title: Perceptions of Australasian emergency department staff of the impact of alcohol-related presentations.
abstract: OBJECTIVE
  To survey emergency department (ED) clinical staff about their perceptions of alcohol-related presentations.
  
  
  METHODS
  A mixed methods online survey of ED clinicians in Australia and New Zealand, conducted from 30 May to 7 July 2014.
  
  
  METHODS
  The frequency of aggression from alcohol-affected patients or their carers experienced by ED staff; the perceived impact of alcohol-related presentations on ED function, waiting times, other patients and staff.
  
  
  RESULTS
  In total, 2002 ED clinical staff completed the survey, including 904 ED nurses (45.2%) and 1016 ED doctors (50.7%). Alcohol-related verbal aggression from patients had been experienced in the past 12 months by 97.9% of respondents, and physical aggression by 92.2%. ED nurses were the group most likely to have felt unsafe because of the behaviour of these patients (92% reported such feelings). Alcohol-related presentations were perceived to negatively or very negatively affect waiting times (noted by 85.5% of respondents), other patients in the waiting room (94.4%), and the care of other patients (88.3%). Alcohol-affected patients were perceived to have a negative or very negative impact on staff workload (94.2%), wellbeing (74.1%) and job satisfaction (80.9%).
  
  
  CONCLUSIONS
  Verbal and physical aggression by alcohol-affected patients is commonly experienced by ED clinical staff. This has a negative impact on the care of other patients, as well as on staff wellbeing. Managers of health services must ensure a safe environment for staff and patients. More importantly, a comprehensive public health approach to changing the prevailing culture that tolerates alcohol-induced unacceptable behaviour is required.
authors.affiliation: Monash Medical Centre, Melbourne, VIC angela.wadsworth@acem.org.au.
authors.forename: Diana
authors.initials: D
authors.lastname: Egerton-Warburton
authors.affiliation: Australasian College for Emergency Medicine, Melbourne, VIC.
authors.forename: Andrew
authors.initials: A
authors.lastname: Gosbell
authors.affiliation: Australasian College for Emergency Medicine, Melbourne, VIC.
authors.forename: Angela
authors.initials: A
authors.lastname: Wadsworth
authors.affiliation: Australasian College for Emergency Medicine, Melbourne, VIC.
authors.forename: Katie
authors.initials: K
authors.lastname: Moore
authors.affiliation: Australian National University Medical School, Canberra, ACT.
authors.forename: Drew B
authors.initials: DB
authors.lastname: Richardson
authors.affiliation: University of Western Australia, Perth, WA.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Fatovich
mesh_terms: D000374:Aggression; D000428:Alcohol Drinking; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D011795:Surveys and Questionnaires; D064450:Workplace Violence / Q000706:statistics & numerical data