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Ali AA. Pearls for Caring for the Boarding Psychiatric Patient in the Emergency Department. J Emerg Med 2024; 67:e42-e49. [PMID: 38816261 DOI: 10.1016/j.jemermed.2024.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 03/07/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Emergency department (ED) boarding of psychiatric patients is a national issue that continues to worsen at a disturbing rate. Implementing strategies in the ED to provide continuous care for patients can help secure patient safety. OBJECTIVE The objective of this review is to discuss the boarding of psychiatric patients and its implications. It will focus on executing best clinical practices in managing boarding psychiatric patients in the ED. It will not focus on the treatment of substance use disorders. DISCUSSION This article will address the pearls for management plans that can be implemented in the ED, alongside discussing pregnant and elderly patients. Risk factors, complications, and treatments for boarding psychiatric patients are discussed. CONCLUSIONS Patients with psychiatric disorders boarding in the ED need careful consideration of management plans to mitigate patient safety events.
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Affiliation(s)
- Afrah A Ali
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD.
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Joyce A, Pellatt R, Ranse J, Doumany A, Hall E, Sweeny A, Keijzers G. Occupational violence in a tertiary emergency department: A retrospective descriptive study. Australas Emerg Care 2023; 26:346-351. [PMID: 37331906 DOI: 10.1016/j.auec.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 05/10/2023] [Accepted: 05/23/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE Occupational violence in emergency departments (EDs) impacts staff and patients. Most hospitals have a response mechanism called a 'Code Black' or similar. We aimed to determine the incidence of Code Black activations in a tertiary ED and describe contributory factors, management strategies and adverse events. METHODS Descriptive study in a tertiary ED in South-East Queensland in 2021. Adult patients for who a Code Black had been activated were eligible. Data were obtained from a prospectively collected Code Black database, supplemented with retrospective electronic medical records. RESULTS There were 386 Code Black events. The incidence of Code Black activation was 11.0 per 1000 adult ED presentations. Individuals requiring Code Black activation were 59.6 % male with a mean age of 40.9 years. The primary diagnosis was mental illness related in 55.1 %. Alcohol was a suspected factor in 30.9 %. When Code Black activation occurred, median length of stay increased. Restraint including physical, chemical or both were used in 54.1 % of Code Blacks. CONCLUSION Occupational violence occurs at a three-fold greater incidence within this ED than reported elsewhere. This study reinforces other literature suggesting an increase in occupational violence, demonstrating the need for dedicated preventative strategies for patients at risk of agitation.
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Affiliation(s)
- Alexander Joyce
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia.
| | - Richard Pellatt
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia; LifeFlight Retrieval Medicine, Brisbane, Queensland, Australia; Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia; School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Jamie Ranse
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Amy Doumany
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Emma Hall
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Amy Sweeny
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia; Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia; School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Gerben Keijzers
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia; Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia; School of Medicine, Griffith University, Gold Coast, Queensland, Australia
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Alcock J, Ranse J, Crilly J, Wardrop R. People brought to the emergency department under involuntary assessment orders: A scoping review. Int Emerg Nurs 2023; 69:101290. [PMID: 37295224 DOI: 10.1016/j.ienj.2023.101290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 03/02/2023] [Accepted: 03/13/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Some people with mental health problems arrive to the Emergency Department (ED) under involuntary assessment orders (IAOs) and can have complex medical and socioeconomic factors, which may impact on the delivery of care in the ED. Therefore, this scoping review aimed to identify, evaluate and summarise the current literature regarding the demographic characteristics, clinical characteristics and outcomes for people brought to the ED under IAOs. METHOD A scoping review was undertaken guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Guidelines and the Arksey and O'Malley framework. RESULTS In total 21 articles were included in this review. People under IAOs most commonly present to EDs with suicidal ideation/intent, with interagency involvement noted when responding to these people in the pre-hospital setting. Most people arriving to ED under IAOs were reported to experience length of staylonger than four hours. CONCLUSION This review highlights the limited information pertaining to people brought to EDs under an IAO. High levels of mental health problems and extended length of stay for people under IAOs suggests the need for interagency collaboration to inform the development and implementation of models of care that incorporates social determinants of health and are tailored to this complex population.
