Patient-related violence at triage: A qualitative descriptive study

Abstract

The aim of the study was to describe the experiences of a group of triage nurses with patient-related workplace violence during the previous month. Globally and within the Australian health industry, nurses have been reported to be the occupation at most risk of patient-related violence, with triage nurses identified as a high risk group for both verbal and physical violence. The study took place in the Emergency Department of a tertiary referral and teaching hospital in regional New South Wales, Australia. Data were collected from August to September 2008, and a qualitative descriptive methodology was employed. The participants all reported experiencing episodes of patient related violence that were perceived as inevitable and increasing in intensity and frequency. Themes included identification of precipitating factors such as long waiting times and alcohol and substance misuse. Organisational issues included lack of aggression minimisation training; lack of formal debriefing following episodes of violence and frustration at lengthy reporting processes. In the context of the Emergency Department where patients present with a range of diagnoses and behaviours, it is unlikely that the issue of patient-related violence can be totally eliminated. However it can be prevented or managed more effectively on many occasions. Strategies to support staff and prevent and manage violence effectively should be a priority to provide a safe working environment and occupational health and safety for staff.