Security interventions for workplace violence in the emergency department

Area of Science:

• Emergency Medicine
• Public Health
• Security Management

Background:

• Workplace violence (WPV) in Australian public hospital Emergency Departments (EDs) is a persistent and increasing problem.
• Existing zero-tolerance policies have not curbed the rise in WPV incidents.

Purpose of the Study:

• To characterize security responses to workplace violence within an adult, Level 4 ED.
• To analyze the effectiveness of security interventions, including police presence, in managing WPV.

Main Methods:

• A retrospective, single-centre review of WPV episodes in an adult ED from January 2013 to December 2015.
• Data collected from a prospectively recorded security register, focusing on security personnel attendance.
• The primary exposure variable examined was the presence of police officers during violent episodes.

Main Results:

• 1853 violent episodes involving 1224 patients required security intervention.
• Nearly half (49%) of violent episodes were perpetrated by repeat offenders.
• The majority of incidents (57%) occurred without police presence, and only 7.8% were managed solely by security without physical intervention.

Conclusions:

• Emergency Departments should not solely rely on police response for violence prevention or management.
• Identifying and sharing data on repeat offenders is crucial for preventing future WPV.
• The Australasian College for Emergency Medicine (ACEM) policy on WPV needs enhancement regarding security credentialing and preventive strategies.