The Emergency Department Violence Surveillance Study also found that 15 percent of the nurses who reported experiencing physical violence said they sustained a physical injury as a result of the incident and in almost half of the cases (44.9 percent), no action was taken against the perpetrator.
“We are extremely alarmed that there are so many cases in which hospitals do not respond to violence in the emergency department,” said ENA President Diane Gurney, RN, MS, CEN. “These incidents are not only frightening and dangerous for nurses, but also for patients in the emergency department. Hospital administration has a responsibility to keep patients and the health care providers who care for them safe. Every hospital should be required to adopt and implement policies to keep their emergency departments safer.”
Three in four nurses (74.4 percent) who were victims of physical violence reported that the hospital gave them no response regarding that violence. Nurses working in emergency departments at hospitals with policies regarding violence reported experiencing fewer incidents of physical or verbal violence. Hospitals with zero-tolerance reporting policies had an 8.4 percent physical violence rate; hospitals with a non-zero-tolerance policy had a 12.3 percent physical violence rate; and hospitals with no policy had an 18.1 percent physical violence rate.
“These data underscore what nurses know first-hand,” said Gurney. “Hospitals that have policies in place to respond to violence and to prevent it are safer for the health care professionals that work in them and the patients who seek treatment in them. The Emergency Nurses Association strongly urges the Occupational Safety and Health Administration to make its guidelines for preventing violence into mandatory standards that to which all hospital and health care centers must adhere.”
The study revealed that certain physical safeguards are correlated with lower rates of violence. The presence of a panic button or silent alarm is associated with lower physical violence rates. Having an enclosed nurses’ station, security signs and well-lit areas are associated with significantly lower verbal abuse rates.
The Emergency Department Violence Surveillance Study is based on quarterly surveys of a total of 3,211 emergency nurses across the country from May 2009 to February 2010. ENA collected the data at three-month intervals in order to assess whether there were fluctuations in violence over the course of a year. The study found that rates of abuse remained constant over time.
The Emergency Department Violence Surveillance Study also found that:
* Patients and their relatives were the perpetrators of the abuse in nearly all incidents of physical violence (97.1 percent) and verbal abuse (91 percent).
* The majority of incidents of physical violence occurred in patients’ rooms (80.6 percent). Nearly a quarter (23.2 percent) occurred in corridors, hallways, stairwells or elevators and only 14.7 percent occurred at the nurses’ station.
* The most frequently reported activities that emergency nurses were involved in when they experienced physical violence were triaging a patient (38.2 percent), restraining or subduing a patient (33.8 percent) and performing an invasive procedure (30.9 percent).
* Male nurses reported higher physical violence rates than female nurses (15 percent versus 10.3 percent); and physical violence rates tended to decline as nurses ages increased.
* Physical violence rates were higher in large urban areas (13.4 percent) than in rural areas (8.3 percent). Nurses working in emergency departments with more beds and treatment space, and those with higher numbers of visits were more likely to experience physical and verbal abuse than nurse in lower-traffic departments.
The ENA surveyed 3,211 nurses from May 2009 to February 2010. The first round included 674 nurses, the second round included 715 nurses, the third round included 801 nurses and the fourth and final round included 1,021 nurses. The majority of respondents (85 percent) were women and 35 to 54 years of age (64.2 percent). The margin of error ranges from 3.1 percent to 3.9 percent for all four rounds.
About the Emergency Nurses Association
The Emergency Nurses Association (ENA) is the only professional nursing association dedicated to defining the future of emergency nursing and emergency care through advocacy, expertise, innovation, and leadership. Founded in 1970 and currently celebrating its 40th anniversary, ENA serves as the voice of more than 37,000 members and their patients through research, publications, professional development, injury prevention, and patient education. Additional information is available at ENA’s Web site, www.ena.org http://www.ena.org/ .
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