Perpetrator and situational characteristics associated with security alerts in regional Australian emergency departments

Perpetrator and situational characteristics associated with security alerts in regional Australian emergency departments

Workplace violence, Emergency service, Hospital, Risk management, Occupational injuries, Security alert,
Code black

Background: Workplace violence is a regular feature of emergency departments (ED) and reported to be increasing
in frequency and severity. There is a paucity of data from regional EDs in Australia. The aim of this study was to identify
the perpetrator and situational characteristics associated with security alerts in regional emergency departments.
Methods: This retrospective descriptive study was conducted in two regional Australian hospital EDs. All incident
reports, hospital summary spreadsheets, and patient medical records associated with a security alert over a two-year
period (2017 - 2019) were included. The situational and perpetrator characteristics associated with security alerts in
the ED were recorded.
Results: One hundred ffty-one incidents were reported in the two-year period. Incidents most frequently occurred
on late shifts and in an ED cubicle. Most incidents included multiple disciplines such as ED staf and paramedics,
police and psychiatric services. One hundred twenty-fve incidents had sufcient information to categorise the perpetrators. Mental and behavioural disorders (MBD) were the most frequent perpetrator characteristic present in security
alerts (n =102, 81.6%) and were associated with increased severity of incidents. MBDs other than psychoactive substance use (PSU) were associated with 59.2% (n =74) of incidents and 66.7% (n =18) of injuries. PSU was associated
with 42.4% (n =53) of incidents. Following PSU and MBDs other than PSU, repeat perpetrators were the next most
prominent perpetrator category (24.8% n =31) and were almost always associated with an MBD (93.5% n =29).
Conclusions: Violence incidents in the ED are often complex, patients present with multiple issues and are managed
across disciplines. Interventions need to extend from one size fts all approaches to targeting specifc perpetrator
groups. Since MBDs are one of the most signifcant perpetrator factors, interventions focussing on this characteristic
are needed to address workplace violence in EDs.

Brodie Thomas, Peter O’Meara, Kristina Edvardsson, Damhnat McCann and Evelien Spelten

BMC Emergency Medicine

(2022) 22:48

Fajar bagus W

PDF

English

Text