Workplace Violence in the Emergency Department: Case Study on Staff and Law Enforcement Disagreement on Reportable Crimes

Abstract

Violence in the emergency department (ED) remains underreported. Patient factors are often cited as a source of confusion in determining the culpability of perpetrators and whether to proceed with incident reporting. This study’s objective was to determine how ED staff at one academic medical center perceive certain clinical scenarios and how this compares to local law enforcement officers (LEO). An anonymous survey with 4 scenarios was sent to multidisciplinary ED staff at our academic medical center, as well as local LEO and inquired whether respondents considered any of the scenarios to be reportable as a crime. Chi-square analysis was used for comparison. The study was deemed exempt by the Institutional Review Board. A total of 261 ED staff and 77 LEO completed the survey. Both groups were equally likely to believe that a reportable crime occurred in Scenario 1, where a patient with dementia punches a nurse (LEO: 26.0% vs. ED: 31.4%, p = 0.44), and in Scenario 2, where an intoxicated patient spits at a phlebotomist (LEO: 97.4% vs. ED: 95.0%, p = 0.56). However, the two groups differed in Scenario 3, in which a patient with delirium makes verbal threats to a doctor (LEO: 20.8% vs. ED: 42.9%, p < 0.001), and Scenario 4, in which a patient’s parent throws a chair at a medical student (LEO: 66.2% vs. ED: 81.2%, p = 0.009). As health systems seek to improve workplace safety, it is important to consider the barriers to reporting violent incidents, including staff’s understanding of what acts may constitute reportable violence, as well as LEO understanding of the unique ED environment and patient responsibilities.

The growing burden of workplace violence against healthcare workers: trends in prevalence, risk factors, consequences, and prevention – a narrative review

“…Historically, reporting of WPV has been deficient due to organizational and HCW related barriers with multiple studies identifying reporting rates from 20% to 50% 39 , 40 , 41 , 42 and one study finding underreporting rates above 89%. 43 Multiple barriers to WPV reporting have been identified in the literature 44 , 45 and can be categorized as organizational and HCW related ( Table 6 ).…”

Mediational Analysis of Occupational Stress on the Relationship Between Workplace Violence and Staff Performance: Evidence from Khyber Pakhtunkhwa Public Sector Commerce Colleges

“…It is evident from the study's findings that occupational stress mediates the association between workplace violence and staff performance. Therefore, stress cannot be avoided in educational institutions to improve the academic performance of the employees in public sector commerce colleges (McGuire et al, 2022), and thus has become a dire need to reduce the level of stress among the academic employees (Shiyab et al, 2022;Musengamana et al, 2022). Workplace violence adversely affects staff performance (Godbless, 2022).…”

Risk-Reduction Research in Occupational Safety and Ergonomics: An Editorial

“…The set of eleven has three on risk management, five on work organization, and three on ergonomic work design. The international nature of safety research is represented by the countries of the principal authors: Thailand [ 3 ], Saudi Arabia [ 4 ], Iran [ 5 ], China [ 7 ], Poland [ 11 ], and the United States [ 1 , 2 , 6 , 8 , 9 , 10 ].…”

“…Regarding work organization approaches, five papers contributed to the body of knowledge [ 4 , 5 , 6 , 7 , 8 ]. One of these papers described findings from surveys involving construction workers carrying out electrical substation projects in Saudi Arabia [ 4 ].…”

“…A fifth survey related to work climate examined hospital emergency room violence experienced by hospital employees [ 8 ]. The survey described four incident scenarios and asked respondents if they considered the incident a reportable crime.…”