title: The effect of an education program on violence in the emergency department.
abstract: OBJECTIVE
  We examine whether a specific educational effort reduces emergency department violence in the short term and quantify the amount of violence in the ED.
  
  
  METHODS
  Cross-sectional prospective surveys were conducted at a tertiary referral center at baseline (1998) and at 3 and 6 months (1999) after the Prevention and Management of Aggressive Behavior Program (PMABP). ED staff on all shifts for 7 alternate days in a 2-week period were surveyed. We measured the total and mean number of physical and violent events per survey. A generalized estimating equation Poisson regression model examined the effect of the program on the numbers of physically and verbally violent events per shift per employee, after adjusting for other covariates. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.
  
  
  RESULTS
  Physical violence events per survey at baseline, 3 months posttraining, and 6 months posttraining were 0.27, 0.10, and 0.21, respectively. The number of reported violent interactions at the same intervals were 49, 19, and 46 (adjusted OR 1.0, 0.35 [95% CI 0.15 to 0.84], and 0.79 [95% CI 0.48 to 1.40]), respectively. Verbal violence events per survey at baseline, 3 months posttraining, and 6 months posttraining were 0.85, 0.31, and 0.51, respectively. The number of reported interactions involving verbal violence at the same intervals were 154, 58, and 69 (adjusted OR 1.0, 0.31 [95% CI 0.21 to 0.46], and 0.47 [95% CI 0.33 to 0.66]), respectively.
  
  
  CONCLUSIONS
  Violent events are frequent in the ED. Education programs may reduce the number of events at least temporarily but do not clearly reduce violence in the long term.
authors.affiliation: Department of Emergency Medicine, the Centre for Health Evaluation and Outcome Sciences, Nursing Research, St. Paul's Hospital, Vancouver, British Columbia, Canada. cfernand@unixg.ubc.ca
authors.forename: Christopher M B
authors.initials: CM
authors.lastname: Fernandes
authors.forename: Janet M
authors.initials: JM
authors.lastname: Raboud
authors.forename: James M
authors.initials: JM
authors.lastname: Christenson
authors.forename: France
authors.initials: F
authors.lastname: Bouthillette
authors.forename: Linda
authors.initials: L
authors.lastname: Bullock
authors.forename: Leisa
authors.initials: L
authors.lastname: Ouellet
authors.forename: Catherine  F
authors.initials: C
authors.lastname: Moore
mesh_terms: D001955:British Columbia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D007318:Inservice Training; D016272:Occupational Health; D010353:Patient Education as Topic; D016012:Poisson Distribution; D015397:Program Evaluation; D011446:Prospective Studies; D014754:Violence / Q000517:prevention & control* / Q000706:statistics & numerical data*