Epidemiology of unarmed threats in the emergency department

Knott, Jonathan; Bennett, Dianne; Rawet, Jennifer; Taylor, David

doi:10.1111/j.1742-6723.2005.00756.x

Cited by 58 publications

(84 citation statements)

References 13 publications

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“…This may indicate that aggression prevention training on its own only increases awareness and wariness and does not improve perceived safety like the BAR and associated policy. Consistent with previous research, 11 the majority of respondents reported having been verbally abused by patients, whereas more than half reported incidences of physical abuse during their period of employment in the ED. A large proportion of ED staff members reported being affected personally by violence or aggression in the workplace, with many taking leave due to these incidences.…”

Section: Discussionsupporting

confidence: 77%

“…8 The Australasian College of Emergency Medicine and Australian Nursing Federation have clear policies regarding occupational violence, 17,18 however there have been few innovative strategies incorporated into emergency health care. In light of recent reports of escalating violence within EDs both domestically 3,11 and internationally, 9,10,[19][20][21] this strategy is both timely and warranted.…”

Section: Discussionmentioning

confidence: 99%

“…Violence in the ED is generally under-reported, 8,9 and that which is reported indicates an alarming trend. 8,10,11 The occupational violence prevention strategy recommended by the Australian Institute of Criminology involves a three-part approach comprising ■ structural changes to the work environment; ■ administrative strategies such as audits and response teams; and ■ the effective communication of practices and policies through staff training. 12 Despite these recommendations, models for managing acutely behaviourally disturbed patients within a general medical context are rarely described in the scientific literature.…”

Section: What Are the Implications For Practitioners?mentioning

confidence: 99%

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Managing acute behavioural disturbance in an emergency department using a behavioural assessment room

Cowling

McKeon²,

Weiland³

2007

Aust. Health Review

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This study was conducted to evaluate a behavioural assessment room (BAR) as a strategy in the management of people exhibiting acute behavioural disturbance in the St Vincent's Hospital, Melbourne Emergency Department (ED). The study involved a retrospective audit of the data documented for BAR use over a 12-month period and a structured questionnaire of clinical and nonclinical emergency department staff.Patients managed in the BAR presented with various behaviours; 58% were substance induced. The median duration of stay in the room was 20 minutes, during which assessment and containment or "behavioural resuscitation" proceeded. 98.5% of questionnaire respondents believed that the BAR created a safer environment EMERGENCY DEPARTMENTS (EDs) are faced with an increasing number of patients exhibiting behavioural disturbance that interferes with health care provision and may place patients, staff and/or others at risk. Workplace violence has also been on the rise over the past few decades. 1,2 Effective containment of this escalating situation demands an innovative approach and change in attitude by health professionals. 3 The increase in behavioural disturbance may be attributed to a growing demand on EDs, changing trends in illicit drug use, 4 and the redirection of mental health care towards a "mainstream" community-based model. [5][6][7] The structural design and care pathways of EDs have traditionally been geared towards medical emergencies rather than managing adverse behaviour. With respect to the increased number of behaviourally disturbed patients within EDs and the associated difficulties in managing their care, the typical ED environment is no longer conducive to optimum safety; patient care may be compromised and undue stress is placed on staff and visitors to the department. Previous research indicates that although ED staff feel able to assess the potential for violence, they perceive themselves as being inadequately skilled to manage aggression. 7 A recent internal quality improvement survey of St Vincent' s Hospital, Melbourne (SVHM) ED staff revealed that only one third of staff felt safe to very What is known about the topic? Despite escalating demands on emergency departments there are few strategies for managing the behaviourally disturbed patient. Clinicians have struggled to provide an adequate environment for the management of aggressive behaviour, and while most hospitals have a generic response to acute aggressive incidences, this strategy is insufficient for emergency department environments. What does this paper add?This paper describes and evaluates a strategy for managing behavioural disturbance; a dedicated space in association with supported processes and policies. It is demonstrated that this formula increases the perceived safety of ED staff. What are the implications for practitioners? Providing a dedicated area to manage behavioural disturbance provides effective behavioural resuscitation, thereby facilitating a more streamlined and safe approach to health care delivery.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: What Are the Implications For Practitioners?mentioning

confidence: 99%

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Managing acute behavioural disturbance in an emergency department using a behavioural assessment room