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Affiliation(s)
- Julia Alcock
- School of Nursing and Midwifery, Griffith University, Parklands Dr, Southport, QLD 4222, Australia.
| | - Jamie Ranse
- School of Nursing and Midwifery, Griffith University, Parklands Dr, Southport, QLD 4222, Australia; Menzies Health Institute Queensland, Griffith University, Parklands Dr, Southport, QLD 4222, Australia; Department of Emergency Medicine, Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD 4215, Australia.
| | - Julia Crilly
- School of Nursing and Midwifery, Griffith University, Parklands Dr, Southport, QLD 4222, Australia; Menzies Health Institute Queensland, Griffith University, Parklands Dr, Southport, QLD 4222, Australia; Department of Emergency Medicine, Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD 4215, Australia.
| | - Rachel Wardrop
- School of Nursing and Midwifery, Griffith University, Parklands Dr, Southport, QLD 4222, Australia; Menzies Health Institute Queensland, Griffith University, Parklands Dr, Southport, QLD 4222, Australia.
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Lawrence RE, Rolin SA, Looney DV, Birt AR, Stevenson EM, Dragatsi D, Appelbaum PS, Dixon LB. Physical Assault in the Psychiatry Emergency Room. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2023; 21:89-99. [PMID: 37205038 PMCID: PMC10172533 DOI: 10.1176/appi.focus.23022004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Previous studies of physical assaults in hospitals focused primarily on inpatient psychiatric units, leaving unanswered questions about the extent to which findings generalize to psychiatric emergency rooms. Assault incident reports and electronic medical records from one psychiatric emergency room and two inpatient psychiatric units were reviewed. Qualitative methods were used to identify precipitants. Quantitative methods were used to describe characteristics of each event, as well as demographic and symptom profiles associated with incidents. During the five-year study period, there were 60 incidents in the psychiatric emergency room and 124 incidents on the inpatient units. Precipitating factors, incident severity, means of assault, and interventions were similar in both settings. Among patients in the psychiatric emergency room, a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder with manic symptoms (Adjusted Odds Ratio (AOR) 27.86) and presenting with thoughts to harm others (AOR 10.94) were associated with an increased likelihood of having an assault incident report. Similarities between assaults in the psychiatric emergency room and inpatient psychiatric units suggest that the broader literature from inpatient psychiatry can be generalized to the psychiatric emergency room setting, although some differences exist. Reprinted from J Am Acad Psychiatry Law 2020; 48:484-495, with permission from The American Academy of Psychiatry and the Law. Copyright © 2020.
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Turgut K, Yavuz E, Yıldız MK, Poyraz MK. Violence toward emergency physicians: A prospective-descriptive study. World J Emerg Med 2021; 12:111-116. [PMID: 33728003 DOI: 10.5847/wjem.j.1920-8642.2021.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The highest rate of workplace violence occurs in the health sector, although most cases remain unreported. Emergency services face the majority of these incidents for many reasons, such as the patient profile, long waiting time, and overcrowding. We aimed to determine the characteristics and causes of violence toward emergency physicians. METHODS The acts of violence toward emergency physicians over a one-year period were prospectively recorded. After a violent incident took place, a third party separately interviewed the physician exposed to the violent behavior and the perpetrator who displayed this behavior. We examined the perpetrator's reasons for violence, their demographic characteristics, and the medical complaints of patients involved in such events to determine the characteristics and causes of violence. RESULTS Of the violent acts investigated, 85.1% were verbal, and most were directed toward male doctors by the young male relatives of the patients. More than half of the violent acts occurred within the 15 minutes of presentation to emergency service (60.5%) and at off-hours (69.4%). Concerning the health insurance, 20.4% of the cases were covered by the free green card system, and a small number of the perpetrators of violence lived in rural areas (38.2%). The most common reason for violent behavior was the patients' or their relatives' dissatisfaction with the examination or treatment method (38.2%). CONCLUSIONS Appropriate communication should be established with the patients, and they should be adequately informed about the treatments and interventions to be performed in order to prevent possible acts of violence.
