplace abuse increased their potential to make errors while providing care to patients and reduced their productivity while at work.Conclusions. Compared with health workers who practise in a community setting, the risk of physical abuse among correctional health professionals appears to be low.What is known about the topic? Health professionals are at a high risk of workplace abuse. Studies have demonstrated that the risk of abuse varies by health profession and the practice environment. There is a paucity of research exploring workplace abuse among correctional health professionals. What does this paper add? A cross-sectional survey found that a relatively small proportion of correctional health professionals in New South Wales had been subjected to physical abuse in their workplace in the preceding 3 months. Verbal abuse, however, was reported by a majority of participants. Although patients were the most commonly reported source of abuse, a worrying level of health worker on health worker abuse (also known as horizontal abuse) was found. What are the implications for practitioners? Preventive strategies should address the temporal, environmental and structural determinants of workplace abuse in correctional and forensic facilities. More research is needed to identify the

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Section: Introductionmentioning

confidence: 99%

Workplace abuse among correctional health professionals in New South Wales, Australia

Cashmore

Indig²,

Hampton³

et al. 2012

Aust. Health Review

View full text Add to dashboard Cite

show abstract

“…However, a psychiatric hospital study in Victoria found that there was an approximately even rate of incidents reported between the hours of 9:00 a.m. and 11:00 p.m. and that no aggression occurred between midnight and 5:00 a.m. This may not be generalizable to other types of institutions (Daffern et al, 2003). Other times found to predict a higher occurrence of patient violence are during mealtimes and visiting hours (NIOSH, 2002).…”

Section: Situational Factorsmentioning

confidence: 74%

“…Certain violence control strategies may also increase the risk of further aggressive incidents occurring. It has been found that in psychiatric hospitals, the use of isolation to control aggressive or potentially aggressive patients may contribute to more frequent aggression and injury to staff (Daffern et al, 2003). This is because staff are physically assaulted more frequently during restraint than by direct assault.…”

Section: Situational Factorsmentioning

confidence: 99%

“…Consequences may include: an increased cost to the healthcare system, loss of experienced nurses from the workforce, increased staff absence from work, poor efficiency and performance at work, reduced staff numbers leading to increased pressure on those staff left to cope, higher incidence of patient and family member complaints, litigation, higher likelihood of dissatisfaction felt by patients and staff, security costs, damage to equipment and other property, unfavourable reputation for the institution and/or healthcare industry, and poor patient ratings of patient care quality (Arnetz & Arnetz, 2002;Chapman & Styles, 2006;Daffern, Mayer, & Martin, 2003;Rew & Ferns, 2005). Another important issue faced by many healthcare institutions is the difficulty of attracting people to the healthcare workforce combined with the declining number of enrolments in undergraduate nursing programs (Chang et al, 2005;Jackson & Daly, 2004), and nursing shortfalls (Schubert, 2004).…”

Section: Organizational and Industrial Consequencesmentioning

confidence: 99%

“…Such features include areas with inadequate security; overcrowded waiting rooms and smoking areas; uncomfortable temperature (especially heat); inadequate lighting in corridors, rooms, parking lots, and other areas; high numbers of beds in each room; a ward/unit layout in which beds are in close proximity; lack of privacy; and excessive noise (both common noises such as radios or people shouting, and unexpected noise such as squeaking doors, door bells, or other patients making noise late at night) (Daffern et al, 2003;HCC, 2005;NIOSH, 2002). Additionally, off-site visits to client homes can also put healthcare workers at more risk, as can emergencies where staff must work in car parks or ambulance bays, particularly in high-crime areas (Mayhew & Chappel, 2001a).…”

Section: Situational Factorsmentioning

confidence: 99%

See 2 more Smart Citations

Risk Factors, Consequences, and Management of Aggression in Healthcare Environments

Brooks

Staniford²,

Dollard

et al. 2010

Contemporary Occupational Health Psychology

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Coercive Measures in the Management of Imminent Violence: Restraint, Seclusion and Enhanced Observation

Whittington

Baskind

Paterson

Violence in Mental Health Settings

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First paragraph: Even the most effective prediction techniques will not prevent all aggression in mental health care settings and when deescalation alone (see preceding chapter) is ineffective, staff will make the judgment to move toward more intrusive techniques, alongside continued deescalation, to coerce and ultimately control the patient. Such coercive and physical control is fraught with ethical, moral, and legal dilemmas and can be a potent cause of physical injury and psychological harm in both patients and staff. Once the decision to "up the stakes" has been taken, it is difficult to go back down the ladder of coercive interventions and there is a real risk that incompetent coercion can exacerbate the situation and be highly dangerous to the patient. In this chapter we will consider three things. Firstly, we will examine some of the difficult conceptual, ethical, and legal issues around the use of coercive measures in psychiatry. Secondly we will summarize some key, best practice, guidelines with regard to special observation, physical restraint, and seclusion with reference to the relevant sections of the UK National Institute for Clinical and Health Excellence (NICE) Clinical Practice Guidelines for the management of imminent violence. These guidelines are based on one of the most extensive and thorough appraisals of existing research on this issue. Thirdly, since this is a rapidly evolving area, we will examine recent research emerging in the past two to three years which was not included in the NICE review. Special attention will be paid in this section to two high priority questions: What is the service user perspective on the causes of conflict resulting in coercive measures and the actual experience of undergoing them? And, how can mental health services around the world act to reduce their reliance on seclusion and restraint and develop alternative, less coercive interventions

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A preliminary investigation into patterns of aggression in an Australian forensic psychiatric hospital

Cited by 52 publications

References 31 publications

Workplace abuse among correctional health professionals in New South Wales, Australia

Workplace abuse among correctional health professionals in New South Wales, Australia

Risk Factors, Consequences, and Management of Aggression in Healthcare Environments

Coercive Measures in the Management of Imminent Violence: Restraint, Seclusion and Enhanced Observation

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