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Professional Assessment and Evaluation of Risk Factors risk factors are not diagnostic. They should not be used to label patients, clients, relatives, and friends; nor should they cause professionals to jump to conclusions. However, risk factors are significant and when present in combination, they may indicate that a patient or client needs a referral for evaluation by an appropriate therapist or healthcare provider. In workplace settings, it���s important for nurses to be vigilant and consult with their colleagues and document that they have notified attending providers of their assessment, request for treatment orders, triage, and/or transfer to a specialty unit or higher level of care. In addition, direct-care nurses have a responsibility to notify management of the need for additional staffing and/or a change in work- References Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H... (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job satisfaction. Journal of the American Medical Association 288: 1987-1993. Aiken, L. H., Sloane, D. M., Cimiotti, J. P., Clarke, S. P., Flynn, L., Seago, J. A. , Spetz, J. , & Smith, H. L., (2010). Implications of the California nurse staffing mandate for other states. Health Services Research, 45 (4). 904-21. Aleccia, J., Hospital violence is on the rise, health agency warns. September 16, 2010, MSNBC.com. Retrieved from http://www.msnbc.msn.com/id/39213800/ns/healthhealth_care/t/hospital-violence-rise Associated Press. Suspect in Fatal Shooting at Chicago Hospital Arrested. November 25, 2011. Retrieved on November 26, 2011 from http://www.timesleader.com/news/Shooting-at-Chicagohospital.html Black, H. C., (1979). Black���s Law Dictionary: Definitions of the Terms and Phrases of American and English Jurisprudence, Ancient and Modern. Fifth Edition by The Publisher���s Editorial Staff. West Publishing Co., St. Paul, Minnesota. Broward, C., Family: Security at fault in slaying at Shands Jacksonville pharmacy. September 27, 2011. Retrieved on November 14, 2011 from http://jacksonville.com/news/crime/2011-0927/story/family-security-fault-slaying-shands-jacksonvillepharmacy Centers for Disease Control & Prevention (CDC). Occupational Violence. NIOSH Workplace Safety and Health Topic. Retrieved on November 14, 2011 from http://www.cdc.gov/ niosh/topics/violence/ Colliver, V., Children���s Hospital Oakland Fined. February 23, 2011. Retrieved on November 14, 2011 from http://articles.sfgate.com/ 2011-02-23/bay-area/28620778_1_emergency-room-shootingvictim-california-nurses-association Department of Health and Human Services. Centers for Disease Control and Prevention. National Institute for Occupational Safety and Health (2008). Exposure to stress: Occupational hazards in hospitals. DHHS (NIOSH) Publication No. 2008-136. 18 N AT I O N A L N U R S E place accommodations to enhance the safety of patients and staff. Such requests should be documented in writing, for purposes of accountability and to eliminate the possibility of administrative deniability. Nurses��� Health and Safety Tool Kit: the national institute for Occupational Safety and Health defines occupational stress as ���the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources, or needs of the worker.��� In addition to psychological distress, other outcomes of job stress include burnout, absenteeism, employee intent to leave, reduced patient satisfaction, and treatment errors. In general, studies of nurses have found the following factors to be linked with stress: work overload, time pres- Dock, L. L., & Stewart, I. M. (1931). A Short History of Nursing: From the Earliest Times to The Present Day. New York; London: G.P. 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In keeping patients safe: Transforming the work environment of nurses (Ed. A, pp. 226-285). Washington, D.C., The National Academies Press. Institute of Medicine, (2011). Social and Economic Costs of Violence: The Value of Prevention. Washington, D.C., The National Academies Press. Jaffe, I. (2011). At California Mental Hospitals, Fear Is Part of the Job. Accessed on December 7, 2011 at http: //www.uapd.com/ wp-content/uploads/NPR-Transcript.pdf Kohn LT, Corrigan JM, Donaldson MS, eds. To err is human: building a safer health system. Washington, DC: National Academy Press, Institute of Medicine; 1999. Kuehn, B. M. (2010). Violence in healthcare settings on the rise. Journal of the American Medical Association, 304(5), 511-512. Magnavita, N., & Heponiemi, T. (2011). Workplace violence against nursing students and nurses: An Italian experience. Journal of Nursing Scholarship 43 (2), 203-210. Massachusetts Nurses Association, (2010) Workplace Violence: Prevention & Intervention Brochure. Retrieved on November 14, 2011 from: http://www.massnurses.org/health-andsafety/workplace-violence/brochure W W W. N A T I O N A L N U R S E S U N I T E D . O R G MARCH 2012