Lisa A Pompeii

University of Houston, Houston, Texas, United States

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Publications (44)77.11 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: Under-reporting of non-fatal violence perpetrated by patients or visitors (type II) against healthcare workers is a recognized barrier to adequately examining the risk of these events. We sought to improve methods for reporting type II violence through formal hospital-based surveillance systems. Methods: A mixed methods approach of surveys, focus groups and key-informant interviews among workers at 6 U.S. hospitals was employed to ascertain details about the mechanisms through which workers report and factors that influenced reporting. Findings: Workers were more likely to report verbally to coworkers rather than reporting through a formal hospital reporting system. Contextual factors that influenced formal reporting included type of event (physical abuse more than verbal); workers’ injury severity and feeling worried about safety at work; management involvement and their level of response in prior violence events; and, perpetrator’s age, medical condition, and (perceived) intent to harm. Institutional policies that place an emphasis on patient satisfaction fostered concern among workers about being blamed for violent events or for mismanaging them which deterred some from reporting, while others felt compelled to formally document their actions to avoid being reprimanded. Conclusion: These contextual factors contribute to the incomplete capturing of events resulting in underestimates of exposure to type II violence for workers. Incomplete capture of events results in underestimates of exposure for workers, as well as erroneous conclusions that could result in failure to intervene in high risk areas. Institutional policies that focus on patient satisfaction can give workers mixed messages about “acceptable” reporting practices.
    142nd APHA Annual Meeting and Exposition 2014; 11/2014
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    ABSTRACT: Background/Objective: Patient and visitor perpetrated violence against healthcare workers (type II) is a well-recognized, growing public health concern. We describe various effects of hospital workers’ perception of type II violence as “part of the job.” Methods: Across 6 acute-care hospitals, data were collected through surveys, telephone interviews, focus groups, and key informant interviews. Results: Hospital workers described violence as “part of the job.” Influences of this perception on workers’ social support and job satisfaction were observed and highlighted the lack of coordinated institutional efforts to address type II violence from an occupational safety perspective. The perception influenced the research approach and interpretation of findings. Type II violent events based on the study definition were not always reported by participants who perceived them as “part of the job.” Researchers were struck by participants’ composure recounting experiences of dangerous situations, including violent encounters that researchers and other study participants found clearly traumatic. Workers’ experiences supported their concerns and recommendations for prevention, mitigation, and follow-up of violent events to ensure worker and patient well-being. However, various agendas within complex healthcare systems create barriers to making even simple, albeit urgently needed, changes to enhance workers’ safety. Conclusions: Currently, there is a general lack of tangible, practiced, and enforced comprehensive institutional-level efforts to address type II violence from an occupational safety perspective. Such inattention, coupled with an intense focus on customer service in hospitals, perpetuates an acceptance of violence against healthcare workers, rather than appropriately ensuring it is not “part of the job.”
    142nd APHA Annual Meeting and Exposition 2014; 11/2014
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    ABSTRACT: Hospital sitters provide continuous observation of patients at risk of harming themselves or others. This study examined violence perpetrated by patients/visitors (type II) against hospital sitters in two US healthcare systems.
    Occupational and environmental medicine. 06/2014; 71 Suppl 1:A53.
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    ABSTRACT: To examine the management of workplace violent events (type II) by hospital unit nurse managers and staff.
    Occupational and environmental medicine. 06/2014; 71 Suppl 1:A52.
  • Sadie Conway, Lisa Pompeii, David Gimeno
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    ABSTRACT: To operationalize a definition of long working hours that overcomes limitations of existing heterogeneous definitions and to examine the temporal trends of long working hours across worker characteristics in the US.
    Occupational and environmental medicine. 06/2014; 71 Suppl 1:A114.
