Infiltrative violence towards health care workers in a lower-crime community affects less the pediatrics; under-reporting, perspectives and effects on the victims

Background Violence towards Health Care Workers (HCW) by patients, relatives or visitors is prevalent in health care systems. This study seeks to investigate the characteristics but also the effect of violence on HCW and on patient care in a regional hospital, and more specifically in pediatrics and to explore suggested ways by HCW to reduce this phenomenon. Methods This is a survey among health care workers (HCW) in a hospital and outpatient clinic in the Mid-western United States. Fisher’s exact, or chi ² – test for categorical and t-test for median values were used to compare violence among different HCW, units, factors for under-reporting and satisfaction with training and descriptive statistics to characterize prevalence of violence and effects. Results Response rate was 72% (122/170). Any type of violence was reported by 107 (88%). Verbal threat/abuse, physical threat, physical abuse, sexist remarks and sexual advances occurred more often than once a week or once a month in 52%, 34%, 35%, 36% and 18% respectively. 96% of nurses reported violence and were more likely to be affected than other personnel. All other units were more likely to face violence than the pediatrics/NICU (OR 3.29, 95% CI 0.97–10.86, p = 0.034). Factors triggering violence included difficult patient expectations (67%), intoxication (67%), underlying illness (63%) and long waiting times (58%). Physical violence was less likely not to be reported. Reasons for not reporting were “nothing will change” (63%), “part of the job” (64%), lack of time (33%), and fear of being blamed (14%) among other. More than half were poorly or only somewhat satisfied with their training, security and support from the health system. Patient care was affected in 45% of time and 44% thought to quit their job. Conclusion Violence against HCW is prevalent even in a lower-crime community but less so affects pediatrics. Victims requested more consequences for the perpetrators, security measures, more training and support from the health system.