Let's Get Ready to Rumble: The Prevention of Work Place Violence in the Emergency Department

2.50
Hdl Handle:
http://hdl.handle.net/10755/162518
Type:
Presentation
Title:
Let's Get Ready to Rumble: The Prevention of Work Place Violence in the Emergency Department
Abstract:
Let's Get Ready to Rumble: The Prevention of Work Place Violence in the Emergency Department
Conference Sponsor:Emergency Nurses Association
Conference Year:2009
Author:Cruz, Bryan, RN
P.I. Institution Name:St. David's Medical Center
Title:RN
Contact Address:10047 Larston St., Houston, TX, 77055, USA
Contact Telephone:832-573-6041
[Annual Conference] Injury Prevention Topic: The NIOHS defines workplace violence as violent acts, physical assaults, and threats of assaults directed toward persons at work. Studies indicate that 50% of all healthcare workers will be physically assaulted during their professional career. Other studies indicated that in the past year 80% of RNs working on a medical/surgical unit reported being verbally assaulted and 63.3% reported being physically assaulted. More specifically, 100% of the RNs in the ED at our hospital reported being verbally assaulted and 82% reported being physically assaulted in the past 6 months (April 2008).
For the safety of patients and healthcare workers, the Violent Patient Protocol was created to provide a means of addressing workplace violence in the ED. Considering the ED is the primary entry and stabilization point of the medical facility, the goal is to prevent injury to our healthcare workers, patients and staff. Due to observed increase in exposure to unstable violent patients and a severe increase in the number and severity of violent alcohol/drug affected patients, I found it prudent to implement a safety plan for the benefit of patients and staff.

Implementation: For a fellowship program, I took on the challenge of making the protocol as a best practice presentation. With the permission of the nurse manager I researched current policies and procedures for use of physical restraints, availability of security personnel, use of seclusion rooms, and therapeutic nursing interventions. I discussed with our medical director what interventions were appropriate prior to contact with patients.
I compiled my research into a thorough list of instructions, actions and interventions for the nurses as well as a suggested set of MD orders with PRN medications. The protocol lists criteria for the implementation and goals for evaluation. The hospital attorney agreed that the context of the protocol was within the guidelines for our scope of practice. The protocol was in place June 20th, 2008.

Outcomes: To evaluate the effectiveness of the violence protocol a survey of nursing staff was given December 2008. 50% of nurses and 30% of ED MDs used the protocol. 70% of nurses feel safer since the protocol was enacted. 100% of nurses have been verbally assaulted in the past 6 months, 40% of nurses have been physically assaulted. Security presence in the ED has been increased by 20%. 100% of all violent patients have had security escort. There has already been an observed decrease in the number of harmed patients from three to zero since the beginning of 2008.

Recommendations: The escalating violence in the ED is an ongoing problem that is under addressed in the workplace. It is our duty as healthcare providers not only to protect patients undergoing treatment, but also our fellow workers. The decrease in the number of violent incidences reflects the success of the protocol. I recommend teaching the protocol for new nurses, and I recommend implementation of a violence protocol for hospitals.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleLet's Get Ready to Rumble: The Prevention of Work Place Violence in the Emergency Departmenten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162518-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Let's Get Ready to Rumble: The Prevention of Work Place Violence in the Emergency Department</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Cruz, Bryan, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">St. David's Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">RN</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">10047 Larston St., Houston, TX, 77055, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">832-573-6041</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Bryan.philip@gmail.com</td></tr><tr><td colspan="2" class="item-abstract">[Annual Conference] Injury Prevention Topic: The NIOHS defines workplace violence as violent acts, physical assaults, and threats of assaults directed toward persons at work. Studies indicate that 50% of all healthcare workers will be physically assaulted during their professional career. Other studies indicated that in the past year 80% of RNs working on a medical/surgical unit reported being verbally assaulted and 63.3% reported being physically assaulted. More specifically, 100% of the RNs in the ED at our hospital reported being verbally assaulted and 82% reported being physically assaulted in the past 6 months (April 2008). <br/> For the safety of patients and healthcare workers, the Violent Patient Protocol was created to provide a means of addressing workplace violence in the ED. Considering the ED is the primary entry and stabilization point of the medical facility, the goal is to prevent injury to our healthcare workers, patients and staff. Due to observed increase in exposure to unstable violent patients and a severe increase in the number and severity of violent alcohol/drug affected patients, I found it prudent to implement a safety plan for the benefit of patients and staff. <br/><br/>Implementation: For a fellowship program, I took on the challenge of making the protocol as a best practice presentation. With the permission of the nurse manager I researched current policies and procedures for use of physical restraints, availability of security personnel, use of seclusion rooms, and therapeutic nursing interventions. I discussed with our medical director what interventions were appropriate prior to contact with patients. <br/> I compiled my research into a thorough list of instructions, actions and interventions for the nurses as well as a suggested set of MD orders with PRN medications. The protocol lists criteria for the implementation and goals for evaluation. The hospital attorney agreed that the context of the protocol was within the guidelines for our scope of practice. The protocol was in place June 20th, 2008.<br/><br/>Outcomes: To evaluate the effectiveness of the violence protocol a survey of nursing staff was given December 2008. 50% of nurses and 30% of ED MDs used the protocol. 70% of nurses feel safer since the protocol was enacted. 100% of nurses have been verbally assaulted in the past 6 months, 40% of nurses have been physically assaulted. Security presence in the ED has been increased by 20%. 100% of all violent patients have had security escort. There has already been an observed decrease in the number of harmed patients from three to zero since the beginning of 2008.<br/><br/>Recommendations: The escalating violence in the ED is an ongoing problem that is under addressed in the workplace. It is our duty as healthcare providers not only to protect patients undergoing treatment, but also our fellow workers. The decrease in the number of violent incidences reflects the success of the protocol. I recommend teaching the protocol for new nurses, and I recommend implementation of a violence protocol for hospitals. <br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:29:33Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:29:33Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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