Patient physical violence toward healthcare workers at a US children's hospital

Area of Science:

• Pediatric Healthcare
• Healthcare Worker Safety
• Behavioral Health

Background:

• Patient violence toward healthcare workers (HCWs) is a significant concern in pediatric medical settings.
• Understanding the context, triggers, and management of these events is crucial for mitigation strategies.

Purpose of the Study:

• To describe the timing, setting, antecedents, and management of pediatric patient-related physical violence toward HCWs.
• To analyze trends in patient violence within a children's hospital over a five-year period.

Main Methods:

• Retrospective analysis of electronic health records (EHR) from 2017 to 2022.
• Inclusion of physical violent events involving youth hospitalized at a freestanding children's hospital.
• Data extraction on event timing, patient characteristics, antecedents, and interventions.

Main Results:

• 144 violent events were identified involving 75 pediatric patients.
• A majority of events (66.7%) occurred after patients were medically cleared for discharge.
• Most events (55%) were preceded by the patient attempting to avoid an aversive experience; 77.1% received de-escalation medications, and 47.9% experienced mechanical restraints.

Conclusions:

• Pediatric patient violence toward HCWs presents significant challenges, particularly concerning behavioral escalations.
• Findings underscore the necessity of integrated, comprehensive in-patient behavioral health teams to manage at-risk youth.
• Further research into preventative strategies and tailored interventions is warranted.