This study aims to investigate the occurrence of workplace violence, both physical, verbal, and sexual assaults, from patients and their relatives towards intensive care unit staff members.
Workplace violence, as defined by the International Labor Organization, includes any action, incident, or behavior that assaults, threatens, harms, or injures a person during their work. Healthcare workers face the highest risk of workplace violence among all professions. Violence can take many forms, including verbal abuse, physical offenses to sexual harassment. While most research focuses on psychiatric and emergency departments, workplace violence in intensive care units (ICUs) is understudied and often underreported. As a result, little is known about its prevalence and risk factors, leading to a lack of awareness and effective prevention strategies. The aim of this retrospective single-center cohort study is to investigate the occurrence of workplace violence, both physical, verbal, and sexual assaults, from patients and their relatives towards ICU staff members. The study will assess the frequency, characteristics, and circumstances of these events in an intensive care setting. Additionally, the consequences of such incidents and the measures taken afterward will be examined. This analysis aims to identify potential risk factors and possible targets for intervention, ultimately contributing to the development and implementation of protocols that enhance the safety of both healthcare professionals and patients.
Study Type
OBSERVATIONAL
Enrollment
865
University Hospital Base, Intensive Care Unit
Basel, Canton of Basel-City, Switzerland
Demographic information
Demographic information of persons involved in the assault (e.g., age, sex, function) is collected.
Time frame: 2011-06/2024
Acute prehospital management data
Data from acute prehospital management, as documented in emergency medical services (EMS) treatment protocols, is collected. The collected data elements are aggregated to describe the overall EMS response.
Time frame: 2011-06/2024
Duration of intensive care unit stay
The length of intensive care unit (ICU) stay is recorded.
Time frame: 2011-06/2024
Duration of hospital stay
The length of the total hospital stay is recorded.
Time frame: 2011-06/2024
Discharge destination
The destination at discharge (e.g., other hospital, nursing home, hospice, rehabilitation, or home) is recorded .
Time frame: 2011-06/2024
Date of assault
The specific date of reported workplace violence is documented.
Time frame: 2011-06/2024
Characteristics of assault
Details on the assault incident as documented in nurses' and physicians' progress notes (e.g. wording) to characterize the event.
Time frame: 2011-06/2024
Type of assault
The type of workplace violence (e.g. verbal, physical, emotional) is recorded.
Time frame: 2011-06/2024
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Additional features of the assault
Assessment of additional features related to workplace violence, including involved staff members, shift type, and environment. These features are aggregated to characterize the context in which the assault occurred.
Time frame: 2011-06/2024
Patient characteristics
Information on the patient (e.g., main diagnosis, comorbidities, medication) is documented.
Time frame: 2011-06/2024
Consequences of the assault
Evaluation of the consequences, including staff changes, safety measures, and debriefing following workplace violence incidents.
Time frame: 2011-06/2024
Neurological status based on validated clinical assessment
Neurological status during ICU stay is assessed using available data in the patient register from validated neurological assessments. These may include the Richmond Agitation-Sedation Scale (RASS), Sedation-Agitation Scale (SAS), Glasgow Coma Scale (GCS), Intensive Care Delirium Screening Checklist (ICDSC), or Status Epilepticus Severity Score (STESS). The specific tool used, as well as the scale of the score and meaning behind the score, depends on routine clinical practice and available documentation in the register. If multiple scores are available for a patient, they will be aggregated to provide a comprehensive assessment of neurological status.
Time frame: 2011-06/2024
Critical illness severity score
Disease severity is assessed using standardized scoring systems, such as Acute Physiology and Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score II (SAPS II), and Sequential Organ Failure Assessment (SOFA) scores. The scale of the score and meaning behind the score depends on the severity assessment that is applied.
Time frame: 2011-06/2024
Charlson Comorbidity Index
The Charlson Comorbidity Index (CCI) is calculated based on pre-existing comorbidities and additional diagnoses. The CCI predicts the ten-year mortality for a patient who may have a range of comorbid conditions. It assigns weighted scores (from 0 to maximal 6) to 17 comorbid conditions (e.g., heart disease, diabetes, cancer), resulting in a total score ranging from 0 to 33, if the patient had the most severe form of each of the 17 conditions.
Time frame: 2011-06/2024
Laboratory parameters
Routine laboratory value for e.g. C-Reactive Protein (CRP), albumin, Lactate Dehydrogenase (LDH), Creatine Kinase (CK), procalcitonin, white blood cell levels, creatinine, liver enzymes, blood gas analyses, and metabolic data, is collected. The specific parameters recorded may vary depending on the laboratory assessments documented in the patient register. All values will be reported using their respective units of measurement.
Time frame: 2011-06/2024
Glasgow Outcome Score
The Glasgow Outcome Score (GOS) is calculated based on the assessment of key clinical outcomes such as in-hospital mortality, survival, survival with neurofunctional alteration, return to premorbid neurological function, and hospital readmission to determine the patient outcome. The GOS ranges from 1 (death) to 5 (good recovery).
Time frame: 2011-06/2024
Therapeutic intervention
The therapeutic intervention is document, including information on duration, dosage and number of treatment medication, number of neuroleptic, sedative and analgesic drugs, invasive procedures, such as intubation, mechanical, ventilation, vasopressors, installation of central lines, nutrition, etc.
Time frame: 2011-06/2024
Vital signs
Vital signs are analyzed based on the data available in the patient register. These may include blood pressure, heart rate, respiratory rate, oxygen saturation, body temperature, and level of consciousness. The specific parameters recorded depend on the clinical documentation available. All values will be reported using their respective units of measurement. The collected parameters are aggregated to provide an overall assessment of the patient's clinical condition.
Time frame: 2011-06/2024
Fluid balance data
Fluid balance data, including the administration of fluids such as blood products, crystalloids, and enteral/parenteral nutrition, are documented. These components are aggregated to represent overall fluid input for each patient.
Time frame: 2011-06/2024