Protecting the Protectors: Violence-Related Injuries to Hospital Security Personnel and the Use of Conducted Electrical Weapons

Abstract

Healthcare workers suffer high rates of violence-related injuries compared to other industries, with wide variances in risk dependent upon location and role. Hospital security guards, demonstrated to have high risk levels, are tasked with protecting the safety of healthcare personnel, visitors, and patients, and are called on to help control violent situations, but little is known about their protective and risk factors for violence-related injuries. Two separate and complementary investigations were undertaken to learn more about the risk and protective factors and to find whether one intervention, carriage of conducted electrical weapons, decreases the rates of violence-related injuries or injury severity. The first study was a mixed-methods design investigating the violence-related injuries and other violent events experienced by hospital security workers over the course of 1 year at an urban level 1 trauma center. Qualitative and quantitative analyses were performed on three existing data sources: the security officer narratives, occupational injury reports, and patient health records. There were 19 reported injuries over the course of a year, with an additional 300 violent incidents in 7 months. Most of the violent incidents involving security officers occurred at night, with most of the officer injuries taking place in the psychiatric departments. Qualitative analyses found that hospital policies may increase risk for violence. The second study was a retrospective cohort analysis of all security and ED nursing staff violence-related injuries at the same institution for the time period 4 years prior and 7 years after security workers were armed with conducted electrical weapons. A violence-related injury rate was calculated as all violence-related injuries incurred by each employee for the numerator and the productive hours worked by each individual during the study period of each model for the denominator. The hospital employed 98 security officers and 468 nursing staff over the 11 years of study. Security officers’ injury rate was 13 times higher than nursing staff. The risk ratio was 1.0 (95% CI 0.7-1.4) between the 2 examination periods for security officers, with similar results for nurses. However, among security workers the severity of injuries may have decreased in the post-implementation period.