Author(s): Kelen GD, Catlett CL, Kubit JG, Hsieh YH, Kelen GD, Catlett CL, Kubit JG, Hsieh YH
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Abstract STUDY OBJECTIVE: Workplace violence in health care settings is a frequent occurrence. Emergency departments (EDs) are considered particularly vulnerable. Gunfire in hospitals is of particular concern; however, information about such workplace violence is limited. Therefore, we characterize US hospital-based shootings from 2000 to 2011. METHODS: Using LexisNexis, Google, Netscape, PubMed, and ScienceDirect, we searched reports for acute care hospital shooting events in the United States for 2000 through 2011. All hospital-based shootings with at least 1 injured victim were analyzed. RESULTS: Of 9,360 search "hits," 154 hospital-related shootings were identified, 91 (59\%) inside the hospital and 63 (41\%) outside on hospital grounds. Shootings occurred in 40 states, with 235 injured or dead victims. Perpetrators were overwhelmingly men (91\%) but represented all adult age groups. The ED environs were the most common site (29\%), followed by the parking lot (23\%) and patient rooms (19\%). Most events involved a determined shooter with a strong motive as defined by grudge (27\%), suicide (21\%), "euthanizing" an ill relative (14\%), and prisoner escape (11\%). Ambient society violence (9\%) and mentally unstable patients (4\%) were comparatively infrequent. The most common victim was the perpetrator (45\%). Hospital employees composed 20\% of victims; physician (3\%) and nurse (5\%) victims were relatively infrequent. Event characteristics that distinguished the ED from other sites included younger perpetrator, more likely in custody, and unlikely to have a personal relationship with the victim (ill relative, grudge, coworker). In 23\% of shootings within the ED, the weapon was a security officer's gun taken by the perpetrator. Case fatality inside the hospital was much lower in the ED setting (19\%) than other sites (73\%). CONCLUSION: Although it is likely that not every hospital-based shooting was identified, such events are relatively rare compared with other forms of workplace violence. The unpredictable nature of this type of event represents a significant challenge to hospital security and effective deterrence practices because most perpetrators proved determined and a significant number of shootings occur outside the hospital building. Copyright © 2012. Published by Mosby, Inc.
This article was published in Ann Emerg Med
and referenced in Advanced Practices in Nursing