Staff perceptions of workplace violence in a pediatric emergency department

A teenage patient with an undiscovered gun in a pediatric emergency department (ED) created risk for violence and high staff stress.

To describe ED staff views of workplace violence risk to guide improvements and address staff fears.

Two hundred thirty four health care staff in a Midwestern pediatric hospital system including ED and urgent care locations.

An electronic survey gathered staff perceptions of workplace safety via multiple choice, forced rank, and narrative responses. Frequency of concern and fear for personal safety from patient or visitor violence was calculated. Events causing fear, and perceptions about presence of local police and hospital security staff, were examined.

26% of staff expressed concern for safety at least weekly. Twenty seven percent experienced situations causing fear at least monthly. Primary causes of fear were patient or visitor agitation (with violence potential) and weapons in the ED. Respondents would feel ``more safe'' with increased presence from hospital security staff (55%) and local police (71%).

Workplace violence occurs in pediatric emergency departments. Both real and perceived threats must be addressed for staff wellbeing. Utilization of staff perception of risk and improvement ideas is a valuable strategy to guide violence reduction at work.