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    ABSTRACT: While violence can adversely affect mental health of victims, repercussions of violence against workers is not as well characterized. We explored relationships between workplace violent events perpetrated by patients or visitors (Type II) against hospital employees and the employee use of psychotropic medications or mental health services using a data system that linked violent events with health claims. Significant associations were observed between reported Type II workplace violent events and employee prescription claims for anti-depressants and anxiolytics combined (RR = 1.45, 95% CI = 1.01-2.33) and anti-depressants alone (RR = 1.65, 95% CI = 1.10-2.48). No significant association between reported violent events and health claims for treatment of depression or anxiety was observed. Type II violence experienced by hospital workers may lead to increased use of psychotropic drugs, particularly anti-depressants but also anxiolytics. Our results suggest an important role of employee assistance programs in mitigating the psychological consequences of workplace violent events. Am. J. Ind. Med. © 2014 Wiley Periodicals, Inc.
    American Journal of Industrial Medicine 02/2014; · 1.97 Impact Factor
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    ABSTRACT: To examine the relationship between the frequency of Internet use and depression among people with spinal cord injury (SCI). Cross-sectional survey SETTING: The Model Spinal Cord Injury System in the United States PARTICIPANTS: People with SCI (N=4,618) who were interviewed between 2004 and 2010. Not applicable. The frequency of Internet use and the severity of depressive symptoms were measured simultaneously by interview. Internet use was reported as daily, weekly, monthly, or none. The depressive symptoms were measured by the Patient Health Questionnaire-9 (PHQ-9), with two published criteria being used to screen for depressive disorder. The diagnostic method places more weight on non-somatic items (i.e., items 1, 2, and 9), and the cut-off method that determines depression by a PHQ-9 score ≥ 10 places more weight on somatic factors. The average scores of somatic and non-somatic items represented the severity of somatic and non-somatic symptoms, respectively. Our multivariate logistic regression model indicated that daily Internet users were less likely to have depression (OR=.77, 95% CI: .64-.93) if the diagnostic method were used. The linear multivariate regression analysis indicated that daily and weekly Internet usage was associated with fewer non-somatic symptoms; no significant association was observed between daily or weekly Internet usage and somatic symptoms. People with SCI who use the Internet daily are less likely to have depression.
    Archives of physical medicine and rehabilitation 08/2013; · 2.18 Impact Factor
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    ABSTRACT: Non-fatal type II violence experienced by hospital workers (patient/visitor-on-worker violence) is not well described. Hospital administration data (2004-2009) were examined for purposes of calculating rates of type II violent events experienced by workers. We also conducted a review of the hospital-based literature (2000-2010) and summarized findings associated with type II violence. 484 physical assaults were identified in the data, with a rate of 1.75 events/100 full-time equivalents. Only few details about events were captured, while non-physical events were not captured. The literature yielded 17 studies, with a range proportion of verbal abuse (22%-90%), physical threats (12%-64%) and assaults (2%-32%) reported. The literature lacked rigorous methods for examining incidence and circumstances surrounding events or rates of events over time. For purposes of examining the impact of type II violence on worker safety, satisfaction and retention, rigorous surveillance efforts by hospital employers and researchers are warranted.
    Journal of safety research 02/2013; 44:57-64. · 1.34 Impact Factor
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    ABSTRACT: Multiple studies have identified single-nucleotide polymorphisms (SNPs) that are associated with coronary heart disease (CHD). We examined whether SNPs selected based on predefined criteria will improve CHD risk prediction when added to traditional risk factors (TRFs). SNPs were selected from the literature based on association with CHD, lack of association with a known CHD risk factor, and successful replication. A genetic risk score (GRS) was constructed based on these SNPs. Cox proportional hazards model was used to calculate CHD risk based on the Atherosclerosis Risk in Communities (ARIC) and Framingham CHD risk scores with and without the GRS. The GRS was associated with risk for CHD (hazard ratio [HR] = 1.10; 95% confidence interval [CI]: 1.07-1.13). Addition of the GRS to the ARIC risk score significantly improved discrimination, reclassification, and calibration beyond that afforded by TRFs alone in non-Hispanic whites in the ARIC study. The area under the receiver operating characteristic curve (AUC) increased from 0.742 to 0.749 (Δ = 0.007; 95% CI, 0.004-0.013), and the net reclassification index (NRI) was 6.3%. Although the risk estimates for CHD in the Framingham Offspring (HR = 1.12; 95% CI: 1.10-1.14) and Rotterdam (HR = 1.08; 95% CI: 1.02-1.14) Studies were significantly improved by adding the GRS to TRFs, improvements in AUC and NRI were modest. Addition of a GRS based on direct associations with CHD to TRFs significantly improved discrimination and reclassification in white participants of the ARIC Study, with no significant improvement in the Rotterdam and Framingham Offspring Studies.
