Violence directed toward healthcare workers (HCWs) is prevalent, particularly in the emergency department (ED). Workplace violence leads to physical injuries and has other consequences, such as increased risk of burnout, post-traumatic stress disorder, reduced job satisfaction, and feelings of avoidance and futility. Understanding the behaviors underlying workplace violence is crucial in implementing effective mitigation strategies. For a study, researchers sought to assess the prevalence and types of violence against HCWs in a large urban ED.

The study was conducted in the ED of an urban hospital with an annual ED census of approximately 100,000 patients. A pre-existing general patient safety incident “dropbox” for HCWs was used to collect workplace violence reports. At the end of the study period, all data was compiled into an electronic database, and each report was categorized based on the nature and severity of the abuse. Additionally, all events were coded as involving or not involving racist, sexist, or homophobic content. The primary outcomes were the number of reported events during the study period and the percentage of events falling into each category. The secondary outcomes were the overall prevalence and ratio of events involving racist, sexist, or homophobic language or provocation.

During the 5-month survey period, 130 reports of workplace violence were documented, averaging 0.85 incidents per day. Male individuals were predominantly identified as perpetrators, while most victims were nurses. Hospital security was involved in 26% of the cases. Approximately 37% of the incidents involved intoxicated patients and/or those with a history of psychiatric illness. The most common events (44% of encounters) were categorized as Type I, involving provocative swearing, shouting, and legal threats. Physical violence was present in 22% of the incidents. Racist, sexist, and homophobic comments were reported in 8 (6%), 18 (14%), and 3 (2%) incidents, respectively.

The study revealed a high prevalence of workplace violence against HCWs, with some incidents involving racist, sexist, or homophobic bias. Consistent with previous literature on EDs, abusive events occurred almost daily, and approximately 20% involved physical violence. It was essential to implement policy changes at local, state, and national levels to address workplace violence in healthcare settings.

Source: sciencedirect.com/science/article/abs/pii/S0735675723000414