Literature Review On Emergency Department Violence

However, what some don’t know is that assaults on first responders are happening across the nation and many go unreported. Violence against EMS experts takes many forms. Most acts of brutality are not less than deadly. Statistics shows that the risk of non-fatal assault resulting in lost work time among EMS workers is 0.6 cases per 100 workers a year; the national average is about 1.8 per 10,000 workers. The National Association of Emergency Medical Technicians (NAEMT) found 4/5 medics have experienced some form of injury as a result of the job. The U.S. Department of Labor reported that about 52 percent of EMTs operating in the field have been assaulted.

Kelly et al. (2015) continued with the statement that staff who are insulted tend to be younger, less experienced or educated, provide more direct care and spend more time with patients, receive lower pay, and possess low levels of qualifications (Kelly et al., 2015). The most common injuries on psychiatric units are kicking, hitting, shoving, and beating (Occupational Safety and Health Administration, 2015). The most common health complaints reported by staff that were involved in a physical assault are headaches, muscle soreness, and headaches; other complaints that are more serious include dizziness, shortness of breath, and numbness and tingling of the extremities (Kelly et al., 2015). These aggressive behaviors of patients are preceded by many things. Patients may be upset about being admitted to the unit or feel as if their control has been taken away. Literature suggested that poor medication compliance, positive symptoms (such as command hallucinations), and substance misuse makes act of violence (Graham, 2012). Graham (2012) stated that it should not be assumed that there is a direct relationship between a specific disease (or symptoms) and acts of violence. The reason for patient violence is varying and sometimes unknown. It was reported

The problem has led to poor quality care to patients, burnouts and high staff turnover among the nurses. Statistics indicate that 65%-80% of nurses face this challenge. Nurses who are affected by the violence extend the effects to those whom they closely work with for instance physicians and medical supervisors (Howe, 2001). However, the worst hit population is the patients because they will eventually pay for poor quality services they received. Some succumb to their ailments.

Tony York, the chief operating officer for Healthcare Security Services in Denver, Colorado, which monitors security at hospitals throughout the nation, says there has been an “explosion of patient-generated violence” in the past several years – both from patients themselves and, often, the people accompanying them to the hospital. “Those are things that have driven this industry immensely,” York

Literature that investigates the rates of lateral violence has confirmed that LV has been and currently still is prevalent in the nursing profession. A survey taken during the Upstate AHEC Lateral Violence Among Nurses Project by Jacobs and Kyzer (2010) revealed that 93 percent of nurses have witnessed lateral violence among coworkers, while 85 percent have been a victim of lateral violence. As can be seen by these percentages, lateral violence in nursing is very real and affects many of those who are identified as a nurse. Although these statistics are informative, it is critical to remember that they do not capture all incidents of LV in the nursing profession. Since these statistics come from reported incidents of lateral violence in nursing, there may be additional incidents that were not reported. Therefore, the rates of

Furthermore, this issue of lateral violence is not new to nursing. For the past 20 years,

Workplace violence has existed throughout history. However, historical documentation of workplace violence is vague and sometimes non-existent. Documented workplace violence is believed to have existed during the Roman Empire, the Renaissance Era, and it continues today. It seems unfortunate, but as long as a “society” exists, workplace violence will more than likely exist. Therefore, employers must understand: the history of workplace violence, the effects it has on the organization, the reasons why it occurs, the warning signs, and ways to prevent it from occurring. Most importantly, it is the responsibility of the Manager, to not only understand workplace violence, but to ensure that all employees

Behaviors of horizontal violence include name calling, spreading rumors and making threats to someone (Echevarria, 2013). These activities may cause mayhem for the victim of horizontal violence and can drastically reduce patient safety. When a nurse is being bullied through horizontal violence, a patients’ safety is put at a great risk of being affected. Effective communication is necessary for nurses to provide safe and reliable care.

