Location
Virtual
Start Date
1-3-2024 10:00 AM
End Date
1-3-2024 10:15 AM
Keywords:
california; plcmmc
Description
Background: Workplace violence (WPV) is defined as physical violence or verbal threats of physical violence, regardless of whether an employee sustains an injury. Emergency department (ED) staff are at high risk of exposure to WPV, which can lead to burnout, job dissatisfaction, and secondary stress. Effective preparation for and response to WPV incidents can help mitigate these negative effects. Multicomponent interventions, including education, safety huddles, behavioral health rapid response teams, and environmental modifications, have been shown to reduce WPV incidents and increase staff perceptions of safety.
Purpose: The purpose of this evidence informed-quality improvement project was to increase knowledge of WPV prevention policies and procedures, increase the rate of behavioral health rapid response team activations, and decrease perceptions of violence among surveyed ED Staff by implementing evidence-based multicomponent interventions over a 90-day period.
Methods: In a community hospital ED, a task force composed of registered nurses (RNs) and ancillary staff was established in April 2023. The task force first identified that while the hospital had a mechanism for activating a behavioral health rapid response team (Code Grey), ED staff rarely used it. The task force conducted an exploratory survey of ED staff consisting of questions related to frequency of physical and verbal WPV incidents and familiarity with the hospital’s WPV prevention policies and procedures. Based on the results, evidence-based interventions were implemented including education on utilizing the Code Grey, environmental modifications (“Risk for Violence” signage), and safety huddles. After 90 days, ED staff were surveyed again; pre and post-intervention survey data and Code Grey activation data were compared.
Results: Pre-intervention survey (n = 67) indicated a knowledge deficit in WPV prevention policies and procedures which led to the interventions described above. Post -intervention (n =32), the percentage of survey respondents reporting physical violence at least monthly decreased from 51% to 41%, (a 20% decrease), while the percentage reporting verbal violence at least weekly increased from 79% to 90% (a 14% increase). Self-reported knowledge of WPV prevention policies, procedures, expectationsincreased from 30% to 53% (a 92% increase). Code Grey activation rates increased from 0.05 to 3.45 per 1,000 ED visits (a 7,280% increase).
Conclusions: WPV interventions contributed to an increase in staff familiarity with WPV policies and procedures, an increase in Code Grey activations, and a decrease in reported physical violence. Although there was an increase in reported verbal violence, this may reflect an increased awareness of verbal threats as a form of WPV.
Implications for practice: WPV prevention policies and procedures and Code Grey education will be incorporated into ED staff orientation. Quarterly Code Grey reviews will become standard of practice and will inform ongoing education needs. This project was ED focused but much of the education and WPV strategies are transferable to other units and departments within the organization. Efforts will be made to share results, interventions, and tools with other units to encourage implementation throughout the organization.
Recommended Citation
Lai, Stefanie and Rodriguez, Alicia, "Preventing and Responding to Workplace Violence in the Emergency Department" (2024). Providence Nursing Research Conference 2023 – Present. 12.
https://digitalcommons.providence.org/prov_rn_conf_annual/2024/podiums/12
Department
Emergency Medicine
Department
Nursing
Included in
Preventing and Responding to Workplace Violence in the Emergency Department
Virtual
Background: Workplace violence (WPV) is defined as physical violence or verbal threats of physical violence, regardless of whether an employee sustains an injury. Emergency department (ED) staff are at high risk of exposure to WPV, which can lead to burnout, job dissatisfaction, and secondary stress. Effective preparation for and response to WPV incidents can help mitigate these negative effects. Multicomponent interventions, including education, safety huddles, behavioral health rapid response teams, and environmental modifications, have been shown to reduce WPV incidents and increase staff perceptions of safety.
Purpose: The purpose of this evidence informed-quality improvement project was to increase knowledge of WPV prevention policies and procedures, increase the rate of behavioral health rapid response team activations, and decrease perceptions of violence among surveyed ED Staff by implementing evidence-based multicomponent interventions over a 90-day period.
Methods: In a community hospital ED, a task force composed of registered nurses (RNs) and ancillary staff was established in April 2023. The task force first identified that while the hospital had a mechanism for activating a behavioral health rapid response team (Code Grey), ED staff rarely used it. The task force conducted an exploratory survey of ED staff consisting of questions related to frequency of physical and verbal WPV incidents and familiarity with the hospital’s WPV prevention policies and procedures. Based on the results, evidence-based interventions were implemented including education on utilizing the Code Grey, environmental modifications (“Risk for Violence” signage), and safety huddles. After 90 days, ED staff were surveyed again; pre and post-intervention survey data and Code Grey activation data were compared.
Results: Pre-intervention survey (n = 67) indicated a knowledge deficit in WPV prevention policies and procedures which led to the interventions described above. Post -intervention (n =32), the percentage of survey respondents reporting physical violence at least monthly decreased from 51% to 41%, (a 20% decrease), while the percentage reporting verbal violence at least weekly increased from 79% to 90% (a 14% increase). Self-reported knowledge of WPV prevention policies, procedures, expectationsincreased from 30% to 53% (a 92% increase). Code Grey activation rates increased from 0.05 to 3.45 per 1,000 ED visits (a 7,280% increase).
Conclusions: WPV interventions contributed to an increase in staff familiarity with WPV policies and procedures, an increase in Code Grey activations, and a decrease in reported physical violence. Although there was an increase in reported verbal violence, this may reflect an increased awareness of verbal threats as a form of WPV.
Implications for practice: WPV prevention policies and procedures and Code Grey education will be incorporated into ED staff orientation. Quarterly Code Grey reviews will become standard of practice and will inform ongoing education needs. This project was ED focused but much of the education and WPV strategies are transferable to other units and departments within the organization. Efforts will be made to share results, interventions, and tools with other units to encourage implementation throughout the organization.
