Original contribution
Aggression directed toward emergency department staff at a university teaching hospital

https://doi.org/10.1016/S0196-0644(05)80941-2Get rights and content

Study objective:

To determine the scope and magnitude of patient and visitor aggression directed toward emergency department staff.

Design:

One-year retrospective review of university police log records and ED staff incident reports.

Setting:

Medium-sized, urban, noncounty, university Level I teaching hospital treating approximately 40,000 ED patients annually.

Type of participants:

All violent incidents involving patients/visitors and ED staff that triggered a police response to the ED area were included in the study.

Interventions:

None.

Measurements and main results:

All ED violent episodes were recorded and categorized by shift, type of incident, type of police response, perpetrator, and site of incident. It was found that police responded to the ED nearly twice daily; the night shift had 32% of the cases with only 13% of the patient volume; custody and medical psychiatric clearance patients accounted for 40% of the cases; more than 20% of incidents occurred in the waiting room; and 4.2% of the incidents represented a significant threat to ED staff.

Conclusion:

ED violence is a significant and under-reported problem at our medium-sized university teaching hospital. These data are useful in objectively quantifying the scope of violence in our institution, and they underscore the potential risks to emergency patients, visitors, and staff. There is an acute need for additional studies in other settings so that appropriate and cost-effective security recommendations can be formulated.

References (13)

  • DrummondD et al.

    Hospital violence reduction among high-risk patients

    JAMA

    (1989)
  • CullenEJ

    Violence to staff in the health services

    Br Health Safety Comm

    (1987)
  • MorganM et al.

    Violence and the accident and emergency department

    Health Bull

    (1985)
  • CardwellS

    Aggression management: Violence in accident and emergency departments

    Nurs Times

    (1984)
  • WrightB

    Hostility in accident and emergency departments

    Nurs Mirror

    (1985)
  • PinkneyD

    ER violence growing

    Am Med News

    (1987)
    PinkneyD

    ER violence growing

    Am Med News

    (1987)
There are more references available in the full text version of this article.

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Presented at the Third International Conference on Emergency Medicine in Toronto, Ontario, Canada, June 1990.

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