Violence in the ED: No Quick Fixes for Pervasive Threat

Violence in the Emergency Department: A National Survey of Emergency Medicine Residents and Attending Physicians

“…However, in the free-text responses to our survey, there was a great concern among participants that violence in the ED is a pervasive problem, with the belief that the incidence is increasing. This sentiment is reflected in other recent surveys as well (1,8,10,22).…”

“…Table 1 denotes the demographic and program characteristics of the 263 respondents, whereas Tables 2-5 present the demographic and program characteristics cross-tabulated with the reported type and frequency of occurrence of 267 violent acts (four individuals did not report the frequency of occurrence). Responses came from 37 different residency programs with an average number of respondents per program of 6.32 (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Residents comprised 70% (n ϭ 183) of the sample, with post-graduate year (PGY)-2 residents accounting for 37% (n ϭ 98) and PGY-3 residents comprising an additional 25% (n ϭ 65).…”

“…Few recent studies have been done to assess the incidence and nature of violence in the ED (10). The seminal national study on ED violence was published by Lavoie et al in 1988, and examined types of violence as well as patient-restraining techniques (5).…”

Security Implications of Physical Design Attributes in the Emergency Department

“…Literature suggests numerous long-term impacts of ED violence, which manifest in a complex combination entailing impaired job performance and productivity (for different periods of time), loss of staff time, retention and recruitment challenges, staff morale, increase in substance abuse, depression, and posttraumatic stress disorder (PTSD), consequently affecting both healthcare finances and patient satisfaction (Fernandes et al, 1999;Gates et al, 2011;Luck, Jackson, & Usher, 2007, 2008Pich et al, 2010;Wilkes, Mohan, Luck, & Jackson, 2010). Security in the ED is a current and critical issue.…”

“…It either facilitates or impedes operations, thereby leading to suboptimal process solutions or workaround that impact optimal patient care. The focus on the ED physical environment in a lesser number of published papers serves as acknowledgment of this association (ENA, 2011; Greene, 2008; Ferns et al, 2005; Hoag-Apel, 1998; Lavoie et al, 1998; McAneney & Shaw, 1994; Whitley et al, 1996) where factors such as location of facility, inadequate lighting, waiting room conditions, and so forth have been cited.…”