2.50
Hdl Handle:
http://hdl.handle.net/10755/324148
Category:
Abstract
Type:
Presentation
Title:
Life Threatening: The Active Shooter in the Emergency Department
Author(s):
Bradley, Darlene; Stepp, Sherlene
Author Details:
Darlene Bradley, PhD, RN, CNS, FAEN, email: darlene004@aol.com; Sherlene Stepp, RN, MICN
Abstract:
Evidence-based Practice AbstractPurpose: Hospital shootings most commonly occur in emergency departments culminating in the injury or death of 20% of hospital employees. In United States hospitals from 2000-2011, 91 shootings occurred within the hospital, with an additional 63 on hospital grounds. The purpose of this project is to sustain life through the preparation of emergency department staff for the possibility of an onsite active shooter. Design: This multidisciplinary quality improvement project was derived from the debrief of two emergency department cases occurring within six months of each other. One individual walked to the bathroom within the emergency department waiting room and committed suicide with a single gunshot to the head. A second unrelated visitor insinuated she would pull a gun from her purse to shoot visitors and staff in the waiting room. A table top exercise with security and campus police was the impetus to create an all hazards approach to an active shooter threat. Setting: The project was developed at a University Medical Center in a Level I trauma center, Comprehensive 36-bed Emergency Department, associated with a Designated Psychiatric Facility. The medical center is secured by onsite unarmed security officers and armed campus police, 20 minutes offsite. Participants/Subjects: Participants in the project include registered emergency nurses, trauma technicians, security officers, ancillary personnel, physicians and residents; all regularly assigned to the emergency department. All have received extensive training on an annual basis in the prevention and management of assaultive behavior and emergency preparedness with an all hazards approach. Methods: An all hazards approach was taken to implement the active shooter plan under the auspices of “save yourself first so you can save others.” An acronym (ED-A: Escape-Duck-Attack) guideline was used to drive the survival plan. Upon completion of staff training, a departmental drill occurred using the recorded sounds by police of actual gunshots. A live drill was conducted within a designated part of the emergency department with the agreement, awareness, and participation of patients to verify staff understanding, compliance, and behaviors. An essential element of survival is the staff’s ability to apply the learned approach when the actual threat exists. Results/Outcomes: The reliability of staff response was verified with the sound recognition of gun shots, application of the ED-A: Escape-Duck-Attack approach, and staff understanding of their role during the active drill. Replication of the scenario reinforced the interdisciplinary approach and the simultaneous and integrated response of clinical staff, security and police. Implications: As with all emergency preparedness programs, ongoing training, and readiness is the impetus for rapid response and survival. Staff competency with the all hazards approach for an active shooter may reduce the likelihood of mortality in the emergency setting.
Keywords:
Shootings in the ED
Repository Posting Date:
4-Aug-2014
Date of Publication:
4-Aug-2014
Conference Date:
2014
Conference Name:
2014 ENA Leadership Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Phoenix, Arizona USA
Description:
2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleLife Threatening: The Active Shooter in the Emergency Departmenten_GB
dc.contributor.authorBradley, Darleneen_GB
dc.contributor.authorStepp, Sherleneen_GB
dc.author.detailsDarlene Bradley, PhD, RN, CNS, FAEN, email: darlene004@aol.com; Sherlene Stepp, RN, MICNen_GB
dc.identifier.urihttp://hdl.handle.net/10755/324148-
dc.description.abstractEvidence-based Practice AbstractPurpose: Hospital shootings most commonly occur in emergency departments culminating in the injury or death of 20% of hospital employees. In United States hospitals from 2000-2011, 91 shootings occurred within the hospital, with an additional 63 on hospital grounds. The purpose of this project is to sustain life through the preparation of emergency department staff for the possibility of an onsite active shooter. Design: This multidisciplinary quality improvement project was derived from the debrief of two emergency department cases occurring within six months of each other. One individual walked to the bathroom within the emergency department waiting room and committed suicide with a single gunshot to the head. A second unrelated visitor insinuated she would pull a gun from her purse to shoot visitors and staff in the waiting room. A table top exercise with security and campus police was the impetus to create an all hazards approach to an active shooter threat. Setting: The project was developed at a University Medical Center in a Level I trauma center, Comprehensive 36-bed Emergency Department, associated with a Designated Psychiatric Facility. The medical center is secured by onsite unarmed security officers and armed campus police, 20 minutes offsite. Participants/Subjects: Participants in the project include registered emergency nurses, trauma technicians, security officers, ancillary personnel, physicians and residents; all regularly assigned to the emergency department. All have received extensive training on an annual basis in the prevention and management of assaultive behavior and emergency preparedness with an all hazards approach. Methods: An all hazards approach was taken to implement the active shooter plan under the auspices of “save yourself first so you can save others.” An acronym (ED-A: Escape-Duck-Attack) guideline was used to drive the survival plan. Upon completion of staff training, a departmental drill occurred using the recorded sounds by police of actual gunshots. A live drill was conducted within a designated part of the emergency department with the agreement, awareness, and participation of patients to verify staff understanding, compliance, and behaviors. An essential element of survival is the staff’s ability to apply the learned approach when the actual threat exists. Results/Outcomes: The reliability of staff response was verified with the sound recognition of gun shots, application of the ED-A: Escape-Duck-Attack approach, and staff understanding of their role during the active drill. Replication of the scenario reinforced the interdisciplinary approach and the simultaneous and integrated response of clinical staff, security and police. Implications: As with all emergency preparedness programs, ongoing training, and readiness is the impetus for rapid response and survival. Staff competency with the all hazards approach for an active shooter may reduce the likelihood of mortality in the emergency setting.en_GB
dc.subjectShootings in the EDen_GB
dc.date.available2014-08-04T13:28:23Z-
dc.date.issued2014-08-04-
dc.date.accessioned2014-08-04T13:28:23Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Leadership Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationPhoenix, Arizona USAen_GB
dc.description2014 ENA Leadership Conference Theme: Safe Practice, Safe Care. Held at the Phoenix Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_GB
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