Blando, James D.

Paul, Chalsie

Szklo-Coxe, Mariana

English

Old Dominion University

Old Dominion University ODU Digital Commons Community & Environmental Health Faculty Publications Community & Environmental Health 2022 Response and Rebuttal to "Comment on: Risk Factors for Workplace Encounters With Weapons by Hospital Employees" in Public Health in Practice; 3 (2022) 100256 by Chidinma Okani and Carmen Black James D. Blando Old Dominion University, jblando@odu.edu Chalsie Paul Old Dominion University, cpaul@odu.edu Mariana Szklo-Coxe Old Dominion University, mszklo@odu.edu Follow this and additional works at: https://digitalcommons.odu.edu/commhealth_fac_pubs  Part of the Health and Medical Administration Commons, Organizational Behavior and Theory Commons, and the Public Health Commons Original Publication Citation Blando, J. D., Paul, C., & Szklo-Coxe, M. (2022). Response and rebuttal to “Comment on: Risk factors for workplace encounters with weapons by hospital employees” in public health in practice; 3 (2022) 100256 by Chidinma Okani and Carmen Black. Public Health in Practice, 4, 1-2, Article 100304. https://doi.org/10.1016/j.puhip.2022.100304 This Article is brought to you for free and open access by the Community & Environmental Health at ODU Digital Commons. It has been accepted for inclusion in Community & Environmental Health Faculty Publications by an authorized administrator of ODU Digital Commons. For more information, please contact digitalcommons@odu.edu. Public Health in Practice 4 (2022) 100304Available online 3 August 20222666-5352/© 2022 The Authors. Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC BY-NC-NDlicense (http://creativecommons.org/licenses/by-nc-nd/4.0/).Response and rebuttal to “Comment on: Risk factors for workplace encounters with weapons by hospital employees” in public health in practice; 3 (2022) 100256 by Chidinma Okani and Carmen black  A R T I C L E  I N F O   Keywords Workplace violence Weapons Safety Security Confiscation       We would like to thank Drs. Okani and Black for their interest in our paper and their commentary published in PHIP but believe that we must clarify and respond to several of the points made in their commentary. Drs. Okani and Black state that the premise of our article is that armed conflict is the leading cause of assaults in healthcare. This was not the purpose of our study. As stated in the abstract and elsewhere in the paper, “The specific aim of this study was to determine which risk factors were associated with frequent weapons confiscation in a healthcare facility. This study investigated the hypothesis that hospital-related factors impact the frequency of weapons confiscation.” [1] We did not argue that armed conflict is the leading cause of assaults. Our study design and in-terpretations are aimed at examining this issue through a public health injury prevention perspective in which violence is examined as a public health problem. Drs. Okani and Black also state that the risk of being a victim of a hospital shooting is less than being struck by lightning, implying that hospital shootings are not a safety priority because they are rare events. The fallacy of this argument is that they are not using the correct denominator in their estimation. The only people at risk of a hospital shooting are people who are in a hospital, for work, visits, or as a patient. Using an inappropriate denominator such as the entire US population to estimate the probability or risk for a specific select sce-nario is not appropriate or in-line with conventional risk assessment techniques. In addition, the article by Kelen et al. [2] has limited applicability to our study because Kelen et al. [2] only investigated hospital shootings with no assessment of other weapons and, as Smalley et al. [3] points out, the majority of assaults with weapons occur with edged weapons such as box cutters and knives. Metal detectors have the ability to identify these edged weapons, which are much more frequently encountered. Drs. Okani and Black summarized the results of the study by Rankins et al. [4] by stating that the presence of metal detectors had no influence on assaults at the hospital they analyzed; in fact, upon careful review of that paper, you will find that they found a reduction in assaults with weapons but not a reduction in the frequency of assaults without weapons, suggesting that metal detectors had an important contribution to workplace safety. We interpret that result to imply that without weapons the consequences of an assault have the potential to be less severe. Drs. Okani and Black also state that we mischaracterized the paper by Roche et al. [5] stating that this paper did not imply that fear of violence increased medical mistakes; however, Roche et al. [5] did show that “medication errors” were more prevalent when there were concerns about violence. Drs. Okani and Black also argue that security measures do not impact violence rates and that money should be “diverted” from security programs to clinical opera-tions, unfortunately this is not supported by research for the last 20 years on workplace violence [6]. . There is a wealth of literature showing that the largest causes of workplace violence in the health care setting are not the result of poor clinical operations