Wearable Technology and Pulse Transit Time (PTT) Used to Assess Workplace Violence Incidents in Nursing

Abstract

Nurses are exposed to incidents of workplace violence involving patients and their family members, and also coworkers. Studies of occupational stressors generally rely on subjective self-reports, questionnaires, or biometric and biochemical markers in long-cycle time intervals, but such assessments offer little guidance to HF/E intervention efforts. This study examined the viability of using wearable sensors to detect workplace violence incidents, and included measurement of pulse transit time (PTT) as a biomarker of continuous blood pressure. Six nurses were monitored over seven days. The electrocardiogram, PTT, and activity level were measured using a custom-designed armband. Participants used a wristwatch (Empatica E4) to log incidents, and a smartphone survey app to rate incident severity. Results show PTT was a more reliable indicator of workplace incidents than low- to high-frequency (LF/LH) ratio heart rate variability, offering a more robust way to continuously monitor critical events noninvasively over long periods in demanding work environments.