    Atherosclerosis 06/2012; 223(2):421-6. · 3.71 Impact Factor
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    ABSTRACT: We assessed whether low-density lipoprotein particle concentration (LDL-P) and high-sensitivity C-reactive protein [hs-CRP] can identify subclinical atherosclerosis better than traditional cholesterol parameters in retired National Football League (NFL) players. It is not known whether LDL-P and the biomarker hs-CRP can identify subclinical atherosclerosis better than low-density lipoprotein cholesterol (LDL-C) or non-high-density-lipoprotein cholesterol (non-HDL-C) in retired NFL players, given high prevalence of metabolic syndrome in these players. Carotid artery plaque screening was performed with traditional lipids, LDL-P, and hs-CRP in 996 retired players. Logistic regression analyses comparing highest with the lowest quartile were performed. Carotid artery plaques were seen in 41%. LDL-C (odds ratio [OR] 1.66, 95% confidence interval [CI] 1.06-2.59), non-HDL-C (OR 1.67, 95% CI 1.04-2.67), and LDL-P (OR 2.21, 95% CI 1.35-3.62) were associated with plaques in adjusted models. Among 187 retired players with metabolic syndrome, LDL-C (OR 1.40, 95% CI 0.53-3.72) was not associated with carotid plaques, whereas LDL-P (OR 3.71, 95% CI 1.16-11.84) and non-HDL-C (OR 2.63, 95% CI 0.91-7.63, p=0.07; borderline significant) were associated with carotid plaques. hs-CRP (OR 1.13, 95% CI 0.71-1.79) was not associated with carotid plaques. Carotid artery plaques were common in retired NFL players and were strongly associated with LDL-P, especially among those with metabolic syndrome. hs-CRP was not associated with carotid plaques in this cohort.
    Atherosclerosis 04/2012; 222(2):551-6. · 3.71 Impact Factor
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    ABSTRACT: Specific occupations are associated with adverse respiratory health. Inhalation exposures encountered in these jobs may place workers at risk of new-onset respiratory disease. We analyzed data from 8,967 participants from the Atherosclerosis Risk in Communities (ARIC) study, a longitudinal cohort study. Participants included in this analysis were free of chronic cough and phlegm, wheezing, asthma, chronic bronchitis, emphysema, and other chronic lung conditions at the baseline examination, when they were aged 45-64 years. Using data collected in the baseline and first follow-up examination, we evaluated associations between occupation and the three-year incidence of cough, phlegm, wheezing, and airway obstruction and changes in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) measured by spirometry. All associations were adjusted for age, cigarettes per day, race, smoking status, and study center. During the approximately three-year follow-up, the percentage of participants developing chronic cough was 3%; chronic phlegm, 3%; wheezing, 3%; and airway obstruction, defined as FEV1 < lower limit of normal (LLN) and FEV1/FVC < LLN, 2%. The average annual declines in FEV1 and FVC were 56 mL and 66 mL, respectively, among men and 40 mL and 52 mL, respectively, among women. Relative to a referent category of managerial and administrative support occupations, elevated risks of new-onset chronic cough and chronic phlegm were observed for mechanics and repairers (chronic cough: RR: 1.81, 95% CI: 1.02, 3.21; chronic phlegm: RR: 2.10, 95% CI: 1.23, 3.57) and cleaning and building service workers (chronic cough: RR: 1.85, 95% CI: 1.01, 3.37; chronic phlegm: RR: 2.28, 95% CI: 1.27, 4.08). Despite the elevated risk of new-onset symptoms, employment in cleaning and building services was associated with attenuated lung function decline, particularly among men, who averaged annual declines in FEV1 and FVC of 14 mL and 23 mL, respectively, less than the declines observed in the referent population. Employment in mechanic and repair jobs and cleaning and building service occupations are associated with increased incidence of respiratory symptoms. Specific occupations affect the respiratory health of adults without pre-existing respiratory health symptoms and conditions, though long-term health consequences of inhalation exposures in these jobs remain largely unexplored.
