2.50
Hdl Handle:
http://hdl.handle.net/10755/198296
Title:
Empowering Staff to Reduce Violence in the Emergency Department
Abstract:
[ENA Annual Conference 2011 - Evidence-based Practice Presentation] Empowering Staff to Reduce Violence in the Emergency Department

Purpose: The purpose of this project was to promote a safe environment to improve staff, patient and family satisfaction and enhance healing in the Emergency Department; to provide associates with early intervention skills to minimize violent/aggressive behaviors in the ED; and decrease stress in the ED.
Emergency Nursing is one of the most challenging specialties as nurses have to deal with diverse groups of individuals at very stressful periods in their life. Kansagra, et al, in their survey of 69 emergency rooms stated, “Workplace violence is a concerning issue. Healthcare workers represent a significant portion of the victims, especially those who work in the emergency department (ED).”

Design: A multidisciplinary team was formed to create a forum and develop evidence-based guidelines to address aggressive behavior/violence in the ED

Setting: An Urban regional-referral teaching hospital with 804 licensed beds, a 1200-member medical staff and over 50 medical/ surgical specialties. Emergency Department volume is approximately 110,000 patients per year.

Participants: Staff nurses, physicians, ancillary staff, pastoral care, security, administration and patient representatives participated

Methods: Standard operating procedures for crowd control for all ED patients/visitors, guidelines for grieving families and for potential violent situations were developed for staff to follow.
Teams were assigned to: Prevention, Verbal de-escalation; Visitor Policy (general, special circumstances); Proactive identification of potential situations; Communication techniques.

Results: Increased signage was added to set expectations for visitor guidelines to include no rude behavior. Metal detectors; electronic surveillance, increased Security presence; panic buttons; and a more cohesive team approach contribute to preventing aggressive behavior.

In addition to required Crisis Prevention Institute (CPI) training, we created a Verbal de-escalation presentation including key messages and a PowerPoint presentation to assist in managing situations that are escalating. We established a “three attempt” rule and set expectations that staff do not have to take verbal abuse; they are taught to get security involved as soon as possible.

Policy was created and enforced manage visitor traffic. . The biggest assistance was adherence to visitor limits for potential violent trauma victims or deaths. We enforce a strict policy of 4-6 patients in the ED for deaths and/or “trauma” patients. A huddle consisting of operations supervisor/charge nurse, security, patient representative, and pastoral care (if needed) can be called if needed. To initially meet and discuss a plan of action and every 15 minutes or more frequently if necessary to keep in communication.

Scripting for the staff for wait times, visitor policy, and delivering bad news assists them to consistently communicate for situations that could provoke violence.

Implications: The staff expresses satisfaction and increased feelings of safety with use of the guidelines. They feel empowered now that they have some control over their environment. Data is being collected to evaluate the results of our process improvement.

Repository Posting Date:
21-Dec-2011
Date of Publication:
21-Dec-2011

Full metadata record

DC FieldValue Language
dc.titleEmpowering Staff to Reduce Violence in the Emergency Departmenten_GB
dc.identifier.urihttp://hdl.handle.net/10755/198296-
dc.description.abstract[ENA Annual Conference 2011 - Evidence-based Practice Presentation] Empowering Staff to Reduce Violence in the Emergency Department<br/><br/>Purpose: The purpose of this project was to promote a safe environment to improve staff, patient and family satisfaction and enhance healing in the Emergency Department; to provide associates with early intervention skills to minimize violent/aggressive behaviors in the ED; and decrease stress in the ED. <br/>Emergency Nursing is one of the most challenging specialties as nurses have to deal with diverse groups of individuals at very stressful periods in their life. Kansagra, et al, in their survey of 69 emergency rooms stated, “Workplace violence is a concerning issue. Healthcare workers represent a significant portion of the victims, especially those who work in the emergency department (ED).” <br/><br/>Design: A multidisciplinary team was formed to create a forum and develop evidence-based guidelines to address aggressive behavior/violence in the ED<br/><br/>Setting: An Urban regional-referral teaching hospital with 804 licensed beds, a 1200-member medical staff and over 50 medical/ surgical specialties. Emergency Department volume is approximately 110,000 patients per year. <br/><br/>Participants: Staff nurses, physicians, ancillary staff, pastoral care, security, administration and patient representatives participated<br/><br/>Methods: Standard operating procedures for crowd control for all ED patients/visitors, guidelines for grieving families and for potential violent situations were developed for staff to follow. <br/>Teams were assigned to: Prevention, Verbal de-escalation; Visitor Policy (general, special circumstances); Proactive identification of potential situations; Communication techniques. <br/><br/>Results: Increased signage was added to set expectations for visitor guidelines to include no rude behavior. Metal detectors; electronic surveillance, increased Security presence; panic buttons; and a more cohesive team approach contribute to preventing aggressive behavior. <br/><br/>In addition to required Crisis Prevention Institute (CPI) training, we created a Verbal de-escalation presentation including key messages and a PowerPoint presentation to assist in managing situations that are escalating. We established a “three attempt” rule and set expectations that staff do not have to take verbal abuse; they are taught to get security involved as soon as possible.<br/><br/>Policy was created and enforced manage visitor traffic. . The biggest assistance was adherence to visitor limits for potential violent trauma victims or deaths. We enforce a strict policy of 4-6 patients in the ED for deaths and/or “trauma” patients. A huddle consisting of operations supervisor/charge nurse, security, patient representative, and pastoral care (if needed) can be called if needed. To initially meet and discuss a plan of action and every 15 minutes or more frequently if necessary to keep in communication.<br/><br/>Scripting for the staff for wait times, visitor policy, and delivering bad news assists them to consistently communicate for situations that could provoke violence. <br/><br/>Implications: The staff expresses satisfaction and increased feelings of safety with use of the guidelines. They feel empowered now that they have some control over their environment. Data is being collected to evaluate the results of our process improvement. <br/><br/>en_GB
dc.date.available2011-12-21T12:45:09Z-
dc.date.issued2011-12-21T12:45:09Z-
dc.date.accessioned2011-12-21T12:45:09Z-
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