Workplace Violence int he Emergency Department ebianchini

World Health Organization (WHO): Events

where workers are Abused Threatened Physically hurt in situations related to work, including: Traveling for work, involving a threat to their safe-ty or health.

OSHA/CDC: Violent acts

including physical assaults threats of physically hurt directed toward people at work.

Bureau of Labor Statistics’ data showed the

most common cause of nonfatal injuries and

illnesses that required days off from work in

the health care industry was assault.

Verbal abuse rates were lower when emer-

gency departments had:

locked entries

an enclosed nurses’ station,

security signs

well lit areas.

Physical violence were

lower in emergency

rooms with panic but-

tons.

In hospitals with higher commitment to

safety and reporting policies, particularly

with ,

had lower rates of physical

and verbal abuse.

Lancman, S., Mângia, E. F., & Muramoto, M. T.

(2013). Impact of conflict and violence on

workers in a hospital emergency room.

Work, 45(4), 519-527. doi:10.3233/WOR-

131638

Wolf, L. A., Delao, A. M., & Perhats, C. (2014).

Nothing Changes, Nobody Cares: Under

standing the Experience of Emergency

Nurses Physically or Verbally Assaulted

While Providing Care. JEN: Journal Of

Emergency Nursing, 40(4), 305-310.

doi:10.1016/j.jen.2013.11.006

Pacing and/or restlessness

Clenched fist

Loud speech

Excessive demands

Threats

Cursing

Respect Personal Space

Do not be challenge agitated person

Begin verbal communication

Identify wants and feelings

Be short and to-the-point

Listen to what they have to say

Agree or agree to disagree

Lay down law and set clear limits

Offer choices and optimism

interview the patient and staff

Warning Signs of

increasing violence

Main objectives when

dealing with an agitated

individual

1. ensure the safety of the pa-

tient, staff, and others in

the area

2. help the patient handle

their emotions and main-

tain or regain control of

his behavior

3. avoid the use of restraint

(if at all possible)

4. avoid forced influence that

increases anger

Verbal De-escalation

Guidelines

Security Measures to

Improve Staff

- Concealed panic buttons -In nurse’s stations, on staff, in check-in areas -Notify security when pressed -Improve lighting and video surveillance - Limit access to ED area - Waiting room with controlled access to the ED - Doors only used for emergency exits - Escort or buddy system

Over 70% of emergency nurs-

es reported physical or verbal

attacks by patients or visitors

while they were providing pa-

tient care in the emergency

room. Emergency Department Violence: An overview and

compilation of Resource. (2011, April 1). Re

trieved March 13, 2015, from http://

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sa=t&rct=j&q=&esrc=s&source=web&cd=1&

ved=0CCQQFjAA&url=http://www.acep.org/

content.aspx?

id=81782&ei=WDYDVYXzFOvdsATXjIHgAQ&u

sg=AFQjCNE2kqtt8Ntb4MpGqWrL15jR7wxjk

w&sig2=uTgO97kfeiNU3FraVsr3XA&bvm=bv.

88198703,d.cWc

Speroni, K. G., Fitch, T., Dawson, E., Dugan, L., &

Atherton, M. (2014). Incidence and Cost

of Nurse Workplace Violence Perpetrated

by Hospital Patients or Patient Visitors.

JEN: Journal Of Emergency Nursing, 40(

3), 218-228. doi:10.1016/

j.jen.2013.05.014