Violence in emergency services and preventative measures: results from an online survey from Germany

Violence in emergency medical services (EMS) presents a critical issue, yet data on its extent and on effective preventative measures are lacking. We aim to explore violence experiences and opportunities for prevention from the actor-centered perspective of EMS workers in Bavaria, Germany. We conducted a questionnaire-based online survey of EMS workers (September 2023-January 2024), comprising standardized items and open questions on experiences and perceptions of workplace violence. In this context, we collected data on requested preventive measures. Mixed-methods analysis was applied, including descriptive statistics and qualitative thematic analysis. Of 224 completed questionnaires, 38.4% reported to have experienced physical and 57.6% non-physical violence at work during the past 12 months. Experiences of physical violence were associated with the female gender, while non-physical violence showed an inverse association with age and seniority. Participants also reported physical (0.022%) and non-physical violence (17.9%) from colleagues. Only a third noted that there are established reporting procedures for violent incidents in their workplace, thereof over a third had refrained from submitting a report despite experiencing violence. Among the most effective and urgently requested preventive measures, respondents listed communication-based de-escalation and crisis management as well as improvement of working conditions including managers' leadership competencies. Results' interpretation is impeded by the limited response. Physical and non-physical violence are prevalent in the workplace context of EMS in Germany. An improvement in the working conditions, which should include transparent and effective reporting mechanisms as well as communication-based prevention strategies is explicitly requested by employees.