    Respiratory research 03/2012; 13:24. · 3.64 Impact Factor
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    ABSTRACT: OBJECTIVE: Using an observational research design and robust surveillance data, we evaluated rates of musculoskeletal (MS) injuries, days away from work, and restricted work days among patient care staff at a medical center and community hospital in the United States over 13 years, during which time a "minimal manual lift" policy and mechanical lift equipment were implemented. METHODS: Workers' compensation claims data were linked to human resources data to define outcomes of interest and person-time at risk to calculate rates. Poisson and negative binomial regression with lagging were used to compare outcome rates in different windows of time surrounding the intervention. Patterns of MS injuries associated with patient-handling were contrasted to patterns of other MS injuries that would not be affected by the use of mechanical lift equipment. RESULTS: At the medical center, no change in the patient-handling MS injury rate followed the intervention. A 44% decrease was observed at the community hospital. At both hospitals, the rate of days away declined immediately - before it was reasonable for the intervention to have been adopted. CONCLUSIONS: Institutional-level changes at the time of the intervention likely influenced observed results with findings only partially consistent with an intervention effect. Observational studies can be useful in assessing effectiveness of safety interventions in complex work environments. Such studies should consider the process of intervention implementation, the time needed for intervention adoption, and the dynamic nature of work environments.
    Scandinavian Journal of Work, Environment & Health 03/2012; · 3.10 Impact Factor
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    ABSTRACT: We evaluated costs for workers' compensation (WC) injuries of a musculoskeletal (MS) nature in a large tertiary care hospital and an affiliated community hospital in the 13 years surrounding an institution-wide shift to a 'minimal manual patient-lifting environment' supported with inpatient mechanical lift equipment. Negative binomial regression was used to model adjusted and discounted payment rates based on full-time equivalents (FTEs), and payment ratios. The risk of higher cost was assessed based on type of injury (patient-handling vs non-patient-handling), hospital, job, age, gender, institutional tenure and time since the implementation of lift equipment. Lagging was used to evaluate the latency of the intervention effect. Patient-handling injuries (n=1543) were responsible for 72% of MS injuries and 53% of compensation costs among patient care staff. Mean costs per claim were 5 times higher for those over age 45 than those <25 years of age. Physical and occupational therapy aides had the highest cost rates ($578/FTE) followed by nursing aides ($347/FTE) and patient transporters ($185/FTE). There was an immediate, marked decline in mean costs per claim and costs per FTE following the policy change and delivery of lift equipment. The observed patterns of changes in cost likely reflect the effects of activities other than use of lift equipment, including targeted efforts to close WC claims and an almost simultaneous policy that shifted cost responsibility to the budgets of managers on individual units. Inference was facilitated through the use of longitudinal data on the workgroups and an internal injury comparison.
