Preventing Injury, Assault, and Abuse of Nurse Aides Working in Long-Term Residential Settings

Nurse aides in long-term care settings experience some of the highest rates of physical injury, assault, and abuse relative to any other occupation. These injuries occur as a function of resident caregiving activities and problematic resident behavior. Nurse aides also report high levels of stress, burnout, and emotional exhaustion which are linked to caregiving activities, interactions with resident family members, interactions with coworkers, and organizational climate.

Research investigating risk factors associated with injury, assault, and abuse among nurse aides is very limited and incomplete. There are some data indicating that nurse aide work stress, burnout, and emotional exhaustion may be important predictors of work-related musculoskeletal injuries, exposure to assault, and exposure to abuse in residential care facilities. Education and training, coworker interactions, and perceived staff support have also been identified as potential predictors of injury, assault, and abuse. Further research is clearly needed to identify how these and other not-as-yet-measured factors contribute to risk for injury, assault, and abuse.

In addition to limited knowledge about prediction of injury, assault, and abuse, there are very few studies that have evaluated the effectiveness of interventions designed to reduce the occurrence of these adverse events among nurse aides. Mindfulness-based interventions such as Acceptance and Commitment Therapy (ACT) have recently been developed and shown to be effective in the treatment of a number of psychological and behavioral problems including work stress, depression, and interpersonal conflict. However, ACT has not as yet been used to target the specific needs of nurse aides nor evaluated as a means for reducing injury, assault, and abuse among this vulnerable population of workers.

The long term objective of this project is to improve the wellbeing and reduce the occurrence of injury, assault, and abuse among nurse aides who work in long-term care settings throughout Ohio. This overarching long term goal is linked to the specific aims of this project which are to: (a) to increase knowledge of how individual, work, and organizational characteristics contribute to risk for injury, assault, and abuse; (b) develop, test, and refine an ACT intervention targeting the reduction of injury, assault, and abuse; and (c) create and evaluate a dissemination webpage that will allow persons working in long term residential care to easily access information about risk factors for, and prevention of, injury, assault, and abuse.