Workplace violence in the emergency department in India and the United States

Grundmann, Nicolas K.; Yohannes, Yonatan; Silverberg, Mark; Balakrishnan, Jayaraj Mymbilly; Krishnan, S Vimal; Arquilla, Bonnie

doi:10.4103/2455-5568.222476

Cited by 4 publications

(4 citation statements)

References 19 publications

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“…With the caveat that existing ED workplace violence data in India is extremely limited, the prevalence found in this study is somewhat higher than previously reported. In the only prior published study to address the issue, a survey of ED residents at a single institution, 89% of respondents said they had witnessed some form of workplace violence, but only 70% reported having been the victim of violence themselves [9]. The reason for this difference is difficult to ascertain given the dearth of data, but highlights the need for continued research into the issues surrounding ED workplace violence in India.…”

Section: Discussionmentioning

confidence: 99%

“…Likewise, in many low resource settings, the field of emergency medicine (EM) is still in its infancy and patient understanding of what care is available in the emergency setting may be lacking, potentially further exacerbating the risk of violence. Of those studies that have been conducted in India and other low resource settings, most have been limited in scope, either focusing exclusively on one type of provider (physicians vs nurses vs paramedics), or limited to a single institution [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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A qualitative study of workplace violence among healthcare providers in emergency departments in India

et al. 2020

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Background: Emergency department (ED) workplace violence is increasingly recognized as an important issue for ED providers. Most studies have occurred in developed countries with established laws and repercussions for violence against healthcare providers. There is a paucity of data on workplace violence against ED providers in less developed countries. The aim of this study was to learn more about workplace violence among healthcare providers in EDs in India. Results: Semi-structured interviews were conducted in-person with physicians, nurses, and paramedics in Indian EDs. Interviews were coded independently using the NVivo qualitative research software. A hybrid thematic analysis approach was used to determine dominant themes. Sixty-three interviews were conducted at 7 sites across India. Interview participants include attending physicians (11), resident physicians (36), nurses (10), and paramedics (5). Events were most often described as involving accompanying persons to the patient, not the patient themselves. Most events involved verbal abuse, although a significant percentage of responses described some kind of physical violence. ED factors such as busy times with high patient volumes or periods of waiting are associated with increased violence, as well as incidents with unanticipated outcomes such as patients with severe illness or death. Decreased levels of health literacy among patients often contribute as the financial stressors of paying for medical care. Providers reported negative consequences of workplace violence on quality of care for patients and their own motivation to work in the ED. Communication strategies were frequently proposed as interventions to mitigate violence in the future including both provider communication as well as public awareness campaigns. Conclusion: Workplace violence is a frequent reality for this sample of Indian ED healthcare providers. Alarming levels of verbal and physical abuse and their impact on patient care are described. This qualitative study identified unique challenges to Indian ED providers that differ from those in more developed settings, including financial stressors, inadequate enforcement of rules governing behavior in the hospital, and an overwhelming frequency of violence emanating from patient family members and attendants rather than the patients themselves. Further investigation into preventive strategies is needed.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A qualitative study of workplace violence among healthcare providers in emergency departments in India

et al. 2020

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“…[ 7 ] A collaborative survey which looked into emergency physicians in India and US concluded that ED workplace violence is common internationally, underreported, and results in poor job satisfaction, workplace fear, and loss of sleep. [ 8 ]…”

Section: Legislative and Legal Perspectivesmentioning

confidence: 99%

The 2017 Academic College of Emergency Experts and Academy of Family Physicians of India position statement on preventing violence against health - care workers and vandalization of health - care facilities in India

Chauhan

Galwankar

Kumar

et al. 2017

Int J Crit Illn Inj Sci

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There have been multiple incidents where doctors have been assaulted by patient relatives and hospital facilities have been vandalized. This has led to mass agitations by Physicians across India. Violence and vandalism against health-care workers (HCWs) is one of the biggest public health and patient care challenge in India. The sheer intensity of emotional hijack and the stress levels in both practicing HCWs and patient relative's needs immediate and detail attention. The suffering of HCWs who are hurt, the damage to hospital facilities and the reactionary agitation which affects patients who need care are all together doing everything to damage the delivery of health care and relationship between a doctor and a patient. This is detrimental to India where illnesses and Injuries continue to be the biggest challenge to its growth curve. The expert group set by The Academic College of Emergency Experts and The Academy of Family Physicians of India makes an effort to study this Public Health and Patient Care Challenge and provide recommendations to solve it.

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“…Patients may misunderstand available care in the ED and feel their needs are not met, potentially further exacerbating the risk of violence against healthcare workers [ 4 ]. Existing studies in low-and middle-income countries, including India, often focus on a single type of provider such as physicians, nurses, or paramedics [ 9 – 11 ]. To address violence against emergency healthcare providers in India and resource-limited settings, understanding the issues related to violence in EDs is crucial.…”

Section: Introductionmentioning

confidence: 99%

Violence in the emergency department: a quantitative survey study of healthcare providers in India

Ahluwalia,

Singh,

Gandhi

et al. 2024

Int J Emerg Med

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Background Workplace violence (WPV) in Emergency Departments (EDs) is an increasingly recognized challenge healthcare providers face in low-resource settings. While studies have highlighted the increased prevalence of WPV in healthcare, most of the existing research has been conducted in developed countries with established laws and repercussions for violence against healthcare providers. More data on WPV against ED providers practicing in low-resource settings is necessary to understand these providers’ unique challenges. Objective This study aims to gain insight into the incidence and characteristics of WPV among ED healthcare providers in India. Methods This study was conducted at two EDs in geographically distinct regions of India. A survey was designed to assess violence in EDs among healthcare providers. Surveys were distributed to ED workplace providers, completed by hand, and returned anonymously. Data was entered and stored in the RedCAP database to facilitate analysis. Results Two hundred surveys were completed by physicians, nurses, and paramedics in Indian EDs. Most reported events involved verbal abuse (68%), followed by physical abuse (26%), outside confrontation (17%), and stalking (5%). By far, the most common perpetrators of violence against healthcare workers were bystanders including patient family members or other accompanying individuals. Notably, reporting was limited, with most cases conveyed to ED or hospital administration. Conclusion These results underscore the prevalence of WPV among Indian ED healthcare providers. High rates of verbal abuse followed by physical abuse are of concern. Most perpetrators of WPV against healthcare providers in this study were patient family members or bystanders rather than the patients themselves. It is imperative to prioritize implementing prevention strategies to create safer work environments for healthcare workers.

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Workplace violence in the emergency department in India and the United States

Cited by 4 publications

References 19 publications

A qualitative study of workplace violence among healthcare providers in emergency departments in India

A qualitative study of workplace violence among healthcare providers in emergency departments in India

The 2017 Academic College of Emergency Experts and Academy of Family Physicians of India position statement on preventing violence against health - care workers and vandalization of health - care facilities in India

Violence in the emergency department: a quantitative survey study of healthcare providers in India

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