Growing violence against health care workers prompted the Occupational Safety and Health Administration in 1996 to publish employer guidelines. Certified nursing assistants (CNAs) working in long term care represent the occupation most at risk of workplace assault. These caregivers receive minimal education regarding the care of some of the most challenging and aggressive patients. As the number of nursing home patients and CNAs increases in the near future, efforts are needed to improve the nursing home environment for both CNAs and residents. A preliminary study by the investigators found that CNAs, who daily experience verbal and physical violence, lack the knowledge and skills to prevent violence. The purpose of the is to use randomized, quasi-experimental methods to test the effectiveness of an intervention to decrease violence against CNAs.
The aims of the study are to: 1) describe the context in which assaults occur, 2) increase CNAs' skills to prevent assaults, and 3) decrease the incidence of assaults against CNAs. The study design is quasi-experimental with three nursing homes serving as a control group and three homes as an intervention group. Within each nursing home 18 subjects will be randomly selected to participate in the three year study. The intervention, based on Social Cognitive Theory, will consist of three 2 hour in-services and six 1/2 hour problem solving groups. Subjects will be assessed for changes in their assault prevention skills prior to the intervention and upon completion of the intervention. The type and number of assaults will also be assessed before and after the intervention. Data analysis will describe the context of the assaults and test whether there was a significant difference in the number of violent incidents between the intervention group and the control group. Data analysis will also determine whether the intervention group demonstrated a significant difference in violence prevention skills than the control group.
| Gates, Donna; Fitzwater, Evelyn; Succop, Paul (2005) Reducing assaults against nursing home caregivers. Nurs Res 54:119-27 |
