Renker Paula, Scribner Shellie A, Huff Pam
Work. 2015;51(1):5-18. doi: 10.3233/WOR-141893.
Violence committed by patients and their families and visitors against Emergency Department staff in the United States is common and detrimental to staff well being, morale, and care practices. Hospitals losses occur due to decreased staff retention, prestige, and patient and visitor satisfaction.
The purpose of the baseline survey reported here was to identify and describe staff experiences, concerns, and perceptions related to violence and abuse perpetrated by patients, family, and non-family visitors in a Level 1 emergency department.
The survey sample was composed of 41 registered nurses and 10 paramedics. The majority of the participants (84%, n= 41) were female and worked full time (82%, n= 41) on the 7P-7A (49%, n= 25) shift.
The cross-sectional mixed-method descriptive design used a survey to measure violence experiences and interviews with key informants. Specific analytical methods included descriptive and inferential statistics and ethnography.
The findings are summarized by a model that portrays 1) Contributing factors to the development of violence in the ED, 2) maladaptive reactions to workplace violence of Cynicism, Concern for focus on customer service, and Conflict, and 3) three themes that, depending on their presence or absence, serve as barriers or facilitators to violence: Consistency, Consequences and Collaboration.
Interventions developed to minimize violence in the ED must focus on modifiable risk factors and address what is in the department's control including staff education in recognizing escalating anxious or aggressive behavior, policy development and implementation, and environmental changes.
在美国，患者及其家属和访客对急诊科工作人员实施暴力的情况很常见，这对工作人员的健康、士气和护理工作产生不利影响。医院会因员工留用率降低、声誉受损以及患者和访客满意度下降而遭受损失。
本文报告的基线调查旨在识别和描述一级急诊科工作人员在患者、家属和非家属访客实施暴力和虐待方面的经历、担忧和看法。
调查样本包括41名注册护士和10名护理人员。大多数参与者（84%，n = 41）为女性，全职工作（82%，n = 41），在7P - 7A班次工作（49%，n = 25）。
横断面混合方法描述性设计采用调查来衡量暴力经历，并对关键信息提供者进行访谈。具体分析方法包括描述性和推断性统计以及人种志。
研究结果通过一个模型进行总结，该模型描绘了1）急诊科暴力行为发展的促成因素，2）对愤世嫉俗、关注客户服务和冲突等工作场所暴力的适应不良反应，以及3）根据其存在与否可作为暴力障碍或促进因素的三个主题：一致性、后果和协作。
为尽量减少急诊科暴力而制定的干预措施必须侧重于可改变的风险因素，并解决部门能够控制的问题，包括对工作人员进行识别焦虑或攻击行为升级的教育、政策制定与实施以及环境改变。
