Violence Against Healthcare Workers in a Pediatric Emergency Department
Workplace violence (WPV) in the healthcare setting occurs four times more often than in all private-sector industries combined; however, only one previous study included findings that violence occurs in a pediatric emergency department (PED). The purpose of this qualitative study was to identify the extent that WPV by patients and visitors occurred in an urban PED and the negative effects on PED workers. The conceptual model for this study was the workplace violence model. The research questions were related to describing the context of WPV; person, workplace, and community/environmental factors for WPV; consequences for workers, perpetrators of violence, patients, and the healthcare employer following WPV; and potential interventions to reduce the incidence and negative consequences of WPV. Interviews with 31 PED workers were audiotaped and transcribed verbatim. A modified form of constant comparative analysis was used to analyze the data. Triangulation of interview data was performed using non-participant observations and a review of medical center policies and continuing education offerings. The study results indicate that physical violence was primarily perpetrated by psychiatric patients; whereas, verbal violence was primarily perpetrated by patients' family members. Consequences reported by participants included worker stress and injury, patients being restrained, parental eviction from the ED, delays in patient care, and perceived negative image of the medical center by parents and visitors. Interventions posed were de-escalation training, early recognition and intervention for WPV, and creation of a specialized psychiatric PED. Study findings indicate that all patients and visitors should be treated as though they have the potential to be violent. Employees need to participate in education to learn how violence affects patient care, the importance of calling for help when violence occurs, and strategies to prevent violence. Employers need to recognize the effects that violence has on workers' ability to provide patient care and offer victims breaks and informal debriefings following violent events. Future research needs to be done to identify the incidence of both verbal and physical violence against PED workers by patients and visitors, as well as the magnitude of the consequences of violence for workers, perpetrators, patients, and healthcare employers.
School:University of Cincinnati
School Location:USA - Ohio
Source Type:Master's Thesis
Keywords:workplace violence pediatrics emergency department occupational safety and health qualitative case study
Date of Publication:01/01/2008