Safety precautions and perceived safety: A cross-sectional study of emergency department nurses

Workplace violence (WPV) is a major occupational hazard for emergency nurses, with verbal, psychological, and physical threats undermining safety. Multiple safety strategies have been proposed, yet little research has examined their prevalence or link to perceived safety.

A cross-sectional design was employed using an anonymous electronic survey of emergency nurses across 17 U.S. states. The survey, validated by nursing experts, assessed demographics, workplace characteristics, exposure to WPV, and 14 safety precautions. Perceived safety was rated on a 10-point scale. Descriptive statistics, bivariate tests, and multivariate regression with bootstrapping were conducted.

Among 134 participants (M age = 42.8 years, 84.3% female), 48.1% reported experiencing WPV in the past month. Mean safety rating was 6.84 (SD = 2). De-escalation and security presence were most prevalent (90.3%), followed by controlled access (80.6%) and security cameras (77.6%). Regression analysis showed urban nurses reported lower safety than suburban nurses (b =  - 1.62, 95% CI [-2.438, -0.913], p < 0.001). Security presence, controlled access, and lighting were associated with higher safety perceptions (b = 1.31, 95% CI [0.487, 2.322], p = 0.018; b = 1.12, 95% CI [0.396, 1.881], p = 0.008; b = 1.09, 95% CI [0.478, 1.784], p = 0.004, respectively).

Findings highlight the prevalence of WPV in EDs and identify key safety interventions linked to nurses' perceptions of safety. Results can inform policy and guide workplace improvements.