title: Prospective study of violence against ED workers.
abstract: BACKGROUND
  Health care support occupations have an assault-injury rate nearly 10 times the general sector. Emergency departments (EDs) are at greatest risk of such events.
  
  
  OBJECTIVE
  The objective was to describe the incidence of violence in ED health care workers (HCWs) over 9 months. Specific aims were to (1) identify demographic, occupational, and perpetrator factors related to violent events (VEs) and (2) identify predictors of acute stress in victims and predictors of loss of productivity.
  
  
  METHODS
  A longitudinal, repeated-methods design was used to collect monthly survey data from ED HCWs at 6 hospitals. Surveys assessed number and type of VEs, and feelings of safety and confidence. Victims also completed specific VE surveys. Descriptive statistics and a repeated-measure linear regression model were used.
  
  
  RESULTS
  Two hundred thirteen ED HCWs completed 1795 monthly surveys and 827 VEs were reported. Average VE rate per person per 9 months was 4.15. Six hundred one events were physical threats (PTs) (3.01 per person). Two hundred twenty six events were assaults (1.13 per person). Five hundred one VE surveys were completed, describing 341 PTs and 160 assaults. Men perpetrated 63% of PTs and 52% of assaults. Significant differences in VEs were reported between registered nurses (RNs) and medical doctors (MDs) (P = .0017) and patient care assistants (P < .05). The RNs felt less safe than the MDs (P = .0041). The MDs felt more confident than the RNs in dealing with violent patients (P = .013). The RNs were more likely to experience acute stress than the MDs (P < .001). Acute stress reduced productivity (P < .001).
  
  
  CONCLUSIONS
  Emergency department HCWs are frequent victims of violence perpetrated by visitors and patients. This results in injuries, acute stress, and lost productivity. Acute stress has negative consequences on workers' ability to perform their duties.
authors.affiliation: University of Michigan, Ann Arbor, MI 48109, USA. terryk@med.umich.edu
authors.forename: Terry
authors.initials: T
authors.lastname: Kowalenko
authors.forename: Donna
authors.initials: D
authors.lastname: Gates
authors.forename: Gordon Lee
authors.initials: GL
authors.lastname: Gillespie
authors.forename: Paul
authors.initials: P
authors.lastname: Succop
authors.forename: Tammy K
authors.initials: TK
authors.lastname: Mentzel
mesh_terms: D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008824:Michigan; D008875:Middle Aged; D016272:Occupational Health; D009820:Ohio; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014754:Violence / Q000706:statistics & numerical data*; D000078329:Workforce