Cowling

McKeon²,

Weiland³

2007

Aust. Health Review

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“…Este estudio contribuyó en explorar características locales, corroborando que, en concordancia con reportes internacionales, la heteroagresividad fue la principal causa de admisión (15,16) . Sin embargo, la presentación de síntomas psicóticos e irritabilidad fueron casi tan frecuentes como la conducta suicida.…”

Section: Discussionunclassified

Emergencias psiquiátricas en niños y adolescentes: Relación entre características clínicas y demográficas

2017

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Introducción. Actualmente, la presentación de cuadros agudos de trastornos psiquiátricos es habitual en niños y adolescentes. Objetivo. Determinar la relación entre variables clínicas y demográficas de niños y adolescentes atendidos por emergencia psiquiátrica. Diseño. Estudio cuantitativo, observacional, retrospectivo y analítico. Lugar. Hospital Hermilio Valdizán, Lima, Perú. Participantes. Pacientes menores de 18 años (N=285), de ambos sexos, atendidos durante el período setiembre 2014 - setiembre 2015. Intervenciones. Se recopiló información de historias clínicas, clasificándolas en variables clínicas y demográficas. El análisis univariado se realizó por distribución de frecuencias y el bivariado por pruebas chi cuadrado y exacta de Fisher. Resultados. El 13% de emergencias psiquiátricas fueron pediátricas. Fue más frecuente en el sexo femenino (60%), grupo etario de 12 a 17 años (93,3%) y procedencia Lima Este (73%). La edad media fue 14,8 (DE=2,1) años. Los motivos de emergencia más frecuentes fueron heteroagresividad (28,4%), alucinaciones (13,7%), irritabilidad (11,9%) y autoagresividad (10,9%). La ideación suicida (9,1%) estuvo asociada al sexo femenino OR 3,05 (IC-95%: 1,12-8,35; p=0,023). Las categorías diagnósticas más frecuentes fueron F20-F29 (31,6%), F30-F39 (25,6%) y F60-F69 (18,6%). El F30-F39 OR 2,31 (IC95%: 1,28 a 4,16; p=0,005) y F60-F69 OR 2,11 (IC95%: 1,09 a 4,10; p= 0,025) estuvieron asociados al sexo femenino. El 49% de los pacientes necesitó internamiento. Conclusiones. Existió aumento en prevalencia y menor edad de presentación al comparar con años previos. La heteroagresividad fue el motivo más frecuente de consulta. El sexo femenino tuvo mayor riesgo de Ideación suicida, trastornos del ánimo y personalidad. Se sugiere la elaboración de protocolos estandarizados y manejo especializado.

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“…In the local hospital of a small Finnish city, every fourth new client in the emergency department was under the influence of alcohol on weekdays and as many as half on weekend nights [28]. In Australia, one third of patients who made threats in emergency departments were under the influence of alcohol [29].…”

Section: Discussionmentioning

confidence: 99%

Injuries of Three Health Care Districts Employees in Finland

Salminen¹,

Parantainen²

2012

OJSST

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Occupational injuries in hospitals have two-fold effects, decreasing both safety employees and the level of patient care. The aim of this study is to examine occupational injuries in Finnish hospitals. Three health care districts reported injuries and violent acts and the number of their employees over a period of three years: 2006-2008. Every eighth hospital worker was involved in an occupational injury each year, which is more than among the general working population. In addition, every twentieth hospital employee had encountered violence or a threat of violence in their work, which corresponds to the risk of violence among working men. There were huge differences in injury and violence rates between health care districts, which were due to different reporting procedures used in districts. Underreporting is another possible explanatory factor especially for minor injuries and verbal aggression.

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Epidemiology of unarmed threats in the emergency department

Cited by 58 publications

References 13 publications

Managing acute behavioural disturbance in an emergency department using a behavioural assessment room

Managing acute behavioural disturbance in an emergency department using a behavioural assessment room

Emergencias psiquiátricas en niños y adolescentes: Relación entre características clínicas y demográficas

Injuries of Three Health Care Districts Employees in Finland

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