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J Occup Environ Med. 2017 Jan;59(1):18-27. doi: 10.1097/JOM.0000000000000909.

Preventing Patient-to-Worker Violence in Hospitals: Outcome of a Randomized Controlled Intervention.

Author information

Department of Family Medicine, Michigan State University, East Lansing, Michigan (Dr Arnetz); Department of Public Health and Caring Sciences, Uppsala University, Sweden (Dr Arnetz); Departments of Family Medicine and Public Health Sciences (Dr Arnetz, Ms Hamblin, Dr Janisse) and Psychology, Wayne State University (Ms Hamblin); Detroit Medical Center Occupational Health Services (Mr Russell, Dr Upfal, Ms Essenmacher); Department of Emergency Medicine (Dr Upfal); Institute of Gerontology (Dr Luborsky), Wayne State University, Detroit, Michigan; and Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet (Dr Luborsky), Sweden.



To evaluate the effects of a randomized controlled intervention on the incidence of patient-to-worker (Type II) violence and related injury in hospitals.


Forty-one units across seven hospitals were randomized into intervention (nā€Š=ā€Š21) and control (nā€Š=ā€Š20) groups. Intervention units received unit-level violence data to facilitate development of an action plan for violence prevention; no data were presented to control units. Main outcomes were rates of violent events and injuries across study groups over time.


Six months post-intervention, incident rate ratios of violent events were significantly lower on intervention units compared with controls (incident rate ratio [IRR] 0.48, 95% confidence interval [CI] 0.29 to 0.80). At 24 months, the risk for violence-related injury was lower on intervention units, compared with controls (IRR 0.37, 95% CI 0.17 to 0.83).


This data-driven, worksite-based intervention was effective in decreasing risks of patient-to-worker violence and related injury.

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