Aggression directed toward emergency department staff at a university teaching hospital

Study objective:

To determine the scope and magnitude of patient and visitor aggression directed toward emergency department staff.

Design:

One-year retrospective review of university police log records and ED staff incident reports.

Setting:

Medium-sized, urban, noncounty, university Level I teaching hospital treating approximately 40,000 ED patients annually.

Type of participants:

All violent incidents involving patients/visitors and ED staff that triggered a police response to the ED area were included in the study.

Interventions:

None.

Measurements and main results:

All ED violent episodes were recorded and categorized by shift, type of incident, type of police response, perpetrator, and site of incident. It was found that police responded to the ED nearly twice daily; the night shift had 32% of the cases with only 13% of the patient volume; custody and medical psychiatric clearance patients accounted for 40% of the cases; more than 20% of incidents occurred in the waiting room; and 4.2% of the incidents represented a significant threat to ED staff.

Conclusion:

ED violence is a significant and under-reported problem at our medium-sized university teaching hospital. These data are useful in objectively quantifying the scope of violence in our institution, and they underscore the potential risks to emergency patients, visitors, and staff. There is an acute need for additional studies in other settings so that appropriate and cost-effective security recommendations can be formulated.