Inpatient psychiatric healthcare worker and administrator perceptions of workplace interventions for patient-on-staff assault
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Psychiatric personnel as an occupational group are among the highest risk for experiencing assault at work. Existing literature is primarily quantitative with a descriptive focus on numbers and types of injuries and environmental factors associated with these assaults. A qualitative study using descriptive interpretation theory was conducted to identify clinical interventions that might prove effective in reducing these assaults. Seven direct care providers and seven administrative leaders were recruited from three inpatient psychiatric specialty hospitals and one general hospital with a psychiatric specialty unit located within Harris County, TX. Using a semi-structured interview, perceptions of inpatient psychiatric personnel and administrators regarding policies and processes in place to prevent, address, and monitor assault were explored. Themes that were identified dealt with precursors to assault, intervention strategies and organizational and staff descriptors. The findings that emerged from the analysis of the data as well as a review of existing policies and procedures used in psychiatric facilities related to patient assault spoke strongly to what organizations could do to prevent assaults. These preventive measures included the need for a comprehensive plan for staff safety, formal opportunities for communication between direct care providers and administration, attention to staffing patterns, ensuring staff's competence with early recognition of agitation and aggression, and a process that ensures timely orders from the physician for medication, seclusion and restraint.