Nursing Awarded $1.3 Million to Find Ways to Curb Violence in Emergency Departments

CINCINNATI—The UC College of Nursing has been awarded a $1.3 million grant to research ways to curb violence against direct care providers in emergency departments.

"We are very excited about this award which will make a significant contribution to an issue that needs to be brought to the forefront of the health care community and the public in general,” says Andrea Lindell, PhD, nursing dean.

The grant comes from the National Institute for Occupational Safety and Health, a division of the Centers for Disease Control and Prevention.

The study focuses on physical violence and verbal threats by patients and visitors against direct care providers—including physicians, nurses and aides—in adult emergency departments.

The researchers also will investigate effective intervention methods. According to principal investigator Donna Gates, EdD, 60 percent of workplace assaults in 2006 occurred in health care settings, and most of those assaults were committed by patients.

"You are not going to be able to get workplace violence to zero, but it should certainly never be tolerated and accepted,” says Gates, a UC professor of nursing whose prior study, "Violence: Recognition, Management and Prevention,” was published in the Journal of Emergency Medicine in 2006.

Gates says while much research has been conducted to establish that violence against health care providers in emergency departments does exist and is on the rise, there are no known studies on how interventions might reduce the alarming trend.

Gates and co-investigator Gordon Gillespie, PhD, will work with six hospital emergency departments nationwide, identifying baseline violent behaviors such as physical assault or verbal threats of harm. They will then implement guidelines and procedures to address violent behaviors when they arise.

Once the interventions are in place, the researchers will measure for violent behaviors again to assess the effectiveness of the interventions.

Ironically, physical assaults and threats to harm most often come from the patient but can come from visitors as well, says Gillespie, UC assistant professor of nursing.

"The perpetrator is often the person most strongly advocating for the patient’s care,” he says.

Violent behaviors, both researchers say, not only interfere with treatment but also have residual effects on the health care provider. Providers can experience acute stress disorder stemming from the incident or may take time off work to heal from a physical assault.

"It’s not a new topic,” says Gates, "but it’s risen to the forefront and efforts need to be made to decrease it.”

The study has begun and is scheduled to be completed in four years.