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Affiliation(s)
- Kasım Turgut
- Department of Emergency Medicine, Research and Training Hospital, Adiyaman University, Adiyaman 02100, Turkey
| | - Erdal Yavuz
- Department of Emergency Medicine, Research and Training Hospital, Adiyaman University, Adiyaman 02100, Turkey
| | - Mine Kayacı Yıldız
- Department of Emergency Medicine, Research and Training Hospital, Adiyaman University, Adiyaman 02100, Turkey
| | - Mehmet Kaan Poyraz
- Department of Emergency Medicine, Research and Training Hospital, Adiyaman University, Adiyaman 02100, Turkey
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Older adults on involuntary hold status in the emergency department. Am J Emerg Med 2020; 45:242-247. [PMID: 33041112 DOI: 10.1016/j.ajem.2020.08.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/05/2020] [Accepted: 08/12/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND As the United States' population ages, the health care system will experience overall change. This study aims to identify factors in the older adult that may contribute to involuntary hold status in the ED. METHODS This study is a retrospective review conducted at a suburban acute-care hospital ED of adult patients evaluated while on involuntary hold from January 1, 2014, through November 30, 2015. Older adults (patients born on or before 06/31/1964) were compared to younger adults (born on or after 07/01/1964) according to demographic and clinical variables including medical comorbidity, ED length of stay, reason for involuntary hold, psychiatric disorder, suicide attempt, substance use disorder, serum alcohol level, urine drug testing, medical comorbidity, violence in the ED, 30-day ED readmission, and 30-day mortality. RESULTS Of 251 patients, 90 (35.9%) were older adults. The most common reason for involuntary hold in both cohorts was suicidal ideation. Medical comorbidities were more prevalent in older adults [60 (66.7%) vs. 64 (39.8%), P ≤.0001]. Older adults were less likely to report current drug abuse [31 (34.4%) vs. 77 (47.8%), P = .04]. The most commonly misused substance in both groups was alcohol; however, despite similar rates, blood alcohol levels (BAC) and urine drug screen (UDS) were performed less often in older adults. Cohorts were not significantly different with respect to sex, race, violence in the ED, psychiatric diagnosis, and ED LOS. CONCLUSIONS Involuntary older adult patients present with medical comorbidities that impact mental health. In the ED, they are less likely report substance use, and drug screening may be underutilized. Medical needs make their care unique and may present challenges in transfer of care to inpatient psychiatric facilities.
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Retrospective Chart Review of Voluntary Admissions to an Inpatient Psychiatric Hospital in New York City: A Demographic Breakdown. Community Ment Health J 2020; 56:448-455. [PMID: 31654251 DOI: 10.1007/s10597-019-00498-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 10/18/2019] [Indexed: 10/25/2022]
Abstract
The current paper evaluates psychiatric needs of voluntary admissions in a large urban psychiatric hospital through a retrospective chart review, as this research is limited within the United States. A total of 581 voluntary adult psychiatric admission charts were reviewed. Continuous variables were evaluated using an ANOVA while associations between variables were examined by an unadjusted Pearson correlation coefficient a stepwise linear regression analysis. Men were significantly more likely to have a past admission for psychiatric services (p = .016), suicidal ideation (p < .001) and test positive for substances (p < .001) than women, and were more likely to be unemployed, homeless and without insurance. Women were more likely to have a past suicide attempt and a depressive disorder. A significant relationship between gender and rationale for seeking voluntary admission (p < .001) was found. This study offers understanding of male and female voluntary admissions, and a foundation for improving treatment interventions to reduce recurrent readmissions.
