title: Hospital employee assault rates before and after enactment of the california hospital safety and security act.
abstract: OBJECTIVE
  This study examines changes in violent event rates to hospital employees before and after enactment of the California Hospital Safety and Security Act in 1995.
  
  
  METHODS
  We compared pre- and post-initiative employee assault rates in California (n = 116) emergency departments and psychiatric units with those in New Jersey (n = 50), where statewide workplace violence initiatives do not exist. Poisson regression with generalized estimating equations was used to compare assault rates between a 3-year pre-enactment period (1993-1995) and a 6-year post-enactment period (1996-2001) using New Jersey hospitals as a temporal control.
  
  
  RESULTS
  Assault rates among emergency department employees decreased 48% in California post-enactment, compared with emergency department employee assault rates in New Jersey (rate ratio [RR] = 0.52, 95% confidence interval [CI]: 0.31, 0.90). Emergency department employee assault rates decreased in smaller facilities (RR = 0.46, 95% CI: 0.21, 0.96) and for-profit-controlled hospitals (RR = 0.39, 95% CI: 0.19, 0.79) post-enactment. Among psychiatric units, for-profit-controlled hospitals (RR = 0.41, 95% CI: 0.19, 0.85) and hospitals located in smaller communities (RR = 0.44, 95% CI: 0.21, 0.92) experienced decreased assault rates post-enactment.
  
  
  CONCLUSIONS
  Policy may be an effective method to increase safety to health care workers.
authors.affiliation: Department of Epidemiology, University of North Carolina at Chapel Hill, NC, USA. ccasteel@email.unc.edu
authors.forename: Carri
authors.initials: C
authors.lastname: Casteel
authors.forename: Corinne
authors.initials: C
authors.lastname: Peek-Asa
authors.forename: Maryalice
authors.initials: M
authors.lastname: Nocera
authors.forename: Jamie B
authors.initials: JB
authors.lastname: Smith
authors.forename: James
authors.initials: J
authors.lastname: Blando
authors.forename: Suzi
authors.initials: S
authors.lastname: Goldmacher
authors.forename: Emily
authors.initials: E
authors.lastname: O'Hagan
authors.forename: David
authors.initials: D
authors.lastname: Valiante
authors.forename: Robert
authors.initials: R
authors.lastname: Harrison
mesh_terms: D002140:California / Q000453:epidemiology; D019548:Crime Victims / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D006801:Humans; D009515:New Jersey / Q000453:epidemiology; D016272:Occupational Health / Q000706:statistics & numerical data*; D010564:Personnel, Hospital / Q000706:statistics & numerical data*; D016012:Poisson Distribution; D011567:Psychiatric Department, Hospital / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D012449:Safety / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D014754:Violence / Q000331:legislation & jurisprudence / Q000517:prevention & control / Q000706:statistics & numerical data*