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Emergency department workplace violence: Clinician-endorsed strategies informing prevention mandates
Kathryn Jane Muir1, Sung Kook Aidan Moon2, Anish K Agarwal3
1Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA; The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Background:
State legislation such as the Pennsylvania Healthcare Worker Violence Prevention Act would mandate hospital reporting of workplace violence (WPV) incidents and require committees that advance safety measures.
Purpose:
Since it is unknown what interventions should be prioritized by hospital committees if such legislation were passed, we described strategies that hinder or facilitate the prevention and de-escalation of WPV.
Methods:
Qualitative, descriptive study using individual and focus group interviews with emergency department (ED) nurses and physicians (n = 23) at a level I trauma center ED in Pennsylvania between August 2023 and February 2024.
Discussion:
Five clinician-informed themes were identified: a) clinical protocols, b) clinician conflict in addressing WPV, c) social vulnerability in emergency care, d) resources and throughput, and e) the presence and responsibility of security.
Conclusion:
Priority interventions included WPV clinical protocols; holding hospital administrators accountable to support clinician decision-making during WPV events, safe nurse staffing levels, and cross-disciplinary training of security personnel.
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