Hospital employee assault rates before and after enactment of the california hospital safety and security act.
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.
Casteel
Carri
C
Department of Epidemiology, University of North Carolina at Chapel Hill, NC, USA. ccasteel@email.unc.edu
Peek-Asa
Corinne
C
Nocera
Maryalice
M
Smith
Jamie B
JB
Blando
James
J
Goldmacher
Suzi
S
O'Hagan
Emily
E
Valiante
David
D
Harrison
Robert
R
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*