Violence in the Emergency Department

Stowell, Keith R.; Hughes, Nolan P.; Rozel, John S.

doi:10.1016/j.psc.2016.07.003

Cited by 39 publications

(34 citation statements)

References 26 publications

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“…Harmful physical contact can include (but not limited to) striking, slapping, punching, spitting, kicking, choking, biting, pushing, sexual assault and use of weapons against staff. Verbal abuse can include (but not limited to) yelling, insults, intimidation, threats, bullying, harassment, use of derogatory gestures and swearing …”

Section: Resultsmentioning

confidence: 99%

“…Nevertheless, it is plausible that OV risk could be identified from either or a combination of, patients' clinical presentations, exhibited behaviours at triage, and historical characteristics. Whereas these findings are reflected in, and endorsed by previous reviews, specific risk factors from each category that could be incorporated in an accurate evidence‐based OV risk assessment tool remain uncertain.…”

Section: Discussionmentioning

confidence: 98%

“…Verbal abuse can include (but not limited to) yelling, insults, intimidation, threats, bullying, harassment, use of derogatory gestures and swearing. 4,6,[8][9][10]14,15,18,[23][24][25][26]29,30,32,33,[39][40][41]43,45,47 OV incidents varied between EDs, which ranged from 1.4 to 17 per 1000 presentations. 8,22,24,29,36 At least 65% of ED staff experienced OV.…”

Section: Scoping Review Findingsmentioning

confidence: 99%

“…Despite an apparently wide body of evidence exploring OV in healthcare, and specifically in EDs, OV risk assessment is underdeveloped. Therefore, the aims of this scoping review were to synthesise patient factors associated with increased risk of OV, and to explore and summarise the validity of existing OV risk assessment tools in the ED.…”

Section: Introductionmentioning

confidence: 99%

“…10 Patient personal characteristics such as history of violence, mental illness, cognitive impairment or drug and/or alcohol intoxication, available during initial contacts with presenting patients, could also be important early predictors of OV. 11,12 Despite an apparently wide body of evidence exploring OV in healthcare, and specifically in EDs, 4,6,[13][14][15][16][17][18] OV risk assessment is underdeveloped. Therefore, the aims of this scoping review were to synthesise patient factors associated with increased risk of OV, and to explore and summarise the validity of existing OV risk assessment tools in the ED.…”

Section: Introductionmentioning

confidence: 99%

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Review article: Identifying occupational violence patient risk factors and risk assessment tools in the emergency department: A scoping review

Cabilan

Johnston

2019

Emerg Medicine Australasia

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Occupational violence (OV) is a daily risk for ED staff. It contributes to staff stress, sick leave, turn‐over and burn‐out, and limits the capacity of staff to provide unimpeded quality care to patients and their families. Many factors contribute to incidents of OV; however, early detection of such risk factors could pre‐empt incidences of OV during ED episodes of care. A five‐stage methodological framework for scoping reviews was used to identify, summarise and synthesise OV risk factors from five key databases. A validated tool was used to appraise the quality of included studies. Independent evaluation by the reviewers was used throughout. Patient factors were extracted and described from 24 methodologically and geographically diverse papers. Methodological quality for these studies varied from moderate to high. A total of 34 OV risk factors were identified. Although there was variation in, and differences between, staff‐perceived and objective (documented) OV risk factors, patient risk factors can be categorised into three main groups: clinical presentation, behaviours and past history. Five existing ED OV risk assessment tools were identified, with limited supporting evidence for each. The results support the development of a reliable and validated OV risk assessment tool to be initiated at triage.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

Section: Scoping Review Findingsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Review article: Identifying occupational violence patient risk factors and risk assessment tools in the emergency department: A scoping review

Cabilan

Johnston

2019

Emerg Medicine Australasia

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Prevalence of Discrimination, Abuse, and Harassment in Emergency Medicine Residency Training in the US

Lall

Bilimoria

et al. 2021

JAMA Netw Open

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IMPORTANCEThe prevalence of workplace mistreatment and its association with the well-being of emergency medicine (EM) residents is unclear. More information about the sources of mistreatment might encourage residency leadership to develop and implement more effective strategies to improve professional well-being not only during residency but also throughout the physician's career. OBJECTIVETo examine the prevalence, types, and sources of perceived workplace mistreatment during training among EM residents in the US and the association between mistreatment and suicidal ideation. DESIGN, SETTING, AND PARTICIPANTS In this survey study conducted from February 25 to 29, 2020, all residents enrolled in EM residencies accredited by the Accreditation Council for Graduate Medical Education (ACGME) who participated in the 2020 American Board of Emergency Medicine computer-based In-training Examination were invited to participate. A multiple-choice, 35-item survey was administered after the examination asking residents to self-report the frequency, sources, and types of mistreatment experienced during residency training and whether they had suicidal thoughts. MAIN OUTCOMES AND MEASURESThe types and frequency of workplace mistreatment and the sources of the mistreatment were identified, and rates of self-reported suicidality were obtained.Multivariable logistic regression models were used to examine resident and program characteristics associated with suicidal thoughts. RESULTSOf 8162 eligible EM residents, 7680 (94.1%) responded to at least 1 question on the survey; 6503 (79.7%) completed the survey in its entirety. A total of 243 ACGME-accredited residency programs participated, and 1 did not. The study cohort included 4768 male residents (62.1%), 2698 female residents (35.1%), 4919 non-Hispanic White residents (64.0%), 2620 residents from other racial/ethnic groups (Alaska Native, American Indian, Asian or Pacific Islander, African American, Mexican American, Native Hawaiian, Puerto Rican, other Hispanic, or mixed or other race) (34.1%), 483 residents who identified as lesbian, gay, bisexual, transgender, queer, or other (LGBTQ+) (6.3%), and 5951 residents who were married or in a relationship (77.5%). Of the total participants, 3463 (45.1%) reported exposure to some type of workplace mistreatment (eg, discrimination, abuse, or harassment) during the most recent academic year. A frequent source of mistreatment was identified as patients and/or patients' families; 1234 respondents (58.7%) reported gender discrimination, 867 (67.5%) racial discrimination, 282 (85.2%) physical abuse, and 723 (69.1%) sexual harassment from patients and/or family members. Suicidal thoughts occurring during the past year were reported by 178 residents (2.5%), with similar prevalence by gender (108 men [2.4%]; 59 women [2.4%]) and race/ethnicity (113 non-Hispanic White residents [2.4%]; 65 residents from other racial/ethnic groups [2.7%]).

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Multisite study of Aggressive Behavior Risk Assessment Tool in emergency departments

et al. 2022

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Violence in the Emergency Department

Cited by 39 publications

References 26 publications

Review article: Identifying occupational violence patient risk factors and risk assessment tools in the emergency department: A scoping review

Review article: Identifying occupational violence patient risk factors and risk assessment tools in the emergency department: A scoping review

Prevalence of Discrimination, Abuse, and Harassment in Emergency Medicine Residency Training in the US

Multisite study of Aggressive Behavior Risk Assessment Tool in emergency departments

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