Using action research to plan a violence prevention program for emergency departments.
BACKGROUND
Although there are numerous studies that show that emergency department (ED) violence is a prevalent and serious problem for healthcare workers, there is a lack of published evaluations of interventions aimed at reducing this alarming trend. Using an action research model, the authors partnered with six hospitals to plan, implement and evaluate a violence prevention and management intervention. Phase one of this project involved gathering information from employees, managers and patients using focus groups.


METHODS
Ninety-seven persons participated in one of twelve focus groups. The Haddon matrix was used to develop focus group questions aimed at gathering data about the pre-assault, during assault, and post-assault time frames and to compare these findings to planned strategies. Analysis consisted of identification of themes related to intervention strategies for patients/visitors, employees, managers, and the work environment.


RESULTS
Thematic analysis results supported the relevance, feasibility, and saliency of the planned intervention strategies. With the exception of a few items, employees and managers from the different occupational groups agreed on the interventions needed to prevent and manage violence against ED workers. Patients focused on improved staff communication and comfort measures.


CONCLUSIONS
Results support that violence in the emergency department is increasing, that violence is a major concern for those who work in and visit emergency departments, and that interventions are needed to reduce workplace violence. The Haddon matrix along with an action research method was useful to identify intervention strategies most likely to be successfully implemented and sustained by the emergency departments.
College of Nursing, University of Cincinnati, Cincinnati, OH 45221-0038, USA. donna.gates@uc.edu
Donna
D
Gates
Gordon
G
Gillespie
Carolyn
C
Smith
Jennifer
J
Rode
Terry
T
Kowalenko
Barbara
B
Smith
D001291:Attitude of Health Personnel; D003419:Crisis Intervention; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D017144:Focus Groups / Q000379:methods; D006302:Health Services Research / Q000458:organization & administration*; D006801:Humans; D008297:Male; D015146:Midwestern United States / Q000453:epidemiology; D020380:Needs Assessment; D015404:Nursing Methodology Research; D016272:Occupational Health / Q000706:statistics & numerical data; D010564:Personnel, Hospital / Q000193:education / Q000523:psychology / Q000600:supply & distribution; D010934:Planning Techniques; D016730:Program Development / Q000379:methods*; D015397:Program Evaluation; D012107:Research Design; D017751:Safety Management; D014754:Violence / Q000517:prevention & control* / Q000523:psychology / Q000706:statistics & numerical data