Copyright © 2017 American College of Occupational and Environmental Medicine. Unauthorized reproduction of this article is prohibited Effect of Mindfulness-Based Stress Reduction Training on Health Care Worker Safety A Randomized Waitlist Controlled Trial Morgan Anne Valley, MPH, PhD and Lorann Stallones, MPH, PhD Objective: The study assessed the impact of mindfulness training on occupational safety of hospital health care workers. Methods: The study used a randomized waitlist-controlled trial design to test the effect of an 8-week mindfulness-based stress reduction (MBSR) course on self-reported health care worker safety outcomes, measured at baseline, postintervention, and 6 months later. Results: Twenty-three hospital health care workers participated in the study (11 in immediate intervention group; 12 in waitlist control group). The MBSR training decreased workplace cognitive failures (F [1, 20] ¼ 7.44, P ¼ 0.013, h 2 p ¼ 0:27) and increased safety compliance behaviors (F [1, 20] ¼ 7.79, P ¼ 0.011, h 2 p ¼ 0:28) among hospital health care workers. Effects were stable 6 months following the training. The MBSR intervention did not significantly affect participants’ promotion of safety in the workplace (F [1, 20] ¼ 0.40, P ¼ 0.54, h 2 p ¼ 0:02). Conclusions: Mindfulness training may potentially decrease occupational injuries of health care workers. H ospital health care workers have a high occupational injury rate. In the United States, hospital health care workers had an annual incidence rate of 6.0 recordable non-fatal injuries per 100 full-time equivalent (FTE) employees in 2015, which represents a rate higher than the all-industry non-fatal occupational injury and illness incidence rate (3.3/100 FTE). 1 Research has suggested that in additional to the physical pain and damage caused by an injury incident, occupational injuries affect mental and social well-being through increased stress, family conflict, and decreased daily functioning. 2 Protecting and promoting occupational safety and health among health care professionals is especially important, as evidence suggests that improving aspects of health care worker well-being and safety not only predicts health care worker injuries and clinician job satisfaction, but also reduces medical errors and increases patient satisfaction. 3–5 Given the far reaching impact of health care worker safety and health, researchers, practitioners, and government organizations have called for the creation and evaluation of practical interventions that promote both health care worker occupational safety and overall well-being. 6 These scholars and practitioners hope that such interventions will also ultimately improve patient safety and quality of care. The current study responds to this call by testing mindfulness training, generally used as a stress reduction and wellness promotion program among health care providers, 7 as an intervention intended to impact health care worker safety outcomes. Mindfulness is defined as ‘‘a receptive attention to and awareness of present events and experience.’’ 8 While normal func- tioning involves awareness and attention, mindfulness, entails heightened, nonjudgmental awareness, and attention. 8 Mindfulness training, which involves increasing a person’s ability to attain nonjudgmental awareness in the present moment, 9 has been increas- ingly incorporated into workplace wellness programs leading to positive outcomes among workers. 10–13 Mindfulness-based stress reduction (MBSR) interventions in particular have had success in reducing negative outcomes among health care workers including anxiety, depression, and perceived stress levels. 7,14–19 The MBSR program, developed at University of Massachusetts Medical School, trains participants to incorporate mindfulness into their daily lives. 20 The well-validated program consists of eight 2.5- to 3.5-hour weekly group sessions and one longer (typically 6 to 8 hours) silent retreat session. The sessions consist of training and practice in mindfulness meditation, informational presentations on topics such as stress physiology, group discussions, and home assignments that promote practicing the skills learned in the program. 21 A recent review of the role of mindfulness in the workplace found that a growing body of evidence supports a positive associ- ation between mindfulness and attention stability, control, and efficiency, which in turn impacts cognition, emotion, behavior, and physiology. 11 These impacts have implications for workplace safety outcomes, including workplace cognitive failure and safety performance. Workplace cognitive failure refers to cognitively- based errors that occur during the performance of a work task that an individual can normally successfully complete. 22 A decline in workplace cognitive failure can lead to a decline in safety perform- ance and an increase in workplace injuries. Safety performance consists of two factors: safety compli- ance and safety participation. 23 Safety compliance refers to personal safety behaviors including adherence to established workplace safety procedures and rules. Safety participation refers to safety behaviors that are external to an employee’s role, such as offering suggestions on how to improve workplace safety and promoting overall safety within the workplace. A longitudinal study of hospital employees found that as health care workers’ self-reported safety performance increased, the number of injuries in the workplace decreased. 24 The reduction in injuries occurred at the group level, Learning Objectives  Become familiar with recent research on mindfulness-based stress reduction (MBSR) interventions for healthcare workers, and their potential effects on workplace safety.  Summarize the study design and the MBSR training intervention evaluated.  Identify specific safety-related outcomes that were and were not affected by the MBSR intervention. From the Department of Psychology (Dr Valley, Dr Stallones); Graduate Degree Program in Public Health, Colorado School of Public Health at Colorado State University (Dr Stallones); High Intermountain Plains Center for Agricultural Health and Safety (Dr Stallones), Colorado State University, Fort Collins, Colorado. Funding: The study was partially funded by a small grant from NIOSH through the Mountain and Plains Education and Research Center. Authors Valley and Stallones have no relationships/conditions/circumstances that present potential conflict of interest. The JOEM editorial board and planners have no financial interest related to this research. Address correspondence to: Morgan Anne Valley, MPH, PhD, Department of Psychology, Colorado State University, Sage Hall, Fort Collins, CO 80523- 1879 (Morgan.Valley@colostate.edu). Copyright ß 2017 American College of Occupational and Environmental Medicine DOI: 10.1097/JOM.0000000000001090 JOEM  Volume 59, Number 10, October 2017 935 CME A VAILABLE FOR THIS ARTICLE AT ACOEM.ORG