such as wait times, but rather the result of the mental healthcare crisis, poor social services, and drug dependency [e.g. Refs. [7,8]. Furthermore, they argue that the use of the word “violence” is racist language and somehow coded to disparage a particular community. The workplace violence research community has repeatedly shown that assault rates in hospitals are not related to race, ethnicity, financial well-being of a hospital or even strongly associated with index and violence crime rates in a community but rather, much more closely associated with the quality and comprehensiveness of the hospital’s security program [9]. Moreover, our prior work has also clearly shown in a quantifiable way that the biggest predictor of the fear of violence among nurses working in a hospital is not related to race or ethnicity but rather, to the frequency of verbal abuse that nurses expe-rience on the job [10]. Lastly, Drs. Okani and Black also noted the use of citations in our paper that are over 20 years old for metal detector usage. Unfortunately, to our knowledge, there are no recent studies on this question beyond the work discussed here, and we would point out that just because a study is old does not mean that it is not useful or appli-cable. We whole-heartedly would support funding for new additional studies on metal detector usage. Source of funding This project was not funded. Contents lists available at ScienceDirect Public Health in Practice journal homepage: www.sciencedirect.com/journal/public-health-in-practice https://doi.org/10.1016/j.puhip.2022.100304 Received 9 June 2022; Received in revised form 23 June 2022; Accepted 28 July 2022   ELSEVIER Public Health in Practice 4 (2022) 1003042Human studies and subjects This study was reviewed and approved by the Old Dominion Uni-versity Institutional Review Board (protocol #1040377-3) and complies with US Federal Policy for the Protection of Human Subjects. Declaration of competing interest The authors have no perceived or actual conflicts of interest related to this project, paper, or submission. Acknowledgements The authors wish to thank the International Association for Health-care Security and Safety (IAHSS; http://www.iahss.org/) for their sup-port of our study. References [1] J. Blando, C. Paul, M. Szklo-Coxe, Risk factors for workplace encounters with weapons by hospital employees, Public Health Pract. 2 (2021) 1–4, https://doi. org/10.1016/j.puhip.2021.100105. Open access:. [2] G.D. Kelen, C.L. Catlett, J.G. Kubit, Y.H. Hsieh, Hospital-based shootings in the United States: 2000 to 2011, Ann. Emerg. Med. 60 (6) (2012) 790–798 e1. [3] C.M. Smalley, M. O’Neil, R.S. Engineer, E.L. Simon, G.M. Snow, S.R. Podolsky, Dangerous weapons confiscated after implementation of routine screening across a healthcare system, Am. J. Emerg. Med. 36 (8) (2018) 1505–1507. [4] R.C. Rankins, G.W. Hendey, Effect of a security system on violent incidents and hidden weapons in the emergency department, Ann. Emerg. Med. 33 (6) (1999) 676–679. [5] M. Roche, D. Diers, C. Duffield, C. Catling-Paull, Violence toward nurses, the work environment, and patient outcomes, J. Nurs. Scholarsh. 42 (1) (2010) 13–22. [6] National Institute for Occupational Safety and Health (NIOSH), OCCUPATIONAL VIOLENCE, centers for disease control and prevention (CDC). https://www.cdc. gov/niosh/topics/violence/default.html, 6/9/22. [7] J. Blando, M. Ridenour, D. Hartley, M. Nocera, Hospital security director back-ground, opinions, and the implementation of security programs, J. Appl. Secur. Res. 12 (4) (2017) 497–511. [8] J. Blando, M. Nocera, M. Ridenour, D. Hartley, Workplace violence and hospital security programs: regulatory compliance, program benchmarks, and innovation, J. Healthc. Protect. Manag. 33 (1) (2017) 89–105. [9] J. Blando, K. McGreevy, E. O’Hagan, K. Worthington, D. Valiante, M. Nocera, C. Casteel, C. Peek-Asa, Emergency department security programs, community crime, and employee assaults, JEM (J. Emerg. Med.) 42 (3) (2012) 329–338. [10] J.D. Blando, E. O’Hagan, C. Casteel, M. Nocera, C. Peek-Asa, Impact of hospital security programs and workplace aggression on nurse perceptions of safety, J. Nurs. Manag. 21 (2013) 491–498. James D. Blando*, Chalsie Paul, Mariana Szklo-Coxe Old Dominion University, College of Health Sciences, School of Community and Environmental Health, Norfolk, VA, USA * Corresponding author. Old Dominion University, College of Health Sciences, School of Community and Environmental Health, 4608 Hampton Blvd., Norfolk, VA, 23529, USA. E-mail address: jblando@odu.edu (J.D. Blando). J.D. Blando et al.                                                                                                                                                                                                                               

Response and Rebuttal to  Comment on: Risk Factors for Workplace Encounters With Weapons by Hospital Employees  in Public Health in Practice; 3 (2022) 100256 by Chidinma Okani and Carmen Black

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Response and Rebuttal to Comment on: Risk Factors for Workplace Encounters With Weapons by Hospital Employees in Public Health in Practice; 3 (2022) 100256 by Chidinma Okani and Carmen Black

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