What is the impact of restricted access policy on workplace violence in general hospital? A before-after study in a CHINESE tertiary hospital

Abstract

Background To evaluate the impact of a restricted access policy on workplace violence in a healthcare setting. Methods We surveyed healthcare workers before and after the implementation of a restricted-access policy at a tertiary hospital in north-eastern China. Data were collected in April 2017 and January 2019. Fisher’s exact test were used to compare the difference in workplace violence prevalence between responses to two surveys. Survey 1 (S1) collected data from 345 healthcare professionals who had worked in the inpatient ward for at least 12 months. Survey 2 (S2) included 338 healthcare workers from the same ward who had been employed for more than two years. The effective response rates for the two studies was 79.31 and 83.25%, respectively. All 18 female security guards were included in the investigation in S2. Results The prevalence of psychological violence was 62.03% in S1 and 34.62% in S2, the difference in prevalence showing statistical significance (P = 0.000), while the prevalence of physical violence was 3.77 and 4.73% respectively, showing no statistical significance (P = 0.573). The change in the rate of injury caused by physical violence was also statistically significant at 76.92 and 31.25% (P = 0.025), respectively. Security guards were at high risk of workplace violence under the policy. Most healthcare professionals thought this policy ameliorated treatment order, the sense of security, anxiety about workplace violence, and so forth, but one-third of the respondents thought that it caused patient dissatisfaction. Conclusion While the restricted access policy may be effective for healthcare professionals in avoiding or dealing with violence, such policy could contribute to new problems regarding the safety of security guards and the potential dissatisfaction of patients. The policy should be further developed to alleviate this phenomenon.

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“…Exposure to work violence decreased through education in an intensive and emergency department [ 36 ] and through a restricted access policy in a tertiary hospital [ 38 ]. Education and participative working groups to prevent hand eczema led to a more preventive behavior [ 49 ].…”

Anti-violence measures developed by ILO and WHO: Analysis of the prevalence of workplace violence and the effects of implementation in a general hospital in China

“…Previous studies also confirmed the validity of the present study's results ( 41 ). Similarly, controlling public access was shown to reduce the prevalence of WPV in an intervention study in China ( 42 ). We also noted that this measure might increase the risk of WPV among security personnel while reducing the prevalence of WPV in HWs.…”

Professional Preparedness Implications of Workplace Violence against Medical Students in Hospitals: A Cross-Sectional Study

“…While it helps in preventing attacks, security technology also increases racial and religious biases. 39 , 40 Therefore, the interventions should come from policy adjustments, specifically stricter financial fines for assailants or better compensations for students who are abused. Moreover, hospitals should raise awareness of workplace violence to create an environment where reporting acts of violence and aggression toward healthcare workers and students is considered vital.…”