(O-H6) Healthcare Provider Safety Incidents, Measures, and Outcomes in the Emergency Departments in Puerto Rico

Objectives: Study the frequency and type of events that threaten healthcare providers' safety in the emergency departments in Puerto Rico, evaluate measures taken in these events, the outcomes as well as evaluate the perception of safety of our physicians working in the emergency departments.

Background: As stated by Dr. Karen N. Kuehl in the 24th AAEM Annual Scientific Assembly, being a healthcare worker is one of the most dangerous jobs, being #2 in the list of fatal occupational injuries from 2015-2016 following transportation accidents. Security breaches and health provider assaults are an issue that we, as healthcare workers face in a daily basis and yet it is not a topic discussed frequently in Puerto Rico. There are no previous reports demonstrating the incidence of security breaches and healthcare worker assaults in the island, nor the measures taken or the resulting outcomes.

Methods: This investigation consists of a cross-sectional study with independent variables being the number of events and types of events of assault that the healthcare workers interviewed had experienced. Dependent variables consist of the type of outcomes obtained from the measures that were employed in these assaults. Positive outcomes are defined as no acute physical injuries and no long-term physical or emotional consequences, and the negative outcome is described as any type of physical injury to a healthcare worker or physical structure as well as any long-term physical or emotional consequences. We will be using a web-based survey questionnaire that will be distributed among emergency departments across the island by contacting emergency room directors. The survey mainly focuses on obtaining information of whether these healthcare workers have had assault experiences and the security measures available at their hospitals. Also asks about how they currently feel toward their safety while at work. The instrument used in the investigation will be a survey sent by email using the RedCap platform. All three aims will be tabulated and will perform simple descriptive statistics to obtain percentages and statistical correlation studies. The response rate will be calculated to evaluate the quality of the study.

Results: The study remains in data collection phase by RedCap surveys being taken into different hospitals in Puerto Rico.

Once we obtain the results from the surveys, results will be charted in spreadsheets and analyzed with simple statistical calculations to estimate the incidence of these events. Also, the results from an independent survey investigating the perception of their security among the physicians working in the different emergency departments will be analyzed.

We hypothesize that the results obtained will demonstrate that the emergency departments of the hospitals in Puerto Rico are not well prepared to manage individuals that pose a threat to the healthcare professionals in terms of infrastructure as well as personal preparedness. We also believe that the measures taken upon these occurrences lie mostly on a reactive pattern rather than a preventive one, leading to deleterious outcomes of varying severity, daunting our staff with workplace insecurity. For this reason, we hypothesize also that the gross majority of healthcare professionals feel unsafe in their work environment especially when these individuals are present.

Conclusions: By demonstrating our hypothesized high incidence of these cases in our EDs, we will expose the lack of adequate security measures employed to avoid these incidents and ED directors and administrators can be more aware of this situation in Puerto Rico. EDs administrators and medical directors can then focus resources in more efficient measures to assure healthcare worker job security.

A potential problem is recall bias, in which the participant may not remember past events. In that instance, we would need to be aware of the recall bias that is inherent to this study and consider it on our analysis.

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Funding (Optional): N/A