Violence in the emergency department: a literature review

Abstract

Violence in the emergency department (ED) is a significant problem world wide. Psychiatric and emergency settings are widely considered as high-risk areas, with the incidence of nurses' exposure to violence ranging from 60% to 90%. Besides the impact on the health professionals, violence also directly and indirectly affects the quality of patient care and satisfaction of patients. Inevitably, it also contributes to an escalation of health care costs. Understanding the nature of violence in the ED, its risk factors (patient, staff, situational and interaction factors) and the perceptions of health professionals is an important step towards minimising this problem. Knowledge about the theories of violence and the culture that contributes to violence is also critical to the development of effective long-term violence management strategies for the ED. However, a review of the literature about violence in the ED has revealed many gaps in the research such as the potential for identifying the indicators of violence at triage, over reliance on the reactive and coercive traditional violent management strategies, and the paucity of perception from patient perspective pertaining to this problem. This paper provides a descriptive review of the contemporary research in this area and identifies gaps in the research.