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Updated: May 18, 2026
09:12
The Resident-intruder Paradigm: A Standardized Test for Aggression, Violence and Social Stress
Published on: July 4, 2013
Prospective study of violence against ED workers
Terry Kowalenko1, Donna Gates, Gordon Lee Gillespie
1University of Michigan, Ann Arbor, MI 48109, USA. terryk@med.umich.edu
The American Journal of Emergency Medicine
|September 25, 2012
Summary
Emergency department health care workers (HCWs) experience frequent violence, leading to injuries, acute stress, and reduced productivity. This study highlights the impact of these violent events on HCWs.
Area of Science:
- Occupational Health
- Emergency Medicine
- Violence Prevention
Background:
- Health care support occupations face high assault-injury rates, with emergency departments (EDs) being high-risk environments.
- Violence against healthcare workers (HCWs) is a significant concern in emergency settings.
Purpose of the Study:
- To determine the incidence of violence experienced by ED HCWs over a 9-month period.
- To identify demographic, occupational, and perpetrator factors associated with violent events (VEs).
- To examine predictors of acute stress and productivity loss in HCW victims.
Main Methods:
- A longitudinal study involving monthly surveys of ED HCWs across 6 hospitals.
- Data collection included the number and types of VEs, and HCW safety and confidence.
- Analysis utilized descriptive statistics and repeated-measure linear regression.
Main Results:
- 827 VEs were reported by 213 HCWs over 9 months, with an average rate of 4.15 VEs per person.
- Physical threats (PTs) constituted 601 events, and assaults 226 events.
- Registered nurses (RNs) reported significantly more VEs and acute stress than medical doctors (MDs), impacting their productivity.
Conclusions:
- ED HCWs are frequently subjected to violence from visitors and patients, resulting in adverse outcomes.
- Violence leads to injuries, acute stress, and decreased productivity among HCWs.
- Acute stress significantly impairs HCWs' job performance and ability to carry out duties.
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