Aims: Occupational Violence (OV) and behavioural issues faced by health services is an area of importance with the ageing demographics. Our aim is to understand population characteristics and outcomes of this issue in a Geriatric Evaluation and Management setting.
Methods: A retrospective quality assurance study was conducted in a tertiary hospital setting. Incidents captured in a risk management software for the period from February 2021 to July 2022 were reviewed. Descriptive statistics were used to assess characteristics and outcomes.
Results: A total of 53 events were recorded; 66.0% were reported as having challenging behaviours and 33.9% were recorded as OV. The majority (77.3%) were females with a mean (SD) age of 79.3 (8.4) years. Dementia diagnosis was recorded in 50.9%, with a mean (SD) Functional Independence Measure cognitive score of 17.9 (8.2). Median (IQR) comorbidity count was 7 (2-9) and the median medication count was 13 (10-18). Majority (94%) were admitted from home and had a mean (SD) length of stay of 40.2 (25.0) days. For OV, 33.3% were classified as either physical assault, verbal assault, or both. Impulsiveness was the commonly reported (24.5%) behaviour, followed by physical assault (16.9%) and sexual assault (7.5%). Antipsychotics were commenced on 43.4% of patients, with 7.5% of events needing physical restraints. In-hospital mortality was 11.3%, and 58.4% were discharged to residential care.
Conclusions: OV and behavioural issues remain a significant challenge with increased mortality and morbidity in the older population. Older person oriented environmental solutions and care pathways are a future need.