Assault of Long-term Care Personnel

Abstract

The purpose of this study was to explore contributing factors, consequences, and solutions to assault of long-term care personnel. The study sample consisted of three focus groups composed of certified nursing assistants and administrators employed in long-term care facilities within a large Midwestern city. Using content analysis methodology, multiple themes emerged: worker attitude, vulnerability, work culture, job tasks, training, working short-staffed, financial concerns, changes in social values and health care, community crime, substance abuse, accepting assaults, coworker threats, issues of retaliation, professional withdrawal, and inability to share experiences. Preventive measures suggested by the participants are consistent with those recommended by the Occupational Safety and Health Administration. Implications for staff and administrators include both personal and workplace strategies. Recommendations include implementing more comprehensive violence prevention programs that includes conflict management and training tailored to the type of residents.

Violence in Healthcare Facilities: Lessons From the Veterans Health Administration

“…Some recent guidelines focus on the recommendations by OSHA. 17,18 The data presented here suggest that most (85%) of the assaults experienced by clinical staff result from patient interactions and generally represent clinical issues resulting from patient care. When those are subtracted, healthcare workers experience assaults at a rate substantially below those of postal service workers or the U.S. population as a whole.…”

Aggressive Behavior of Nursing Home Residents Toward Caregivers: A Systematic Literature Review

“…The qualitative study results characterized verbal aggression, such as threats, cursing, racial slurs, screaming and yelling [6,29,30], and physical aggression, such as hitting with hand or objects, scratching, pulling hair, twisting wrists, and spitting [6,[29][30][31]. In addition to verbal and physical aggression, 1 study described physical resistance to care, which included spitting out medication or refusing to eat or drink and physically threatening gestures such as a clenched fist directed toward the caregivers [31].…”

“…Personal factors, such as lack of respect for residents or disregarding residents' preferences; workplace factors, such as being short staffed or rushed; lack of communication about specific resident needs between shifts; and lack of work ethic and responsibility (e.g., caregivers attending to residents only after they have actively demanded attention) are factors contributing to assaults on long-term care personnel [29].…”

“…Strategies aiming to prevent or detect aggressive behavior in an early stage included, for example, checking residents' mood at the door, waiting until the patient invites you to act, watching for warning signs, preserving patients' dignity, practicing vigilance, and intuiting [29][30][31]. Furthermore, supporting residents' exercising of their rights and their competence to make decisions was reported to prevent aggressive behavior [34].…”

Psychological trauma and fear for personal safety as a result of behaviours that challenge in dementia: The experiences of healthcare workers

“…Although fearful of sustaining a severe injury, it appears that healthcare workers accept violence as part of the job (Antai-Otong, 2001;Astrom et al, 2002;Levin et al, 2003;Lundstrom, 2005;Middleton, Stewart, & Richardson, 1999). A cross-sectional survey by Astrom et al (2004) revealed that most care staff considered violence to be intentional with a smaller number believing it was unprovoked.…”