ASH staffers spat on, cut and bruised, latest report says

Employees at Atascadero State Hospital said they were spat on, bruised and cut while working with patients inside the facility, according to a roundup of the most recent attacks against staff.

The preliminary incident reports, released Thursday at The Tribune’s request, are part of a new series of attack information The Tribune will publish regularly.

Atascadero State Hospital, licensed for 1,275 patients, is one of five state hospitals that treat mentally ill violent offenders. The goal is to stabilize them through medication, therapy and daily programs so offenders can return to trial or prison within an average of six months.

ASH cost the state nearly $223 million in fiscal year 2011-12, a hospital spokes-man said.

Violent acts by patients toward staff and other patients occur regularly. Last year, there were 409 aggressive incidents against staff. Of them, 151 resulted in injury, according to state data.

The details in each report are preliminary, as they reflect initial information that hospital management still needs to investigate. Staff names are not released and job titles remain general to protect the identity of employees, officials said. For example, an incident involving a “nursing employee” could mean a psychiatric technician or a registered nurse.

The new weekly batch of information on violence from ASH became available after a recent clampdown in which officials decided to limit the release of attack information to the media and public. Under that plan, news outlets would get information on acts resulting in only the most severe outcomes — hospitalization and arrest — as well as incidents of patient escape, murder and suicide.

But because everyday aggressive acts occur at much higher rates than more severe assaults, most attacks would go unreported.

Specifically, only one assault out of 247 aggressive incidents reported through June this year would have been reported to the media under the plan.

The shift in the public’s access to such daily assault reports didn’t affect the way administrators compiled their own attack data for the state, the way ASH informed its employees about attacks internally or data that reporters and the public could seek through the Public Records Act.

But it did mean that real-time attack information would be largely limited since records requests typically result in data that are two months old because of the time it takes the state to track and compile statistics.

Shortly after The Tribune’s article ran Sept. 2 detailing the shift, Department of State Hospitals Chief Deputy Director Kathy Gaither told The Tribune that the practice was “overly restrictive” and that ASH administrators would work on transparency going forward.

From Sept. 6 to Sept. 12, seven nursing employees reported assaults by patients with various degrees of injury, including no injury, according to information The Tribune received Thursday.

When there is injury, the data are broken down into how those physical-injury incidents to staff occurred: either by sudden, outright assaults or when a patient is being stabilized.

Assaults occur when patients become agitated and behave violently toward staff in the course of a day.

Stabilization incidents, previously identified as “containment” incidents, occur when patients become violent and resist staff members who are trying to calm them. Staff tries to contain patients by administering medication, physically restraining them or secluding them in a room, according to the hospital.

Here’s a look at the preliminary incident reports from Sept. 6 through Sept. 12

At 6:30 p.m. Sept. 6, two nursing employees were injured on a unit during the stabilization of a patient. Injuries reported included a bruised elbow and “a bump on the head,” according to the report.

At 11 a.m. Sept. 8, a patient spat on the arm of a nursing employee. No injuries were reported.

At 4 p.m. Sept. 8, a nursing employee was injured during a patient assault. Injury included a superficial cut to the staff member’s leg.

At 5:30 p.m. Sept. 9, a nursing employee was injured during the stabilization of a patient. Injury included back and neck pain.

At 5 a.m. Sept. 12, a patient spat into the eyes of two nursing employees as they were stabilizing a patient.