Behnam Marcelina, Tillotson Roger D, Davis Stephen M, Hobbs Gerald R
Department of Emergency Medicine, West Virginia University, Morgantown, West Virginia 26506, USA.
J Emerg Med. 2011 May;40(5):565-79. doi: 10.1016/j.jemermed.2009.11.007. Epub 2010 Feb 4.
Violence in the Emergency Department (ED) is a well-known phenomenon. Few studies have been done to assess the incidence and nature of violence in the ED.
The purpose of this study was to assess the incidence of violence in the ED nationwide.
This study was a prospective, cross-sectional online survey of Emergency Medicine (EM) residents and attending physicians. Of the 134 accredited United States (US) EM residency programs, 65 programs were randomly selected and invited to participate.
Overall, 272 surveys were returned, of which 263 (97%) were completed and further analyzed. At least one workplace violence act in the previous 12 months was reported by 78% (95% confidence interval 73-83%) of respondents, with 21% reporting more than one type of violent act. Workplace violence was experienced similarly between males and females (79% vs. 75%, respectively; p = 0.65), and was more common in EDs with annual volumes over 60,000 patients (82% vs. 67%; p = 0.01). The most common type of workplace violence was verbal threats (75%) followed by physical assaults (21%), confrontations outside the workplace (5%), and stalking (2%). Security was available full time in most settings (98%), but was least likely to be physically present in patient care areas. The majority of respondent EDs did not screen for weapons (40% screened) or have metal detectors (38% had metal detectors). Only 16% of programs provided violence workshops, and less than 10% offered self-defense training.
Despite the high incidence of workplace violence experienced by the emergency physicians who responded to our survey, less than half of these respondents worked in EDs that screened for weapons or had metal detectors. An even smaller number of physicians worked in settings that provided violence workshops or self-defense training.
急诊科暴力事件是一个广为人知的现象。很少有研究对急诊科暴力事件的发生率及性质进行评估。
本研究旨在评估全国急诊科暴力事件的发生率。
本研究是一项针对急诊医学住院医师和主治医师的前瞻性横断面在线调查。在美国134个经认可的急诊医学住院医师培训项目中，随机选取65个项目并邀请其参与。
总体而言，共收回272份调查问卷，其中263份（97%）完成并进行进一步分析。78%（95%置信区间73 - 83%）的受访者报告在过去12个月中至少发生过一次工作场所暴力行为，21%的受访者报告发生过不止一种暴力行为。男性和女性遭受工作场所暴力的情况相似（分别为79%和75%；p = 0.65），且在年接诊量超过60000例患者的急诊科更为常见（82%对67%；p = 0.01）。最常见的工作场所暴力类型是言语威胁（75%），其次是身体攻击（21%）、工作场所以外的冲突（5%）和跟踪骚扰（2%）。大多数场所（98%）有全职安保人员，但在患者护理区域实际在场的可能性最小。大多数受访的急诊科不进行武器筛查（40%进行筛查）或没有金属探测器（38%有金属探测器）。只有16%的项目提供暴力应对培训工作坊，不到10%的项目提供自卫培训。
尽管参与我们调查的急诊医师遭受工作场所暴力的发生率很高，但这些受访者中不到一半在进行武器筛查或设有金属探测器的急诊科工作。提供暴力应对培训工作坊或自卫培训的场所工作的医师人数更少。