    Occupational and environmental medicine 12/2011; 69(5):367-72. · 3.64 Impact Factor
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    ABSTRACT: To examine associations between occupation and respiratory health in a large, population-based cohort of adults in the United States. Data from 15,273 participants, aged 45 to 64 years, in the Atherosclerosis Risk in Communities study were used to examine associations of current or most recent job held with the prevalence of self-reported chronic cough, chronic bronchitis, wheezing, asthma, and measures of lung function collected by spirometry. Eleven percent of participants reported wheezing and 9% were classified as having airway obstruction. Compared with individuals in managerial and administrative jobs, increased prevalences of respiratory outcomes were observed among participants in selected occupations, including construction and extractive trades (wheezing, prevalence ratio = 1.92, 95% confidence interval = 1.35, 2.73; airway obstruction, prevalence ratio = 1.31, 95% confidence interval = 1.05, 1.65). Specific occupations are associated with adverse respiratory health.
    Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 12/2011; 54(2):157-65. · 1.88 Impact Factor
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    ABSTRACT: Work focused on understanding implementation and adoption of interventions designed to prevent patient-handling injuries in the hospital setting is lacking in the injury literature and may be more insightful than more traditional evaluation measures. Data from focus groups with health care workers were used to describe barriers and promoters of the adoption of patient lift equipment and a shift to a "minimal-manual lift environment" at two affiliated hospitals. Several factors influencing the adoption of the lift equipment and patient-handling policy were noted: time, knowledge/ability, staffing, patient characteristics, and organizational and cultural aspects of work. The adoption process was complex, and considerable variability by hospital and across units was observed. The use of qualitative data can enhance the understanding of factors that influence implementation and adoption of interventions designed to prevent patient-handling injuries among health care workers.
    American Journal of Industrial Medicine 12/2011; 54(12):946-54. · 1.97 Impact Factor
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    ABSTRACT: Interventions to reduce patient-handling injuries in the hospital setting are often evaluated based on their effect on outcomes such as injury rates. Measuring intervention adoption could address how and why observed trends in the outcome occurred. Unit-level data related to adoption of patient lift equipment were systematically collected at several points in time over 5 years on nursing units at two hospitals, including hours of lift equipment use, equipment accessibility, and supply purchases and availability. Various measures of adoption highlighted the adoption process' gradual nature and variability by hospital and between units. No single measure adequately assessed adoption. Certain measures appear well-correlated. Future evaluation of primary preventive efforts designed to prevent patient-handling injuries would be strengthened by objective data on intermediate measures that reflect intervention implementation and adoption.
    American Journal of Industrial Medicine 12/2011; 54(12):935-45. · 1.97 Impact Factor
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    ABSTRACT: There is a paucity of data regarding relations of apolipoproteins (apolipoprotein B [ApoB] and apolipoprotein A-1 [Apo A-1]), lipoprotein particle measures (low-density lipoprotein particle concentration [LDLp] and high-density lipoprotein particle concentration [HDLp]), and lipoprotein cholesterol measures (low-density lipoprotein cholesterol [LDL-C], non-high-density lipoprotein cholesterol [non-HDL-C], and high-density lipoprotein cholesterol [HDL-C]) with atherosclerotic plaque burden, plaque eccentricity, and lipid-rich core presence as a marker of high-risk plaques. Carotid artery magnetic resonance imaging was performed in 1670 Atherosclerosis Risk in Communities study participants. Vessel wall and lipid cores were measured; normalized wall index (NWI), standard deviation (SD) of wall thickness (measure of plaque eccentricity) were calculated; and lipid cores were detected in vessels with ≥ 1.5mm thickness. Fasting concentrations of cholesterol, ApoB and Apo A-1, and LDLp and HDLp were measured. Measures of plaque burden (carotid wall volume, wall thickness, and NWI) were positively associated with atherogenic cholesterol and lipoproteins (p < 0.05 for total cholesterol, LDL-C, non-HDL-C, ApoB, and LDLp), but not with HDL-C, Apo A-1, or HDLp. SD of wall thickness was associated with total cholesterol (p 0.01) and non-HDL-C (p 0.02). Although measures of atherogenic or anti-atherogenic cholesterol or lipoprotein were not individually associated with detection of a lipid-rich core, their ratios (total cholesterol/HDL-C, non-HDL-C/HDL-C, and LDLp/HDLp) were associated with lipid-rich core presence (p ≤ 0.05). Extent of carotid atherosclerosis is associated with atherogenic cholesterol and lipoproteins. Atherogenic/anti-atherogenic cholesterol or particle ratios were associated with presence of a detectable lipid-rich core.
