Violence In Emergency Department Research Articles

Position statement — Violence in emergency departments

Position statement — Violence in emergency departments

Violence: Part of the job for Australian nurses?

According to a recent Australian Institute of Criminology report (1999) the health industry is the most violent industry in Australia. In this paper the authors aim to highlight violence as an important professional issue for Australian nurses that is currently concealed as ‘part of the job’. National and international studies bring attention to the severity of the problem for nurses with a particular focus on Emergency nurses. Some of the issues identified and discussed include: increased waiting times and frustration; increasing use of weapons; inadequate systems of security; culture of silence; inadequate support for emergent mental health needs; lack of reporting; lack of institutional concern and systems of support, and; demands of triage nursing. The nature of workplace violence in Emergency Departments in New South Wales and South Australia will be explored based on the authors research. A research pathway to explore national impact and implications of violence for nurses and nursing practice in general will be outlined.

Violence in the emergency department

PREVIEWThe growing trend of violence in America's emergency departments (EDs) has the medical community on alert. Many hospitals have implemented security protocols, but the very nature of the ED environment makes it vulnerable to violence that jeopardizes the safety of staff and patients. Dr Kuhn discusses management of violent patients as well as safety measures and prevention of dangerous situations.

Security in pediatric emergency departments.

With increasing emergency department (ED) violence, security in pediatric EDs is an important concern. The objective of this study was to document current security measures taken in pediatric EDs in the United States. A telephone survey of the security director or designee in the 42 children's hospitals in the United States with over 150 beds was performed. A questionnaire focusing on ED security was administered. Two hospitals declined to participate. In 62.5% of EDs surveyed, a security officer is present in the ED 24 hours/day. Hospital security officers carry firearms in 32.5% of hospitals surveyed. Most (92.5%) EDs have an alarm system or "panic button" which alerts central security; but only 15% have a direct phone from the ED to security. Seven EDs (17.5%) use bullet-resistant glass, and 14 EDs (35%) have controlled access. No ED reported universal metal detector screening. Fourteen directors (35%) reported having had a firearm-related incident in their ED in the past year. In spite of the relatively common nature of ED violence, security measures in pediatric EDs are varied, with most EDs not using all measures recommended by the American College of Emergency Physicians.

Workplace abuse: unrecognized emergency department violence.

Workplace abuse: unrecognized emergency department violence.

Emergency Department Violence

Emergency Department Violence

Emergency department violence in United States teaching hospitals.

Violence in the emergency department is a common concern. However, most aspects of this problem remain unstudied because no organization or government agency tracks such data and no regulatory or administrative guidelines adequately address its management. We surveyed 170 US teaching hospital ED medical directors with respect to violence and security issues and received responses from 127 (74.7%). Among other findings, 41 institutions report at least one verbal threat each day, and 23 report at least one threat with a weapon each month. Four-point physical restraint is used by 125 of the 127 facilities. Personnel in 32 of these facilities restrain at least one patient each day. Seventeen institutions report having significantly injured a patient during restraint in the last five years, resulting in one death. Twenty institutions report involvement with litigation with respect to restraint. Only 51 institutions provide ED nurses with formal training in recognition and management of aggression and violence, and only 79 institutions have security personnel present in the ED 24 hours a day. A sizable number of facilities receiving frequent threats and batteries are not among those with 24-hour-a-day security personnel. A preventative, risk-management approach that addresses environmental factors, training policies, restraint, security arrangements, and legal precedents is suggested.