Independent expert details hundreds of incidents of restraint and dozens of assaults on patients by staff at private hospital

A practice that has been put in place is the use of call buttons that are installed and easily available for the staff to use when dealing with escalating patients. Within this Veterans Affairs Hospital, the inpatient geriatric unit has at least 2-3 cases of patient-on-patient assault each month. For those that are very aggressive, this is currently being addressed by the use of one-on-one staff and antipsychotic medications. Clinicians are expected to be able to assess whether intervention is needed to protect other patients and staff from patients’ violence, to assess when patients pose a sufficient level of risk, and to assess when patients who have been hospitalized can be safely discharged to the community. However, surveys of practitioners suggest that many receive little formal training in violence risk assessment. (McNeil, et al. 2009) The limitations of formal training in risk assessment for violence suggested by such surveys underscore the need for education in this topic, hence the relevance of this educational training. Nurses on the front lines of care are ill-prepared to deal with this, hence the need for training. (Peek-Asa, et al.

The primary purpose of health care is to serve the patients’ physical, emotional, and spiritual needs. However in a recent news headline in Vancouver Sun newspaper in February 24, 2015 tackle the stories entitled: B.C. nurses to begin filing charges against violent and aggressive patients. It stated that nurses are tired of being kicked, punched and slapped. Nurses are tired for the government and health authorities to take action that leads them the need to protect themselves to get more harm. Such incidents is one of the many example of

First, it is imperative to understand what horizontal violence, lateral violence, or workplace bullying is to become fully aware of this issue’s extent; these terms are often used interchangeably. A commonality among sources is the description of horizontal violence as “acts of aggression” committed by one coworker against another (Becher & Visovsky, 2012, p. 210). Astonishingly, the range of what is considered horizontal violence is vast, and these aggressive acts are revealed in several forms. Some violence is unmistakable such as threatening, name calling, criticizing, or public humiliation; however, other acts are less obvious such as withholding information, eye rolling, silence, and isolation (Becher & Visovsky, 2012). Still, other violence includes “scapegoating

In 3 articles, survivors of healthcare worker directed violence admitted to knowingly spending less time with their patients after the attack.(8, 12, 16) Quality of care is also reduced as survivors admit to being fearful of their patients as well as being reluctant to care for specific patients or any patients at all.(8, 17, 19, 25) After an incident of workplace violence, survivors stated that they have decreased communication with their patients, patient families, and coworkers.(12, 27) Survivors also admitted to having reduced interest in being a part of patient care, as well as being in their current position.(8, 12, 14, 19) One article found that physiotherapists often reduced their expectations for their patients after experiencing an incidence of workplace violence from a patient.(8) Survivors also found that they had reduced empathy and gave reduced emotional support to patients and their families after returning to work.(15) After an attack by a patient, survivors admitted to lacking concentration that led to missed medication administration, increased falls, and increased errors in administration of care.(10, 15, 17, 27)

Physical. Every nine seconds a woman is beaten by her spouse (Protection Against Crime, 2002). Seventy-five percent of the victims of intimate murders are female with a total of three to four million women being battered each year by their respective intimate partners (Protection Against Crime, 2002).The victims of domestic abuse by law enforcement officers endure a special kind of torture, that others in that similar situation do not. The victims are most likely to endure the dangers of professionals who are experienced in firearms, knowledge and training of subduing their victims, etc. During these types of events, one might lose the sense of control and order they once had in their lives. Victims of abuse may suffer physical and emotional pain from the ordeals they had to live through, long after their

Sustained exposure to violence in the workplace including aggression, abuse, and bullying can have serious physical and psychological consequences, causing some nurses to consider leaving the profession. Workplace violence, including disruptive physician behaviour, also results in decreased patient safety. Clearly, violence against nurses is an important issue among nurses, their patients and the nursing profession at large ( RNAO, iaBPGR, 2009 p.30). Likewise, the ICN report revealed that 75 per cent of nurses do not feel safe from assault in their workplace and up to 95 per cent reported having been bullied at work ( ICN,2001.p. 3).