Addressing Workplace Violence With Evidence.

AIM: The purpose of this article is to describe how regional community assessment survey data specific to healthcare workers' (HCWs') attitudes and actions related to workplace violence (WPV) from 1 participating urban tertiary hospital was compared with current evidence to identify evidence-based interventions to promote a safer work environment. The regional survey assessed real-time data regarding the state of WPV and its impact on HCWs, and to drive proposed interventions to prevent and reduce WPV in the healthcare community. BACKGROUND: Incidents of WPV in healthcare continue to increase, resulting in calls for action from staff, leadership, and regulatory organizations. METHODS: Data were collected from the HCWs who completed the survey. Experiences with WPV were analyzed. Qualitative data were evaluated for themes. A review of external evidence was conducted to identify best practices in preparing proposed next steps for the organization. RESULTS: Healthcare worker attitudes and practices related to WPV were described as unreported and not addressed. Violence was more readily perceived as a part of the job. External evidence indicated that education and training alone seemed to have minimal effect on preventing WPV. Evidence from best practices and staff feedback were recommended to be incorporated into plans for the organization.

Disaster preparedness for charge nurses: A program evaluation.

Over the last 3 years at a large, -midwestern, pediatric hospital, there have been near -disaster events, a few of which required transfer or evacuation of patients. The responses from the inpatient units to these events have varied greatly and can be traced back to communication, knowledge, comfort level, and effectiveness of the charge nurses on the nursing units. A task force was formed to understand the variation in their disaster response procedures and to standardize disaster response procedures. Respondents included the bedside, clinical leader-ship, managers of patient services, emergency preparedness management, and senior leadership. This resulted in the creation of a tabletop simulation exercise for use by inpatient charge nurses within the institution. The results indicated that participants reported higher levels of self-reported knowledge, confidence, and effectiveness regarding the disaster preparedness on their units (p < 0.001). The program was effective, with feedback from participants indicating the need for more frequent and/or department -specific education.

Does Participation in a Disease Self-Management Program by Veterans Affect Their Subsequent Utilization of Acute Care Services and Costs of Care?

BACKGROUND: The prevalence and costs of chronic disease continue to escalate with aging of the population and continued advancements in medical care. Studies have been published about programs for the self-management of chronic disease among a variety of populations. Among the outcomes measured were reduction of acute care resource utilization and cost. DATA SOURCE/STUDY SETTING: Among the Veteran population, chronic disease self-management programs have been implemented in a number of Veteran Affairs facilities. Veterans' Integrated Service Network 10 (VISN 10) has implemented the program in all acute care medical centers and ambulatory care centers providing comprehensive inpatient and outpatient health care to their Veterans. DESIGN: A pre/post study design was done for a convenience sample of Veteran participants who completed the program. Utilization and costs of acute care services for the participants before the program were compared to their subsequent costs and utilization 6 months after completion of the program. FINDINGS: Participation in the program alone did not produce significant reductions, nor significant increases, in service volumes or costs after completion of the program. It may be that these outcomes may be better achieved when the program is part of more comprehensive efforts to assist Veterans in managing their chronic disease.