Kennedy Marcus P
Emergency Department, Royal Melbourne Hospital, PO Box 2009, Parkville, VIC.
Med J Aust. 2005 Oct 3;183(7):362-5. doi: 10.5694/j.1326-5377.2005.tb07084.x.
Violence in emergency departments (EDs) has reached a level that requires concerted action and a shift in attitude - to eradicate a socially and professionally unacceptable peril. In some EDs, violence is a daily occurrence, with nursing staff reporting several episodes each week. Increased societal violence results in an increase in presentations for injury. Anger and pain and the influence of alcohol and drugs contribute to violence spilling over into the ED. The well known "system blockers" to reporting adverse events in hospitals result in under-reporting of violence episodes. Violence in EDs is different from other forms of violence - the aggressor has no overt dominance or power status and, in a setting of care, victims are likely to excuse the behaviour. Strategies to curb violence in EDs include modifying building design, providing security systems and personnel, and training staff in aggression management. The key to successful intervention is a strong preventive orientation that looks for high-risk indicators, and may extend to active physical and behavioural screening.
急诊科的暴力行为已达到需要采取一致行动和转变态度的程度，以根除这种在社会和职业层面都不可接受的危害。在一些急诊科，暴力行为每天都有发生，护理人员报告称每周会出现多起此类事件。社会暴力的增加导致因受伤前来就诊的人数增多。愤怒、疼痛以及酒精和药物的影响致使暴力行为蔓延至急诊科。医院中众所周知的不良事件报告“系统阻碍因素”导致暴力事件报告不足。急诊科的暴力行为不同于其他形式的暴力——攻击者没有明显的主导地位或权力身份，而且在医疗环境中，受害者可能会原谅这种行为。遏制急诊科暴力行为的策略包括改进建筑设计、提供安保系统和人员，以及对工作人员进行攻击行为管理培训。成功干预的关键在于具有强烈的预防导向，寻找高风险指标，并且可能延伸至积极的身体和行为筛查。
