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Prospective study of violence against ED workers.

Kowalenko T; Gates D; Gillespie GL; Succop P; Mentzel TK
Am J Emerg Med 2013 Jan; 31(1):197-205
Background: Health care support occupations have an assault-injury rate nearly 10 times the general sector. Emergency departments (EDs) are at greatest risk of such events. Objective: The objective was to describe the incidence of violence in ED health care workers (HCWs) over 9 months. Specific aims were to (1) identify demographic, occupational, and perpetrator factors related to violent events (VEs) and (2) identify predictors of acute stress in victims and predictors of loss of productivity. Methods: A longitudinal, repeated-methods design was used to collect monthly survey data from ED HCWs at 6 hospitals. Surveys assessed number and type of VEs, and feelings of safety and confidence. Victims also completed specific VE surveys. Descriptive statistics and a repeated-measure linear regression model were used. Results: Two hundred thirteen ED HCWs completed 1795 monthly surveys and 827 VEs were reported. Average VE rate per person per 9 months was 4.15. Six hundred one eventswere physical threats (PTs) (3.01 per person). Two hundred twenty six events were assaults (1.13 per person). Five hundred one VE surveys were completed, describing 341 PTs and 160 assaults. Men perpetrated 63% of PTs and 52% of assaults. Significant differences in VEs were reported between registered nurses (RNs) and medical doctors (MDs) (P = .0017) and patient care assistants (P < .05). The RNs felt less safe than the MDs (P = .0041). The MDs felt more confident than the RNs in dealing with violent patients (P = .013). The RNs were more likely to experience acute stress than the MDs (P < .001). Acute stress reduced productivity (P < .001). Conclusion: Emergency department HCWs are frequent victims of violence perpetrated by visitors and patients. This results in injuries, acute stress, and lost productivity. Acute stress has negative consequences on workers' ability to perform their duties.
Violence-prevention; Force; Health-care-facilities; Health-care; Medical-facilities; Health-care-personnel; Statistical-analysis; Epidemiology; Emergency-care; Stress; Physical-stress; Psychological-stress; Demographic-characteristics; Injuries; Medical-personnel; Nurses; Physicians
Terry Kowalenko MD, University of Michigan, Ann Arbor, MI 48109
Publication Date
Document Type
Journal Article
Email Address
Funding Type
Fiscal Year
Identifying No.
Grant-Number-R01-OH-009544; Grant-Number-T42-OH-008432
Issue of Publication
Source Name
The American Journal of Emergency Medicine
Performing Organization
University of Cincinnati
Page last reviewed: May 11, 2023
Content source: National Institute for Occupational Safety and Health Education and Information Division