    Atherosclerosis 08/2011; 219(2):596-602. · 3.71 Impact Factor
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    ABSTRACT: Nail gun use is ubiquitous in wood frame construction. Accessibility and decreasing costs have extended associated occupational hazards to consumers. Compelling evidence documents decreased injury risk among trained users and those with tools with sequential triggers. To prevent inadvertent discharge of nails, this safer trigger requires the nose be depressed before the trigger is pulled to fire. The sequential trigger is not required by the Consumer Product Safety Commission (CPSC) or the Occupational Safety and Health Administration (OSHA) nor are there any guidelines for training. We collected data from personnel at 217 points of sale/rental of framing nail guns in four areas of the country. Sales personnel had little understanding of risks associated with use of framing nail guns. Individuals who had used the tool and those working in construction outlets were more likely to be knowledgeable; even so, less than half understood differences in trigger/actuation systems. Consumers, including contractors purchasing for workers, cannot count on receiving accurate information from sales personnel regarding risks associated with use of these tools. The attitudes and limited knowledge of some sales personnel regarding these potentially deadly tools likely contributes to a culture accepting of injury. The findings demonstrate how influences on the culture of construction are not limited to workers, employers, or the places construction gets done.
    American Journal of Industrial Medicine 04/2011; 54(8):571-8. · 1.97 Impact Factor
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    ABSTRACT: To examine, in light of vague professional guidelines, current obstetrical recommendations for pregnant women engaging in occupational activities. A survey mailed to obstetricians/gynecologists in Texas ascertained data about occupational activity information collected from patients in the prenatal period and recommended activities to avoid, including activities addressed in the American Medical Association (AMA) guidelines. Of 961 obstetricians 427 (46.6%) responded to the survey, with 384 used for these analyses. A large proportion (96.3%) asked women about employment status, while fewer (46.2%) asked about occupational activities (e.g., lifting). Obstetricians were more likely to recommend that women avoid lifting >20 lb (68.6%) and ladder climbing (87.9%), while fewer recommended avoiding night/shift work (15.5%), standing >4 hours/day (26.0%) and bending/twisting at the waist (34.0%) (third trimester), with an increase in recommending limitations on activities as pregnancy progressed. Obstetricians reporting having patients in physically demanding jobs and those with more years of experience were more likely to recommend avoiding these activities. Respondents agreed with the AMA guidelines, except 62.2% disagreed that women should minimize bending at the waist while lifting. These findings highlight the need for professional organizations to develop new or to revise existing guidelines. Rigorous studies that examine adverse pregnancy outcomes associated with exposure to occupational activities are needed to inform guidelines.
    The Journal of reproductive medicine 01/2011; 56(1-2):17-24. · 0.75 Impact Factor
  • Journal of The American College of Cardiology - J AMER COLL CARDIOL. 01/2011; 57(14).

Publication Stats

390 Citations
77.11 Total Impact Points

Institutions

  • 2009–2014
    • University of Houston
      Houston, Texas, United States
  • 2007–2014
    • University of Texas Health Science Center at Houston
      • • School of Public Health
      • • Division of Epidemiology, Human Genetics and Environmental Sciences
      Houston, Texas, United States
  • 2013
    • University of Texas at Tyler
      Tyler, Texas, United States
  • 2005–2012
    • Duke University Medical Center
      • Department of Community and Family Medicine
      Durham, NC, United States
  • 2010
    • University of Texas MD Anderson Cancer Center
      • Department of Epidemiology
      Houston, TX, United States
  • 2006–2010
    • University of North Carolina at Chapel Hill
      • Department of Epidemiology
      Chapel Hill, NC, United States