Violence in the emergency department: An ethnographic study (Part I)

Lau, Jacqui Bee Chuo; Magarey, Judy; Wiechula, Rick

doi:10.1016/j.ienj.2011.07.006

Cited by 22 publications

(44 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It puts in question certain public policy decisions, modes of hospital organization and management, and individual health-care worker's behavior. It corresponds, however, to realities actually observed and referred to in several studies 16,18,24,26) . It also corresponds to published hospital violence prevention guidelines, which stress the need to analyze the risk of violence as close to the ground as possible in order to be able to identify solutions matching the various causal factors identified in work organization 27,28) .…”

Section: Discussionsupporting

confidence: 73%

Impacts of users’ antisocial behaviors in an ophthalmologic emergency department—a qualitative study

d’Aubarede

Sarnin

Touzet

et al. 2016

Journal of Occupational Health

View full text Add to dashboard Cite

avoidance. Several organizational factors concerning the political and economic context, hospital work organization, and health workers' behavior were identified as potentially contributing to ABV. Excessive waiting times, lack of user information, and understaffing emerged as factors contributing to users' ABV. Conclusions: Antisocial behaviors by hospital users are underreported by professionals and under-recognized. They appear to be like continuous occupational exposure leading to delayed adverse consequences either on workers' health or motivation. However, violence in hospitals is not the result of only the action of users, and it may be related to work organization and workers' own behaviors. Only a grounded analysis of the causes of violence in the local work context can uncover relevant solutions. (J Occup Health 2016; 58: 96−106) Key words: Antisocial behavior, France, Grounded theory, Health-care workers, Hospitals, Occupational hazards, Qualitative research, Workplace violence "Third-party violence" in the workplace is a term used to refer to threats and physical and psychological violence (e.g., verbal violence) by third parties such as customers, clients, or patients receiving goods or services 1) . Possible consequences for individual workers, teams, and organizations include impaired psychological well-being, mental and physical illness, absenteeism, impaired performance, and higher turnover 2,3) . Initiatives to address workplace violence come in at the political level (regulations, agreements, guidelines), organizational level (corporate policies, workplace risk assessment, and control), and the level of the individual worker (training, case management, and support). Health-care workers in emergency departments are frequently exposed to risk of antisocial behavior and violence (ABV) by users. Underreporting of ABV by health-care professionals has been identified. In order to understand this phenomenon, we explored the experience of ABV in 30 health workers in an ophthalmology emergency department in the Rhône-Alpes administrative region of France. Methods: A grounded theory qualitative approach was followed. Data were collected from field observations, 30 semistructured individual interviews, violence report forms, and 364 patient satisfaction questionnaires. Qualitative thematic content analysis of the interviews was performed with qualitative data analysis software. Results: Third-party antisocial behaviors and violence were an everyday occurrence, with varying levels of seriousness: impoliteness, vulgarity, nonrecognition, insults, verbal threats, and aggressive gestures. Healthcare workers adopted various strategies to adapt to such violence: proactive and reactive attitudes and

show abstract

Section: Discussionsupporting

confidence: 73%

Impacts of users’ antisocial behaviors in an ophthalmologic emergency department—a qualitative study

d’Aubarede

Sarnin

Touzet

et al. 2016

Journal of Occupational Health

View full text Add to dashboard Cite

show abstract

“…Among the first, lengthy waiting times and conditions such as crowded space, contribute to violence occurrence. Beyond those, other studies suggested that in addition to relatively simply measurable factors such as work overload and waiting times, nurse-patient relations have a profound influence on hospital violence [ 20 – 22 ]. Gaps between staff and patient perceptions were discovered regarding the reasons for violent episodes and the manner in which staff coped with aggression aimed at them [ 23 ] Moreover, as revealed in a companion paper violence assumes different forms and occurs with varying frequencies across different departments, suggesting that perceptions of those involved in violent episodes need to studied more closely [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Violence against physicians and nurses in a hospital: How does it happen? A mixed-methods study

