Safety and Violence Policies in Emergency Departments


It is not a secret that work in emergency departments relates to great responsibility and stresses, which often causes scandals, for example, between the employees of clinics and their patients’ relatives. To avoid any misunderstanding, it is necessary to provide full protection and countermeasures to violence through the training of personnel. Appropriate actions will help to prevent severe conflicts in the workplace and will guarantee safety for all the participants of medical care.

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Ensuring safety in the workplace for emergency workers is accompanied by strong necessity since frequent stresses inevitably entail conflicts and quarrels. The task of the management of medical institutions is to provide subordinates with full protection and, if necessary, organize specialized training courses. According to Gillespie, Gates, Kowalenko, Bresler, and Succop (2014), protection from threats to the safety of clinic staff and, in particular, emergency departments should be created at a high level. Otherwise, there is a risk of frequent trials. To avoid it, the heads of medical institutions develop particular educational methods for personnel.


Emergency workers can face violence and security threats at various stages: when transporting patients to other departments of the hospital, in the process of providing primary care, etc. Trauma care personnel who receive patients from high-risk groups are often threatened with weapons, and many people that they treat are addicts or connected with criminal groups (Stene, Larson, Levy, & Dohlman, 2015). Violence is also possible in parking lots and areas of the hospital, especially in the evening, late at night, and early in the morning. To confront it, it is essential to provide full-fledged support to the safety of personnel and prevent the recurrence of dangerous incidents.

Clinical Presentation

It is significant to train the staff to identify potentially dangerous situations associated with aggressively-minded people, and how to act in such cases. Additional measures that are applied by many authorities are recording the data of all visitors and issuing them special passes indicating a patient’s number. The management ensures that visitors are beside patients and do not stay long in other places. The number of outsiders by the capabilities of staff should be limited and monitored to ensure that the whole amount is not exceeded.


Even preventive measures may not be useful enough if security guards do not closely monitor visitors and patients in clinics. For example, as Gillespie et al. (2014) remark, some people carry weapons or dangerous items under clothing, which further complicates the control process. Also, ensuring safety in the clinic does not mean that doctors or nurses are not endangered outside a particular medical institution. Therefore, it is essential to take into account all these aspects and carefully consider the process of work.


The whole set of safety requirements is best implemented at the stage of emergency department construction. A specific commission consisting of professionals of various fields, such as nurses, doctors, security personnel, firefighters, etc. should develop appropriate safety measures to evaluate the features of a particular department and develop appropriate measures. For a consultation, it is possible to involve certified rescuers specializing in the field of safety and protection of healthcare institutions.


A possible solution to the security problem can be determined with the help of research. To analyze the situation and implement an appropriate intervention, a PICOT question should be developed. The question may be as follows: in an emergency department that has an inadequate safety and plan for violence, who received training on EBP for safety and violence policies and procedures versus a similar ED who does not receive the training show evidence of improved policies and procedures over a six-month study?

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Gillespie, G. L., Gates, D. M., Kowalenko, T., Bresler, S., & Succop, P. (2014). Implementation of a comprehensive intervention to reduce physical assaults and threats in the emergency department. Journal of Emergency Nursing, 40(6), 586-591.

Stene, J., Larson, E., Levy, M., & Dohlman, M. (2015). Workplace violence in the emergency department: Giving staff the tools and support to report. The Permanente Journal, 19(2), 113-117.

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