Overcrowding in XXXX wards and physical assaults on staff: data-linked longitudinal study.

@entity1 @entity146
BACKGROUND: @entity1 overcrowding and violent assaults by @entity1 are two major problems in @entity146 healthcare. However, evidence of an association between overcrowding and @entity146 among @entity1 is mixed and limited to small-scale studies. AIMS: This study examined the association between ward overcrowding and violent physical assaults in acute-care @entity146 in- @entity1 hospital wards. METHOD: Longitudinal study using ward-level monthly records of bed occupancy and staff reports of the timing of violent acts during a 5-month period in 90 in- @entity1 wards in 13 acute @entity146 hospitals in Finland. In total 1098 employees (physicians, ward head nurses, registered nurses, licensed practical nurses) participated in the study. The outcome measure was staff reports of the timing of physical assaults on both themselves and ward property. RESULTS: We found that 46% of hospital staff were working in overcrowded wards, as indicated by >10 percentage units of excess bed occupancy, whereas only 30% of hospital personnel were working in a ward with no excess occupancy. An excess bed occupancy rate of >10 percentage units at the time of an event was associated with violent assaults towards employees (odds ratio (OR) = 1.72, 95% CI 1.05-2.80; OR = 3.04, 95% CI 1.51-6.13 in adult wards) after adjustment for confounding factors. No association was found with assaults on ward property (OR = 1.06, 95% CI 0.75-1.50). CONCLUSIONS: These findings suggest that @entity1 overcrowding is highly prevalent in @entity146 hospitals and, importantly, may increase the risk of violence directed at staff.