Shafran-Tikva

Chinitz

Stern

et al. 2017

Isr J Health Policy Res

View full text Add to dashboard Cite

BackgroundViolence against medical personnel is unexpected in hospitals which are devoted to healing, and yet, it is frequent and of concern in the health system. Little is known about the factors that lead to hospital violence, and even less is known about the interactions among these factors.The aim of the study was to identify and describe the perceptions of staff and patients regarding the factors that lead to violence on the part of patients and those accompanying them.MethodsA mixed-methods study in a large, general, university tertiary hospital. A self-administered survey yielding 678 completed questionnaires, comprising 34% nurses and 66% physicians (93% response rate). Eighteen in-depth interviews were conducted separately with both victims and perpetrators of violent episodes, and four focus-groups (N = 20) were undertaken separately with physicians, staff nurses, head-nurses, and security personnel.ResultsViolence erupts as a result of interacting factors encompassing staff behavior, patient behavior, hospital setting, professional roles, and waiting times. Patients and staff reported similar perceptions and emotions regarding the episodes of violence in which they were involved. Of 4,047 statements elicited in the staff survey regarding the eruption of violence, 39% referred to staff behavior; 26 % to patient/visitor behavior; 17% to organizational conditions, and 10% to waiting times. In addition, 35% of the staff respondents reported that their own behavior contributed to the creation of the most severe violent episode in which they were involved, and 48% stated that staff behavior contributed to violent episodes. Half of the reasons stated by physicians and nurses for violence eruption were related to patient dissatisfaction with the quality of service, the degree of staff professionalism, or an unacceptable comment of a staff member. In addition, data from the focus groups pointed to lack of understanding of the hospital system on the part of patients, together with poor communication between patients and providers and expectations gaps.ConclusionsOur various and triangulated data sources show that staff and patients share conditions of overload, pressure, fatigue, and frustration. Staff also expressed lack of coping tools to prevent violence. Self-conscious awareness regarding potential interacting factors can be used to develop interventions aimed at prevention of and better coping with hospital violence for both health systems' users and providers.

show abstract

“…Several countries have published general safety and security recommendations for health personnel [ 15 - 22 ]. However, the nature of workplace violence differs between parts of the health sector as well as between cultures and countries [ 23 , 24 ]. In Norway, the Work Environment Act states that employees should be protected as far as possible against violence and threats (§ 4–3) [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Dealing with workplace violence in emergency primary health care: a focus group study

2015

View full text Add to dashboard Cite

BackgroundPrevention and management of workplace violence among health workers has been described in different health care settings. However, little is known about which phenomena the emergency primary health care (EPC) organization should attend to in their strategies for preventing and managing it. In the current study, we therefore explored how EPC personnel have dealt with threats and violence from visitors or patients, focusing on how organizational factors affected the incidents.MethodsA focus group study was performed with a sample of 37 nurses and physicians aged 25–69 years. Eight focus group interviews were conducted, and the participants were invited to talk about their experiences of violence in EPC. Analysis was conducted by systematic text condensation, searching for themes describing the participants’ experiences.ResultsFour main themes emerged for anticipating or dealing with incidents of threats or violence within the system: (1) minimizing the risk of working alone, (2) being prepared, (3) resolving the mismatch between patient expectations and the service offered, and (4) supportive manager response.ConclusionOur study shows a potential for development of better organizational strategies for protecting EPC personnel who are at risk from workplace violence.

show abstract

Violence in the emergency department: An ethnographic study (Part I)

Cited by 22 publications

References 21 publications

Impacts of users’ antisocial behaviors in an ophthalmologic emergency department—a qualitative study

Impacts of users’ antisocial behaviors in an ophthalmologic emergency department—a qualitative study

Violence against physicians and nurses in a hospital: How does it happen? A mixed-methods study

Dealing with workplace violence in emergency primary health care: a focus group study

Contact Info

Product

Resources

About