Study of submerged cases of violence on healthcare workers in an emergency department

Background:
Violence at work has negative effects on both workers and
organizations. Among healthcare workers, nurses are the
v1014 European Journal of Public Health, Volume 30 Supplement 5, 2020
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professionals most at risk, especially those who work in
emergency departments. However, literature data are estimated
to be the tip of the iceberg. The study aims at analyze
violence events that are not reported by professionals via
common reporting system, in order to measure the real extent
of the problem and allow the organizations introducing
adequate prevention measures.
Methods:
The study took place in November 2016 in an emergency
department in Southern Italy. A retrospective analysis was
carried out by reviewing both the delivery registers (DR) used
by nurses and doctors during the service, and the reports of
security guards (RSG), in the period between 2011 and 2015.
Results:
The results show that violence frequency was higher than that
present in the risk management reporting (only one case). In
the DR, 40 violence events were reported, yet in the RSG, 109
cases were registered. More nurses (n = 33) than doctors
(n = 8) reported violence events in the DR. In the RSG, guards
reported the same number of cases involving nurses, and 26
cases for doctors. In 50 cases, the professional involved was not
specified. The violence type was physical (5 DR vs 13 RSG),
physical threats or attempted violence (4DR vs 13 RSG), and
verbal (24DR vs 67 RSG). Weapons (e.g., knife, hammer,
syringe) were used in 2 cases as reported in DR and in 4 cases
according to RSG. The aggressor was mainly the patient
(15 DR vs 83 RSG) and the companion (14DR vs 16 RSG).
The shifts with more frequency of events are afternoon (15DR
vs 40 RSG) and night (12DR vs 48 RSG).
Conclusions:
The data show an amount of submerged cases and highlight a
discrepancy between report of professionals and violence
events where security guards intervened.
Key messages:
Under-reporting violence cases require attention by the
organizations.
Prevention and protection strategies must be implemented.
The use of the reporting system must be improved.
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