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Insights of nurses about assault in hospital-based emergency departments.

PURPOSE
To explore contributing factors, consequences, and solutions to the assault of nurses working in U.S. hospital emergency departments. This preliminary study targeted emergency nurses whose risk for assault was significantly greater than many other workers. Exploring nurses' opinions about factors they believe contribute to assault provides important information for designing acceptable preventive measures.


DESIGN
In this descriptive study, an ecological, occupational-health framework was used which integrates personal, organizational, and societal influences. The six components of the framework were personal factors, workplace factors, environmental factors, assault injuries, solutions, and effects of workplace violence.


METHOD
Four focus groups were used comprised of 22 RNs employed in emergency departments in one large metropolitan area in the United States. Half the nurses had been physically assaulted at work.


FINDINGS
Fourteen themes emerged: nurse attitude, vulnerability, security, administrative issues, assault reporting, safety training, beyond control, societal changes, types of patients, geographic location, pervasiveness of anger, previous assault experiences, effects and possible solutions. Personal, workplace, and environmental factors all contribute to assault. Verbal and physical assaults are common and affect nurses' personal and professional lives.


CONCLUSIONS
Assault-related injuries are preventable. Only physical injuries are treated; all employees who have been verbally or physically assaulted should be referred for post-incident debriefing. Hospital managers should implement violence-prevention programs. The ecological, occupational health framework is useful for identifying factors that contribute to assault.