Patient physical violence toward healthcare workers at a US children's hospital

An improved understanding of patient-related violent events toward healthcare workers (HCWs) is a critical step in mitigating patient violence in the pediatric medical hospital setting. Therefore, we sought to describe the timing/setting, potential antecedents to, and management of pediatric patient-related violence toward HCW. Using our electronic health record (EHR), we performed a retrospective study of patient-related physical violent events from 2017 to 2022 among youth hospitalized at our free-standing children's hospital. We identified 144 violent events associated with 75 patients. Most (66.7%) events occurred after a youth was medically cleared for discharge, and most (55%) events were preceded by an aversive experience the youth was trying to avoid. Most (77.1%) youth received medications for de-escalation, and nearly one-half (47.9%) experienced mechanical restraints. Our results highlight the challenges hospitals face while caring for youth at risk for behavioral escalations and support the need for both comprehensive in-patient behavioral health teams.