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Maniaci MJ, Burton MC, Lachner C, Vadeboncoeur TF, Dawson NL, Roy A, Dumitrascu AG, Lewis PC, Rummans TA. Patients Threatening Harm to Others Evaluated in the Emergency Department under the Florida Involuntary Hold Act (Baker Act). South Med J 2019; 112:463-468. [PMID: 31485582 DOI: 10.14423/smj.0000000000001019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This study describes the specific threats of harm to others that led to the use of the Baker Act, the Florida involuntary hold act for emergency department (ED) evaluations. The study also summarizes patient demographics, concomitant psychiatric diagnoses, and emergent medical problems. METHODS This is a retrospective review of 251 patients evaluated while on involuntary hold from January 1, 2014 through November 30, 2015 at a suburban acute care hospital ED. The data that were collected included demographic information, length of stay, reason for the involuntary hold, psychiatric disorder, substance use, medical illness, and violence in the ED. The context of the homicidal threat also was collected. RESULTS We found that 13 patients (5.2%) were homicidal. Three patients had homicidal ideations alone, whereas 10 made homicidal threats toward others. Of the 10 making homicidal threats, 7 named a specific person to harm. Ten of the 13 homicidal patients (76.9%) also were suicidal. Eleven patients (84.6%) had a psychiatric disorder: 9 patients (69.2%) had a depressive disorder and 8 patients (61.5%) had a substance use disorder. Eight patients had active medical problems that required intervention in the ED. CONCLUSIONS We found that three-fourths of patients expressing homicidal threats also were suicidal. The majority of patients making threats of harm had a specific plan of action to carry out the threat. It is important to screen any patient making homicidal threats for suicidal ideation. If present, there is a need to implement immediate management appropriate to the level of the suicidal threat, for the safety of the patient. Eighty-five percent of patients making a homicidal threat had a previously documented psychiatric disorder, the most common being a depressive disorder. This finding differs from previous studies in which psychosis predominated. More than 60% of homicidal patients had an unrelated medical disorder requiring intervention. It is important not to overlook these medical disorders while focusing on the psychiatric needs of the patient; most of our homicidal patients proved to be cooperative in the ED setting.
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Affiliation(s)
- Michael J Maniaci
- From the Division of Hospital Internal Medicine, the Division of Psychiatry, and the Department of Emergency Medicine, Mayo Clinic, Jacksonville, Florida, and the Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - M Caroline Burton
- From the Division of Hospital Internal Medicine, the Division of Psychiatry, and the Department of Emergency Medicine, Mayo Clinic, Jacksonville, Florida, and the Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Christian Lachner
- From the Division of Hospital Internal Medicine, the Division of Psychiatry, and the Department of Emergency Medicine, Mayo Clinic, Jacksonville, Florida, and the Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Tyler F Vadeboncoeur
- From the Division of Hospital Internal Medicine, the Division of Psychiatry, and the Department of Emergency Medicine, Mayo Clinic, Jacksonville, Florida, and the Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Nancy L Dawson
- From the Division of Hospital Internal Medicine, the Division of Psychiatry, and the Department of Emergency Medicine, Mayo Clinic, Jacksonville, Florida, and the Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Archana Roy
- From the Division of Hospital Internal Medicine, the Division of Psychiatry, and the Department of Emergency Medicine, Mayo Clinic, Jacksonville, Florida, and the Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Adrian G Dumitrascu
- From the Division of Hospital Internal Medicine, the Division of Psychiatry, and the Department of Emergency Medicine, Mayo Clinic, Jacksonville, Florida, and the Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Patricia C Lewis
- From the Division of Hospital Internal Medicine, the Division of Psychiatry, and the Department of Emergency Medicine, Mayo Clinic, Jacksonville, Florida, and the Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Teresa A Rummans
- From the Division of Hospital Internal Medicine, the Division of Psychiatry, and the Department of Emergency Medicine, Mayo Clinic, Jacksonville, Florida, and the Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
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Cabilan CJ, Johnston ANB. Review article: Identifying occupational violence patient risk factors and risk assessment tools in the emergency department: A scoping review. Emerg Med Australas 2019; 31:730-740. [DOI: 10.1111/1742-6723.13362] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 06/26/2019] [Accepted: 07/01/2019] [Indexed: 12/24/2022]
Affiliation(s)
- CJ Cabilan
