(P2-64) Pattern and Factors Associated with Violent Incidents in the Emergency Department of a Level-1 Trauma Center

Abstract

Background

Violent incidents (VI) in emergency departments (EDs) are under-reported concerns for emergency care providers (ECP). There are limited data from EDs in India.

Objective

This is a study of pattern and factors associated with VIs in the ED of a Level-1 Trauma Center.

Methods

A qualitative survey questionnaire was distributed to 42 ECPs who worked in the ED of the All India Institute of Medical Sciences. Responses of ECPs were compiled and analyzed.

Results

A total of 78.6% of nurses, 19.1% doctors, and 2.4% registration clerks participated in the study. A total of 54.8% were female. A total of 85.7% had five years of work experience in the ED. A total of 59.5% witnessed and experienced verbal abuse; 19.04% witnessed and experienced physical abuse. The remaining experienced and witnessed verbal abuse as well as physical abuse. A total of 57.1% had experienced VI multiple times in last six months. Of these, 88.2% faced the incident between 8 pm and 8 am. The ECP reported the incident to hospital authority's 54.8% of the time, 19.1% reported it to the police, and 14.29% did not report, while 7.1% reported to police and hospital administration. Eighty-five percent experienced insecurity & emotional disturbance. Patient-related factors included intoxication and anxiety. Healthcare system-related factors included delay in investigations, non-availability of beds, overcrowding of ED, and lack of staff. A total of 47.7% of participants felt that there was improper communication between healthcare workers and 40.1% felt that non-availability of senior doctor were the system deficiency factors. A total of 16.6% of ECPs had formal training regarding communication skills, and 11.9% had grief counseling. All respondents felt that steps should be taken to decrease and mitigate the VIs in the ED.

Conclusions

Verbal and physical abuse of emergency care workers is common.