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An audit released this month says that staff at the Oregon State Hospital in Salem are coping with increased violence from mentally ill patients.
Aggressive events, which are logged electronically by OSH, rose from 701 in 2013 to 822 in 2014, according to Sandy Hilton, who managed the audit.
The audit, conducted by the Oregon Secretary of State's office, looks at a 24-hour-care mental hospital that treats patients with mental disorders or illness who have been committed by their guardians or the justice system.
It says that while the hospital has managed to reduce the number of injury claims filed by nursing staff, patient aggression keeps more than half of them from feeling safe.
"When looking specifically at nursing staff," it says, "nearly 40 percent reported having been assaulted in the past year and just 43 percent reported they felt safe in their job."
Hospital officials say the increase in patient violence is not reason for alarm.
"You have to remember that this audit is just a snapshot in time," said Patricia Feeny, a spokeswoman for the Oregon Health Authority, which oversees the hospital.
"It's a very small percentage of patients that account for the aggression in the audit," she said, "and that's always been true."
The audit, which took place last year, puts that number at less than three percent of patients.
The hospital opened in 1883 and has been working for years to shed a bleak image, finishing a major remodel in 2011 and updating its treatment approaches for patients.
"It's a very, very different culture," now, said Feeny, who worked as the hospital's spokeswoman until 2010. "Its a culture of safety, it's a culture of recovery."
The audit, however, says that the hospital has more ground to cover. Citing a 2014 survey, it says that "a quarter of nursing staff reported they did not believe in the hospital's culture of safety."
Dr. Rupert Goetz is the head of the hospital's safety initiative. "If you sort of turn the card around and look at who is feeling safe, I'm pretty confident we're headed in the right direction," he said.
Goetz says that violence against staff inside the hospital comes largely in two forms, some of it from people right after they get admitted.
Patients like those committed OSH to improve their fitness to stand trial for a crime they've been charged with, he said, are arriving at the hospital during the most trying parts of their lives.
"They come through the door pretty distressed," he said. "It takes them a little bit to get settled in here."
WWeek 2015