Violence Against Nurses and Other Health Care Personnel in an Urban Level I Trauma Center

Purpose:
The purpose of this study was twofold: 1) To compare ED nursing personnel experiences with violence and perceptions of workplace safety with national benchmarks and 2) To identify their perceptions of factors that precipitate and diminish violence in the ED.

Background/Significance:
Violence against nurses and other health care personnel in Emergency Departments (ED) is gaining national attention. Organizations such as The Joint Commission and the Emergency Nurses Association (ENA) have lent their support to the issue by making it priorities for research, policy development, and accreditation

Methods:
This abstract reports Time 1 findings of a prospective quasi-experimental study. The sample consisted of 52 nurses, paramedics, and patient support assistants from an urban Level 1 trauma center. Measures included a survey developed by ENA for two national studies (Gacki-Smith, et al., 2009, ENA, 2011) to measure violence against ED nurses and nursing assistants and interviews with 5 expert informants. Survey items were in multiple formats, including open-ended items. Analyses conducted on quantitative items included descriptive statistics, t-tests and chi-square analyses while open-ended items were analyzed using Cresswell's (2007) generalized approach for qualitative inquiry.

Results:
The final sample consisted of 52 nurses and staff (82% RN) with a mean of 7.6 years experience in the ED. Participants in this study revealed that they were often unsure of the types of security controls used in the ED to protect them. When compared to findings for nurses from high population, urban EDs, participants in this study experienced higher daily or weekly levels of physical violence (study 39.2%, national sub-group 13.4%) and verbal abuse (study 68%, national 43.8%). Qualitatively, participants identified cynicism, collaboration, concerns for customer service, consequences, and consistency as factors that exacerbate or diminish violence in the ED.

Conclusions and Implications for Practice:
Findings from this study are being used to respond to the specific violence concerns identified in this study. Some of the changes in progress include new mandatory staff training and development and implementation of a zero-tolerance and visitor policies.