Introducing routine risk assessment for occupational violence and aggression in the emergency department

Abstract

In reference to the recent work on understanding economic evaluation alongside emergency medicine research by Singh et al 1 , we would like to draw attention to the selection of the discount rate when performing an economic analysis. This choice has implications in that a figure in the lower ranges may overestimate the value of an outcome or the cost of an intervention or project. A higher rate may result in less promising results and may even be enough to send a potential capital investment's Net Present Value into the negative.There are three different options to selecting an appropriate discount rate, depending on what the aim of the calculations are.

Daily reality of violence in a rural emergency department: Is violence becoming the new normal?

“…This finding of perpetrator diversity casts doubt in the presumed success of a one‐size fits all solution, such as de‐escalation training or a zero‐tolerance policy. Despite this, organisational interest in structured risk assessment tools continues 18 …”

Nursing management of emergency department violence—Can we do more?

“…Reports can be as low as Ryan and Maguire's (2006) report of 3% in an Irish ED up to an estimated 91.5% in Italy (Ramacciati et al, 2019) (see Table 1). A recent review confirmed that this disparity and difference in percentages is common across the literature (Nikathil et al, 2017), although it must be noted that some of the studies where higher rates were observed included to small local samples (Ogundipe et al, 2013;Wright-Brown et al, 2016).…”

“…Defining the exact nature and prevalence of violence has always been problematic. As early as 2002, Krug et al reported the difficulty in getting an accurate measure of the scale of the phenomenon due to incident reporting not always being completed, even in health services that supported reporting (Ryan & Maguire, 2006).…”

“…Back in 2006, a survey (n = 80) examined ED nurses' views on violence and reported this as ranging from threatening aggression to severe physical violence; in one month, the occurrence of both was estimated at 54% and 3%, respectively (Ryan & Maguire, 2006). where accompanying adults are the source of violence (Margavi et al, 2020).…”

“…While violence can pervade across many areas of healthcare practice, violence in the adult emergency department (ED) is often highlighted as being of particular concern (Brunero et al, 2021;Lenaghan et al, 2018;Ryan & Maguire, 2006). Indeed, staff in the ED are more likely to experience violence than in other areas of health care (Sharifi et al, 2020;Zoleo et al, 2020) and many nurses are concerned for their own safety (Sharifi et al, 2020).…”