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Copyright © 2023

Are Hospitals Safe Workplaces?

Recent reports of violence against health care workers in hospitals are raising the question: are hospitals safe workplaces? Health care workers are 5 times more likely to experience violence at the workplace than other professions. Close to 40 states now have laws that either establish or increase penalties for assaults on health care workers, according to the American Nurses Association.

The Joint Commission defines workplace violence as “an act or threat occurring at the workplace that can include: verbal, nonverbal, written, or physical aggression; threatening, intimidating, harassing, or humiliating words or actions; bullying; sabotage; sexual harassment; or physical assaults.”

Despite the increased attention to the problem, the incidence of violence has increased, including during the COVID-19 pandemic. And the data may not represent the whole picture as workplace violence is often under-reported. Some of the reasons given by health care workers for not reporting violence include:

• Patients who are not in their “right mind” cannot be held accountable for their actions.

• Reporting can be time-consuming and difficult for health care employees working under high-stress conditions.

• Fear of retaliation from management and/or colleagues who are concerned that reports of violence reflect poorly on a health care team/workplace.

• No injury occurred or time was lost because of the incident, or the violence wasn’t physical.

• The widespread belief that violence is simply “part of the job.”

The American Association of Nurse Practitioners (AANP) has condemned workplace violence. “We urge all health care facilities to implement comprehensive violence prevention programs and freedom from retaliation for reporting workplace incidents,” said AANP.

The expectation of violence should never be “part of the job.” Yes, health care workers face unique challenges and a potentially dangerous patient population but hospitals need to provide support and security to provide safe spaces for workers.

Nikki Kean, Director The Clinical Adviso r

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Features

Departments

Early Intervention for Symptomatic Kidney Stones Is Beneficial

Patients with renal colic benefit from early intervention (shockwave lithotripsy, ureteroscopy, or percutaneous nephrolithotomy) compared with delayed intervention.

IV Drug Use-Associated HIV, HCV Risk Is Higher in Women and Adolescents

British researchers evaluated global data on HIV and primary hepatic C virus infection incidence among individuals who use injectable drugs.

Early Mammography Called for Higher-Risk Persons

Women with higher-than-average breast cancer risk, especially Black and Ashkenazi Jewish women, should start screening at 25 to 40 years, according to the American College of Radiology.

Early Biologic Initiation for Crohn Disease Reduces Costs

Patients with CD who started biologic therapy early (≤12 months after diagnosis) had fewer outpatient follow-up visits and decreased total health care costs compared with patients who initiated biologic use later.

Higher Dietary Choline, Betaine Intake Benefits Individuals With Obesity

Higher dietary choline and betaine intake is associated with lower blood pressure and low-density lipoprotein cholesterol levels among individuals with obesity.

Brady Pregerson, MD Clinical Challenge: Altered Mental Status

A 72-year-old man with a history of bradycardia and transient ischemic attack presents for evaluation of altered mental status. He is alert but cannot give any medical history. His medical records show that he was prescribed sulfamethoxazole and trimethoprim for treatment of a urinary tract infection. See the full case at: clinicaladvisor.com/ case_may_jun23

My Practice

ClinicalAdvisor.com/MyPractice

The Growing Role of PAs in Dermatology Practice

The mean number of dermatology PAs increased by 11.6% annually from 2013 to 2018. With the number of PAs increasing, Cynthia F. Griffith, MPAS, PA-C, and Peter A. Young, MPAS, PA-C, discuss the challenges faced by PAs in this specialty.

The Waiting Room

Official Blog of The Clinical Advisor

ClinicalAdvisor.com/WaitingRoom

Jim Anderson, MPAS, PA-C, DFAAPA Maternity Deserts Pose Increasing Disparities in Prenatal Care

Jim Anderson examines the growth in maternity deserts in rural America, as well as in low-income areas and communities of color.