Personal security alarms for the prevention of assaults against healthcare staff

Abstract

Background: Personal security alarms have been used to try to reduce violence against healthcare staff, some of whose members face relatively high risks of assault. This systematic review focused on the effect of alarms in reducing the incidence and/or severity of assaults.Methods: Electronic databases, including Cochrane Library, Ovid MEDLINE(R); CINAHL Plus (EBSCO); PubMed; PsycINFO (OvidSP) PsycEXTRA; Applied Social Sciences Index and Abstracts (ProQuest) (1987 to current); Criminal Justice Abstracts (EBSCOhost); Psychology and Behavioural Science Collection (EBSCOhost); Social Policy and Practice (OvidSP) Sociological Abstracts; ProQuest theses and dissertations, were searched. Study designs eligible for inclusion were randomised controlled trials, interrupted time series and controlled before-after studies that assessed the impact of personal security alarms on assaults. Searches were undertaken for studies of healthcare staff in all settings (i.e. including staff working in confined spaces such as hospitals and also field personnel such as community health workers). Workplace violence between colleagues (lateral violence and bullying) and other uses of personal alarms (e.g. fall alarms for the elderly, domestic violence prevention) were excluded. Search results were screened by title, abstracts and keywords for possible inclusion. Full text reports for all potentially relevant studies were obtained and independently assessed for final inclusion. The primary outcome was physical assaults (recorded or self-reported). Secondary outcomes included increased confidence or self-efficacy in violence prevention (recorded or self-reported). Main results:No studies were found that met all inclusion criteria. Four reported associations of personal alarms (and other variables) with risks of assault in healthcare settings. These were described narratively. Conclusions:Healthcare workers in emergency departments, psychiatric units and geriatric facilities face much higher risks of assault than those in other healthcare settings. Alarm systems vary widely. Alarm systems form one of a range of measures, which may interact with one another, that are used to reduce the risks of assault. Given this complexity and diversity, prior to field trials EMMIE orientated efficacy trials are recommended to try to establish whether alarms can be introduced and operated in ways that can contribute to reducing assaults in specific high-risk settings. In relation to findings relating to any given intervention, EMMIE refers to effects produced, mechanisms activated to produce the effects, moderators or contexts relevant to the activation of mechanisms, implementation issues that arise, and economic costs and benefits.

Addressing Risks of Violence against Healthcare Staff in Emergency Departments: The Effects of Job Satisfaction and Attachment Style

“…For a variety of reasons, it is unlikely that violence in healthcare workplaces can be completely eliminated [28]. Prevention strategies and interventions are key to reducing future violence [50, 54]. Healthcare staff should therefore be trained to recognise and prevent violence and/or to manage violent situations adequately [68], because they are often not able to foresee a violent act and do not have any premonition of danger before being assaulted [20].…”

“…A second aspect to consider in preventing patient and visitor violence is the implementation of a safe practice environment [32, 54, 72]. Changes to the work environment and at an organisation level, for example, could include fixed emergency alarms and security guards [50], but there is also scope for improvements to occupational health and safety legislation and policy [17, 69]. Teamwork and a supportive workplace can further be helpful and effective in this regard [10, 20, 21].…”

“…Person-related factors include poor [10] and rude [15] communication, insufficient communication [31], miscommunication [38], misunderstandings [50], shortcomings in the way information is shared between practitioner and patient [2], lack of trust between doctors and patients [44, 51], unmet or unrealistic expectations on the part of patients and their families [19], dissatisfaction with the course of treatment and/or disagreement with the doctor [1], and poor patient compliance [9]. Important situational factors that contribute to patient and visitor violence include a combination of organisational [15, 17–19, 28, 32, 50] and the environmental conditions [9, 16, 28, 32, 49, 52]. Other factors include loss of respect for the doctor [53] and the perception of a poor standard of care [2, 44].…”

Comparing panic alarm systems for high-risk domestic abuse victims: a randomised controlled trial on prevention and criminal justice system outcomes

“…In terms of DA prevention, personal panic alarms linked directly to the police have been widely used in the UK, but there is a lack of strong evidence supporting their scope and effectiveness (see more broadly Perkins et al, 2017 ). The use of panic alarms for DA was first documented by Farrell and Pease ( 1993 ) as a basic system that worked with landlines and ‘alarm pendants’, through which automated calls were made to the local police station when the alarm was triggered.…”

An algorithmic approach for optimising biometric systems using liveness and coercion detection

“…For example, the user may carry a key which may be used as a "panic alarm". This is standard practice in areas such as health and elderly care; therefore, the concept is already disseminated throughout society [48]. A second approach would be to utilise a selection of passcodes/keys that would denote coercion.…”