Violence against nurses working in US emergency departments.

UNLABELLED: The objective of this study was to investigate emergency nurses experiences and perceptions of violence from patients and visitors in US emergency departments (EDs). BACKGROUND: The ED is a particularly vulnerable setting for workplace violence, and because of a lack of standardized measurement and reporting mechanisms for violence in healthcare settings, data are scarce. METHODS: Registered nurses members (n=3,465) of the Emergency Nurses Association participated in this cross-sectional study by completing a 69-item survey. RESULTS: Approximately 25% of respondents reported experiencing physical violence more than 20 times in the past 3 years, and almost 20% reported experiencing verbal abuse more than 200 times during the same period. Respondents who experienced frequent physical violence and/or frequent verbal abuse indicated fear of retaliation and lack of support from hospital administration and ED management as barriers to reporting workplace violence. CONCLUSION: Violence against ED nurses in highly prevalent. Precipitating factors to violent incidents identified by respondents is consistent with the research literature; however, there is considerable potential to mitigate these factors. Commitment from hospital administrators, ED managers, and hospitals security is necessary to facilitate improvement and ensure a safer workplace for ED nurses.

Violence against nurses working in US emergency departments.

OBJECTIVE: The objective of this study was to investigate emergency nurses' experiences and perceptions of violence from patients and visitors in US emergency departments (EDs). BACKGROUND: The ED is a particularly vulnerable setting for workplace violence, and because of a lack of standardized measurement and reporting mechanisms for violence in healthcare settings, data are scarce. METHODS: Registered nurse members (n = 3,465) of the Emergency Nurses Association participated in this cross-sectional study by completing a 69-item survey. RESULTS: Approximately 25% of respondents reported experiencing physical violence more than 20 times in the past 3 years, and almost 20% reported experiencing verbal abuse more than 200 times during the same period. Respondents who experienced frequent physical violence and/or frequent verbal abuse indicated fear of retaliation and lack of support from hospital administration and ED management as barriers to reporting workplace violence. CONCLUSION: Violence against ED nurses is highly prevalent. Precipitating factors to violent incidents identified by respondents is consistent with the research literature; however, there is considerable potential to mitigate these factors. Commitment from hospital administrators, ED managers, and hospital security is necessary to facilitate improvement and ensure a safer workplace for ED nurses.

ENA's Delphi study on national research priorities for emergency nurses in the United States.

INTRODUCTION: This study identified and prioritized research questions with greatest value to emergency nurses and of highest importance for health care consumers. METHODS: Three hundred twenty emergency nursing leaders were invited to participate in 3 rounds of mailed surveys aimed at developing consensus. During round I, 147 nurses submitted 456 research problems. These problems were synthesized into 154 researchable questions, encompassing 17 themes. The round II questionnaire listed these questions in random order. Respondents used a 7-point Likert scale to rate each question's value for practicing nurses and importance for health care consumers. One hundred one nurses rated 106 questions >5.0. The round III questionnaire was individualized to provide each respondent's round II score and each item's median group score. Reflecting on these data, subjects again rated the 106 questions. RESULTS: Seventy-nine nurses rated 16 questions 6.0 or greater for value for practicing nurses; 3 questions were rated 6.0 or greater for importance to consumers. Optimum staff to patient ratios, effects of mandatory overtime, holding admitted patients, and ED overcrowding, as well as effective strategies for educating and ensuring competence of nurses, were highest priority research problems for practicing nurses. Pain relief, impact of and methods of decreasing holding/lengthy ED stay, and effective strategies for patient teaching were judged most important for consumers. DISCUSSION: Nurses' concerns with staff shortages and overcrowding of emergency departments and their effects on patients are paramount. Pain management and patient education were chief clinical issues requiring research. The mission of ENA is "to provide visionary leadership for emergency nursing and emergency care." This mission encompasses a number of values, including the following: "The discipline of emergency nursing includes a defined and evolving body of knowledge based on research."(1) In 1998, the ENA appointed vision councils to develop futuristic ideas to advance ENA's mission. The Research Vision Council proposed that ENA develop a center for emergency nursing research to provide leadership and focus for scientific approaches to the many issues that concern emergency nurses and their patients. The Board of Directors supported this idea by formulating a work group to develop the National Institute for Emergency Nursing Research. In 1999, the work group proposed that a study be conducted to determine national priorities for emergency nursing research. This article reports on the methods and results of a Delphi study conducted for that purpose.

Family presence during cardiopulmonary resuscitation and invasive procedures: practices of critical care and emergency nurses.

BACKGROUND: Increasingly, patients' families are remaining with them during cardiopulmonary resuscitation and invasive procedures, but this practice remains controversial and little is known about the practices of critical care and emergency nurses related to family presence. OBJECTIVE: To identify the policies, preferences, and practices of critical care and emergency nurses for having patients' families present during resuscitation and invasive procedures. METHODS: A 30-item survey was mailed to a random sample of 1500 members of the American Association of Critical-Care Nurses and 1500 members of the Emergency Nurses Association. RESULTS: Among the 984 respondents, 5% worked on units with written policies allowing family presence during both resuscitation and invasive procedures and 45% and 51%, respectively, worked on units that allowed it without written policies during resuscitation or during invasive procedures. Some respondents preferred written policies allowing family presence (37% for resuscitation, 35% for invasive procedures), whereas others preferred unwritten policies allowing it (39% for resuscitation, 41% for invasive procedures), Many respondents had taken family members to the bedside (36% for resuscitation, 44% for invasive procedure) or would do so in the future (21% for resuscitation, 18% for invasive procedures), and family members often asked to be present (31% for resuscitation, 61% for invasive procedures). CONCLUSIONS: Nearly all respondents have no written policies for family presence yet most have done (or would do) it, prefer it be allowed, and are confronted with requests from family members to be present. Written policies or guidelines for family presence during resuscitation and invasive procedures are recommended.

Family presence during cardiopulmonary resuscitation and invasive procedures: practices of critical care and emergency nurses.

BACKGROUND: Increasingly, patients' families are remaining with them during cardiopulmonary resuscitation and invasive procedures, but this practice remains controversial and little is known about the practices of critical care and emergency nurses related to family presence. OBJECTIVE: To identify the policies, preferences, and practices of critical care and emergency nurses for having patients' families present during resuscitation and invasive procedures. METHODS: A 30-item survey was mailed to a random sample of 1500 members of the American Association Of Critical-Care Nurses and 1500 members of the Emergency Nurses Association. RESULTS: Among the 984 respondents, 5% worked on units with written policies allowing family presence during both resuscitation and invasive procedures and 45% and 51%, respectively, worked on units that allowed it without written policies during resuscitation or during invasive procedures. Some respondents preferred written policies allowing family presence (37% for resuscitation, 35% for invasive procedures), whereas others preferred unwritten policies allowing it (39% for resuscitation, 41% for invasive procedures). Many respondents had taken family members to the bedside (36% for resuscitation, 44% for invasive procedures) or would do so in the future (21% for resuscitation, 18% for invasive procedures), and family members often asked to be present (31% for resuscitation, 61% for invasive procedures). CONCLUSIONS: Nearly all respondents have no written policies for family presence yet most have done (or would do) it, prefer it be allowed, and are confronted with requests from family members to be present. Written policies or guidelines for family presence during resuscitation and invasive procedures are recommended.