Occupational injury and physical assault experience of nurse aides employed at Duke University Health System
Carolina Digital Repository (University of North Carolina at Chapel Hill)Published 15 August 2019Open access
Rosa L. Rodríguez‐Acosta
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Abstract
Nurse aides and nurses are often combined in occupational injury research. Both of these caregiver populations are predominantly female, each characterized by different educational requirements and job demands. Many nurse aides are African-American females, a segment of the labor force historically understudied in occupational epidemiology and at substantial risk of work-related injury. The objectives of this study were to characterize and identify risk factors associated with unintentional and intentional injuries experienced by acute care nursing staff, and to contrast the experience of nurse aides and nurses. Data from the Duke Health and Safety Surveillance System (DHSSS) were used; the study cohort included all nurse aides (n=1689) and nurses (n=5082) employed in acute care units from 1997-2004. Injury events were ascertained from workers' compensation reports filed from 1997-2004. Covariate information was obtained from employment records and administrative data. Poisson regression was used to calculate injury rates per 100 full-time-equivalents (100-FTEs), rate ratios (RR) and 95% confidence intervals (95%CI). The overall injury rate was higher for nurse aides (28.83/100-FTEs, 95%CI: 26.70- 31.13) than for nurses (23.11/100-FTEs, 95%CI: 22.23-24.03). Nurse aides were more likely to require medical treatment and/or experience lost time for their injuries. Nurse aides had twice the rate of neck/shoulder (2.34/100-FTEs, 95%CI: 1.79-3.06) injuries than nurses had (1.12/100-FTEs, 95%CI: 0.92-1.33). Lifting patients was the most common cause of injury among nurse aides (21%); for nurses needle stick injuries were most common (15%). The rate of intentional injury was 1.65/100-FTEs (95%CI: 1.45-1.89) and was moderately higher for nurse aides than nurses (RR=1.51, 95%CI: 1.10-2.06). Upper extremities (45%) and head/face (27%) were most commonly involved as were injuries due to strikes (72%). Multivariable analyses revealed a higher risk among younger workers (RR=1.38, 95%CI: 1.17-1.62) and among those with shorter job tenure (RR=1.29, 95% CI: 1.08-1.54). Intentional injury risk was greatest among nursing staff employed in psychiatric units (Rate=12.65/100-FTE, 95%CI: 8.90-17.99). Differences were observed in overall injury experience between nurse aides and nurses. These may reflect increased injury severity, more limited light-duty opportunities, or limited schedule flexibility to accommodate recovery. Violence-related injury risk differed markedly by tenure of employment and hospital unit.
Keywords
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