Violence in the Emergency Department: What Can We Do?

Abstract

Violence in healthcare settings is a problem around the world, with hospital emergency departments (EDs) being the most common sites. The most important step in preventing violence is to determine the causes and characteristics of the problem. However, there is not enough information in the literature about the particular areas of EDs in which violence occurs. We aim to produce results that can contribute to violence prevention activities by gathering detailed information about violent incidents in EDs and the intensity of this violence. Our study was planned as a retrospective and descriptive study at a tertiary emergency medicine clinic. Our data include "code white" data between January 1, 2015, and December 31, 2019. The characteristics and types of violence were recorded and categorized. We evaluated 141 incidences of severe violence reported during the study period. We determined that 55.2% of the violence was directed at physicians and 21.3% at nurses. Verbal violence was by far the most common type of violence, comprising 98.6% of the cases. We found that the violence cases occurred in examination rooms, observation areas, and triage units of the ED (58.2%, 24.1%, and 11.3%, respectively). We determined that violence in the ED is most common after standard working hours, and the most frequent exposure to violence is in examination rooms, observation areas, and triage areas. These findings may be useful in determining preventive measures in EDs, where violence is most common.