Workplace violence in the emergency department

Abstract

<p>Session J presented Saturday, September 29, 11:30 am-12:30 pm</p> <p><strong>Purpose:</strong> Acts of workplace violence committed against hospital personnel have seemingly become more pervasive across the country and the Emergency Department (ED) as an entity is one of the most highly vulnerable areas in the healthcare setting. Anecdotal evidence from nurses in our ED was presented as a basis for creating a series of projects aimed at furthering the goal of creating a zero-tolerance environment in accordance with accepted standards of practice to protect ED staff, promote a culture of judgment and punitive-free reporting, and ultimately limit acts of workplace violence.</p> <p><strong>Design:</strong> As part of the hospital's mission of shared governance across disciplines, the ED nurses recognized the need for education on what constitutes workplace violence and how it affects healthcare workers as well as conceptualizing and implementing interventions. Setting: Suburban ED with 100,000+ visitors annually.</p> <p><strong>Participants/Subjects:</strong> ED staff (RNs &amp; technicans). Methods: This ongoing project had its inception utilizing an ENA-based survey on attitudes towards workplace violence in the ED and its results led to targeted interventions aimed at insufficiencies apparent in the survey results. A PDSA project was undertaken to target a deficiency in our reporting structure with the goals of augmenting staff knowledge on what constitutes workplace violence, educating on methods for reporting it, and tracking the events by internal incident reports. This was done by utilizing the &ldquo;Code Gray&rdquo; policy already in use at our facility. Research into the operator logs revealed that only one Code Gray was called in the ED in 2015, and two in 2016 evidencing the need for further education in our department. Follow-up surveys were given at three separate periods to track success of the educational sessions as well as trend staff perception of overall safety within the department.</p> <p><strong>Results/Outcomes: </strong>Initially the pre-education survey revealed that only 17.5% (n=40) of respondents knew how to report incidents of workplace violence. After education on our Code Gray policy, 100% of participants on follow-up surveys answered the question correctly. Another area of data focused on the respondent&rsquo;s perception of safety in the ED. The initial survey revealed that only 11% (n=40) of ED clinical nurses and technicians felt &ldquo;very to extremely safe&rdquo; per the Likert scoring scale. The first re-assessment showed an increase of overall safety in the ED to 52% (n=50); the second to 55% (n=58); and the third follow-up was 36% (n=50).</p> <p><strong>Implications:</strong> As a result of this project, an ED Workplace Violence Committee was formed in order to further our ultimate goal of protecting staff and reducing violence. This interdisciplinary team of ED nurses, technicians, physicians, PAs, management, as well as directors and liaisons from Quality and Safety, Security, Risk Management, and Public Relations meet monthly and have already implemented many successful projects in our ED. The creation of this group has long-term implications for practice. The continual push for protection of staff and visitors against acts of workplace violence is the driving force behind all of our initiatives and will continue to dictate further programs to ensure staff safety.</p>