Violence in the emergency department: a national survey of emergency medicine residents and attending physicians.
BACKGROUND
Violence in the Emergency Department (ED) is a well-known phenomenon. Few studies have been done to assess the incidence and nature of violence in the ED.


OBJECTIVE
The purpose of this study was to assess the incidence of violence in the ED nationwide.


METHODS
This study was a prospective, cross-sectional online survey of Emergency Medicine (EM) residents and attending physicians. Of the 134 accredited United States (US) EM residency programs, 65 programs were randomly selected and invited to participate.


RESULTS
Overall, 272 surveys were returned, of which 263 (97%) were completed and further analyzed. At least one workplace violence act in the previous 12 months was reported by 78% (95% confidence interval 73-83%) of respondents, with 21% reporting more than one type of violent act. Workplace violence was experienced similarly between males and females (79% vs. 75%, respectively; p = 0.65), and was more common in EDs with annual volumes over 60,000 patients (82% vs. 67%; p = 0.01). The most common type of workplace violence was verbal threats (75%) followed by physical assaults (21%), confrontations outside the workplace (5%), and stalking (2%). Security was available full time in most settings (98%), but was least likely to be physically present in patient care areas. The majority of respondent EDs did not screen for weapons (40% screened) or have metal detectors (38% had metal detectors). Only 16% of programs provided violence workshops, and less than 10% offered self-defense training.


CONCLUSIONS
Despite the high incidence of workplace violence experienced by the emergency physicians who responded to our survey, less than half of these respondents worked in EDs that screened for weapons or had metal detectors. An even smaller number of physicians worked in settings that provided violence workshops or self-defense training.
Department of Emergency Medicine, West Virginia University, Morgantown, West Virginia 26506, USA.
Marcelina
M
Behnam
Roger D
RD
Tillotson
Stephen M
SM
Davis
Gerald R
GR
Hobbs
D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D010820:Physicians / Q000523:psychology*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014754:Violence / Q000706:statistics & numerical data*