title: How do intoxicated patients impact staff in the emergency department? An exploratory study.
abstract: OBJECTIVE
  To investigate staff perceptions of the burden of alcohol-related presentations on emergency departments (ED) in New Zealand and the impact on staff of alcohol-related ED presentations.
  
  
  METHODS
  A survey of Wellington Regional Hospital ED staff was conducted using a written questionnaire to measure the impact of alcohol on: staff assault rates, perceived workload, quality of care, and staff mood. In addition, semi-structured interviews were conducted with six ED staff to further explore impacts of alcohol on ED, analysed using thematic analysis.
  
  
  RESULTS
  Forty-seven staff members responded to the questionnaire. Assault rates from alcohol-affected patients were high, particularly amongst nurses. These were mostly verbal assaults. Staff mood was negatively affected and perceptions of workload increased by alcohol-related presentations. Views on whether quality of care of intoxicated patients was affected were mixed although most reported a negative impact on other patients. Interviews confirmed the survey results, confirming the negative impacts of alcohol-related presentations on staff and on the treatment of both intoxicated and non-intoxicated patients.
  
  
  CONCLUSIONS
  This small exploratory study found that alcohol-related presentations have a negative impact on ED staff workload and safety, and may compromise treatment of all patients. More research is needed to corroborate these findings and to investigate policies to reduce the impacts of alcohol-related presentations in the ED.
authors.affiliation: Department of Public Health, Wellington School of Medicine and Health Sciences, University of Otago, PO Box 7343, Wellington South, Wellington 6024, New Zealand. fiona.imlach-gunasekara@otago.ac.nz
authors.forename: Fiona
authors.initials: F
authors.lastname: Imlach Gunasekara
authors.forename: Shaun
authors.initials: S
authors.lastname: Butler
authors.forename: Taisia
authors.initials: T
authors.lastname: Cech
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Curtis
authors.forename: Michael
authors.initials: M
authors.lastname: Douglas
authors.forename: Lynda
authors.initials: L
authors.lastname: Emmerson
authors.forename: Rachel
authors.initials: R
authors.lastname: Greenwood
authors.forename: Sara
authors.initials: S
authors.lastname: Huse
authors.forename: Julia
authors.initials: J
authors.lastname: Jonggowisastro
authors.forename: Camilla
authors.initials: C
authors.lastname: Lees
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.forename: Daniel
authors.initials: D
authors.lastname: McConnell
authors.forename: Andreea
authors.initials: A
authors.lastname: Mogos
authors.forename: Nur I M
authors.initials: NI
authors.lastname: Azmy
authors.forename: Scotty
authors.initials: S
authors.lastname: Newman
authors.forename: Kirstie
authors.initials: K
authors.lastname: O'Donnell
mesh_terms: D000328:Adult; D000339:Affect; D000435:Alcoholic Intoxication / Q000150:complications*; D001291:Attitude of Health Personnel; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010564:Personnel, Hospital; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D014218:Triage; D014754:Violence / Q000706:statistics & numerical data; D016526:Workload