261 Assessment of Emergency Department Staff Awareness of Policy and Expert Opinion Protocol Regarding Active Shooter Event.

Abstract

Workplace violence in the hospital setting is a serious and growing concern in the emergency department (ED). The ED is often by nature and by closed-in design a highly vulnerable location for such workplace violence. This is due to a continuous influx of people in and out of the ED as well as an often closed-in schematic design of the ED itself. Recently, a significantly growing concern is the threat of an active shooter event and gunfire in the ED. In one study concerning hospital-based shootings between 2000-2011, 154 hospital related shootings were identified with 59% occurring inside the hospital and 29% occurring within the ED environment (Kelen et all, 2012). While active shooter incidents are inherently unpredictable by nature, it is still prudent to be as prepared as possible for these scenarios in order to maximize survival rates. The goal of this study is to assess the level of familiarity of emergency department staff with hospital policy and response protocol in regard to a potential active shooter incident (ASI). A survey of ED employees including attending physicians, APRN, emergency medicine residents, nurses, and paramedics was distributed using the Qualtrics® platform via an electronic link. The study was approved by our medical school’s IRB. 44% of the respondents were EM residents, 48% were attendings and 8% were nurses. The majority (84%) had worked at their facilities for 1-5 years. Only 4% had participated in n ASI drill in the past year. Personnel who answered NO to: “To your knowledge, is there a hospital-based emergency action plan for which ED employees know to execute in the event of an active shooter incident (ASI)?” were significantly more likely to feel unprepared for an ASI (P<0.0001). Those who did NOT receive training for a hospital-based emergency action plan in any form such as lectures, reading based modules, quizzes, workplace drills, seminars, workshops were also less likely to feel prepared (P=0.0002). Partaking in a drill was significantly associated with feeling less unprepared (P=0.0003). Many participants provided valuable free text format, including the need for formal ASI training, and lack of awareness of the existence of an ASI policy at their hospital. Most emergency physicians and nurses in our survey sample reported feeling unprepared to handle an active shooter incident in their emergency department. This study underscores the need to implement regular training on ASIs for ED staff.