Personal security alarms for the prevention of assaults against healthcare staff

The review was led and conducted by Chloe Perkins, Phil Edwards and Deirdre Beecher in the Faculty of Epidemiology and Population Health at the London School of Hygiene and Tropical Medicine, assisted by David Colas Aberg and Nick Tilley from the Jill Dando Institute for Security and Crime Science at UCL.

The Crime Survey of England and Wales (2014-2015) found health and social care associate professionals to be the occupational group most at risk of violence after those working in protective services, such as police officers. Over six per cent of health and social care professionals, which include most nurses, suffered one or more incident of violence at work in 2015-6. Personal security alarms comprise one measure to try to reduce violence against healthcare staff.

A 2003 report from the National Audit Office identified a variety of security measures in place across NHS trusts. Panic alarm systems were used in 85% of trusts and were therefore, selected as the focus of this review. A Health & Safety Commission report* outlined three types of alarm system all of which would be eligible for inclusion in the review:

  • Panic button systems are part of an internal alert system, which often comprise hardwired buttons placed in locations where there is a high risk of violence or linked portable attack devices. Their activation triggers an alarm on a monitoring console.
  • Personal security alarms range from simple 'shriek' devices, designed to shock or disorientate an attacker to give victims time to get away, to a component in a monitored system (as above).  
  • Complex personal alarm systems include personal alarms linked to fixed detection systems e.g. by radio or infra-red. Components may include panic buttons (linked to switch board and/or police) and portable personal devices (linked to central system with location information).

Alarms are seldom the sole means used to try to prevent violence against staff in healthcare settings. The contexts in which alarms are employed differ widely in terms, for example, of the other violence prevention methods in use, clinical specialism, whether lone working is a factor, and the population served. This review targeted all studies that examined the use of any personal alarm interventions that were implemented to address the risks of violence and assault. The focus was primarily on studies relevant to NHS or healthcare setting, although evaluations of alarms used in other occupational settings were not excluded.

This review is the fourteenth in a series of systematic reviews to be delivered by the Commissioned Partnership Programme.

A research protocol has been included below.  

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*Commission HaS. 2nd ed.Violence and aggression to staff in health services: guidance on assessment and management. Norwich: 1997.