Violence in the emergency department: a national survey of emergency medicine residents and attending physicians. 2011

Marcelina Behnam, and Roger D Tillotson, and Stephen M Davis, and Gerald R Hobbs
Department of Emergency Medicine, West Virginia University, Morgantown, West Virginia 26506, USA.

BACKGROUND 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. OBJECTIVE The purpose of this study was to assess the incidence of violence in the ED nationwide. METHODS 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. RESULTS 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. CONCLUSIONS 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.

UI MeSH Term Description Entries
D008297 Male Males
D010820 Physicians Individuals licensed to practice medicine. Physician
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D003430 Cross-Sectional Studies Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time. Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D004636 Emergency Service, Hospital Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient. Emergency Outpatient Unit,Emergency Services Utilization,Hospital Emergency Room,Hospital Emergency Service,Hospital Emergency Services Utilization,Accident and Emergency Department,Emergency Departments,Emergency Hospital Service,Emergency Room,Emergency Units,Emergency Ward,Hospital Service Emergency,Service, Hospital Emergency,Department, Emergency,Departments, Emergency,Emergencies, Hospital Service,Emergency Department,Emergency Hospital Services,Emergency Outpatient Units,Emergency Room, Hospital,Emergency Rooms,Emergency Rooms, Hospital,Emergency Services, Hospital,Emergency Unit,Emergency Wards,Emergency, Hospital Service,Hospital Emergency Rooms,Hospital Emergency Services,Hospital Service Emergencies,Hospital Service, Emergency,Hospital Services, Emergency,Outpatient Unit, Emergency,Outpatient Units, Emergency,Room, Emergency,Room, Hospital Emergency,Rooms, Emergency,Rooms, Hospital Emergency,Service Emergencies, Hospital,Service Emergency, Hospital,Service, Emergency Hospital,Services Utilization, Emergency,Services Utilizations, Emergency,Services, Emergency Hospital,Services, Hospital Emergency,Unit, Emergency,Unit, Emergency Outpatient,Units, Emergency,Units, Emergency Outpatient,Utilization, Emergency Services,Ward, Emergency,Wards, Emergency
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.
D014754 Violence Use of physical force causing or intent to cause harm, injury or abuse. Assaultive Behavior,Atrocities,Behavior, Assaultive,Interpersonal Violence,Physical Assault,Physical Attacks,Structural Violence,Violent Crime,Assault, Physical,Attack, Physical,Attacks, Physical,Crime, Violent,Interpersonal Violences,Physical Assaults,Physical Attack,Violence, Interpersonal,Violence, Structural,Violent Crimes

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