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186 Workplace violence ED (Mostly male violence (Mean age range 26.2-42.3…
186 Workplace violence ED
retrospective study desings
Security records/incident reports
36/10000 violent pts per
45/100 drug and etoh related
Nurses fear reporting work place violence (WPV)
physical/psychologica injury also
poor staff recruitment
Poor staff retention
Excluded Psychiatric ED
Substantial potential for violence
Mostly male violence
Mean age range 26.2-42.3 years
Median 40 years
Female violence
Median 28 years old
90% of incidents were verbal violence
physical violence 62-69%
Frequency of violence peaks 4pm- 12am or from 12am - 4am
Number doubled during full moon
Happens more on a wednesday, saturday, then a tuesday
related to mental health 14-78.6%
20% of violent episodes had a previous hx of violence
Quality of evidence low
Risk of bias serious
Critical Confounders
country of orgin
Population demographics
Time of presentation
Security relied on a nurse order
Nurse years of experience, age, gender not accounted for
Inconsistency - unexpected herogeneity
was not seen!!
Methodolgical variability
Selection bias
Statistical heterogenity was seen??
study design/location/data source
strengthened the generality of results
Information bias
Inconsistency of violence definitions
clinical measures of drug and etoh intoxication
Incidents report under represent wpv
Lack of evaluation of policy, training and management
Recommendation
Need to establish effective intervention strategies
better ways of predicting violence