- Emergency DepartmentPrincess Alexandra Hospital Brisbane Queensland Australia
- School of Nursing, Midwifery and Social WorkThe University of Queensland Brisbane Queensland Australia
| | - Amy NB Johnston
- Emergency DepartmentPrincess Alexandra Hospital Brisbane Queensland Australia
- School of Nursing, Midwifery and Social WorkThe University of Queensland Brisbane Queensland Australia
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Involuntary patient length-of-stay at a suburban emergency department. Am J Emerg Med 2019; 38:534-538. [PMID: 31153738 DOI: 10.1016/j.ajem.2019.05.045] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 05/19/2019] [Accepted: 05/22/2019] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Patients who may be a danger to themselves or others often are placed on involuntary hold status in the Emergency Department (ED). Our primary objective was to determine if there are demographic and/or clinical variables of involuntary hold patients which were associated with an increased ED LOS. METHODS Records of ED patients evaluated while on involuntary hold from January 1, 2014 through November 30, 2015 at a suburban acute-care hospital ED were reviewed. Data collected included demographics information, LOS, suicidal or homicidal ideation, suicide attempt, blood alcohol concentration (BAC), urine drug test (UDT), psychiatric disorder, substance use, medical illness, violence in the ED, and hospital admission. Linear regression based on the log of LOS was used to identify factors associated with increased LOS. RESULTS Two-hundred and fifty-one patients were included in the study. ED LOS (median) was 6 h (1, 49). Linear regression analysis showed increased LOS was associated with BAC (p = 0.05), urine drug test (UDT) (p = 0.05) and UDT positive for barbiturates (p = 0.01). There was no significant difference in ED LOS with respect to age, gender, housing, psychiatric diagnosis, suicidal or homicidal ideation, suicide attempt, violence, medical diagnosis, or admission status. CONCLUSIONS Involuntary hold patients had an increased ED LOS associated with alcohol use, urine drug test screening, and barbiturate use. Protocol development to help stream-line ED evaluation of alcohol and drug use may improve ED LOS in this patient population.
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Kleissl-Muir S, Raymond A, Rahman MA. Analysis of patient related violence in a regional emergency department in Victoria, Australia. Australas Emerg Care 2019; 22:126-131. [PMID: 31042524 DOI: 10.1016/j.auec.2019.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 01/22/2019] [Accepted: 01/22/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Emergency Departments (ED) have been identified as high-risk areas for patient related violence (PRV). The aim of the present study was to analyse recorded events of violence in a regional Victorian hospital ED, and examine the association these events had with substance abuse. METHODS A retrospective cohort study was undertaken to establish the incidence of PRV. Data were obtained from the hospital's incident management system, RiskMan, over a five and a half year period for all violent events categorised as Code Grey (CG) and Code Black (CB). The Haddon Matrix attached to the individual incident record was also reviewed. RESULTS A total of 548 violent events were analysed. The incident rate was 3.4 per 1000 ED presentations. Intoxication was the primary reason for violent escalations. There was no association between the frequency of CG events and the day of the week, month of admission, or shift of the day. Intoxicated men (110, 64.3%) were more likely to be the instigator of a violent event compared with intoxicated females (61, 35.7%) (OR 1.5, 95% CI: 1.19-2.02, p<0.001). A form of restraint, chemical, physical or both, was used in the majority of violent events (376, 68.6%). CONCLUSION This study demonstrated an increasing frequency of violent events in the regional ED. Rates of PRV were comparable to those reported in metropolitan hospitals. Intoxication was the most frequently observed underlying factor for PRV. Regional hospitals are in need of additional resources to instigate policies and procedures that will maximise patient and staff safety.
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Affiliation(s)
- Sabine Kleissl-Muir
- Department of Acute Care Services, Latrobe Regional Hospital, Traralgon, Victoria, Australia; School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.
| | - Anita Raymond
- Department of Research, Education and Training, Latrobe Regional Hospital, Traralgon, Victoria, Australia
| | - Muhammad Aziz Rahman
- Austin Clinical School of Nursing, La Trobe University, Heidelberg, Victoria, Australia
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Kleissl-Muir S, Raymond A, Rahman MA. Incidence and factors associated with substance abuse and patient-related violence in the emergency department: A literature review. Australas Emerg Care 2018; 21:159-170. [DOI: 10.1016/j.auec.2018.10.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 10/14/2018] [Accepted: 10/15/2018] [Indexed: 12/29/2022]
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