[Emergency care as a high-risk workplace-Measures to deal with violence against employees]. / Notfallversorgung als risikoreicher Arbeitsplatz ­ Maßnahmen zum Umgang mit Gewalt gegen Beschäftigte.

BACKGROUND: Many employees in the field of emergency care experience verbal and physical violence caused by patients or visitors. The aim of this project is to gain insights into which measures are available to deal with violence in emergency care and how employees subjectively evaluate them. METHODS: A nationwide cross-sectional online survey was conducted in 2020. The questionnaire contained items on violence prevention, intervention, and follow-up measures. Quantitative data were analysed descriptively and free text data according to Mayring's qualitative content analysis. RESULTS: A total of 349 respondents, including 115 supervisors participated in the survey. The availability of security staff and standardised reporting of incidents were considered important measures for dealing with violence. Of the managers, 67% reported not having a security service, while 56% claimed that reported incidents of violence were not dealt with in a structured way. A high workload in emergency care can impede the implementation of measures. Overall, the demand for increased support by supervisors and the hospital management became clear. CONCLUSION: It is evident that employees consider certain measures to be effective; however, these measures are often not consistently implemented. There is a need for structured reporting of violent incidents against employees to facilitate a realistic recording of the prevalence. In addition to increasing the (nursing) staff, restricting access for visitors can decrease the conflict potential.

Risk of Burnout among Emergency Department Staff as a Result of Violence and Aggression from Patients and Their Relatives.

Emergency department staff are often affected by incidents of violence. The aim of the study was to generate data on the frequency of violence by patients and accompanying relatives and the correlation between experienced aggression, a possible risk of burnout and a high sense of stress. Additionally, the buffering effect of good preventive preparation of care staff by the facility on aggressive visitors and patients was examined. In this cross-sectional study, members of the German Society for Interdisciplinary Emergency and Acute Medicine were surveyed. The investigation of risk factors, particularly experiences of verbal and physical violence, as well as exhaustion and stress, was carried out using ordinal regression models. A total of 349 staff from German emergency departments took part in the survey, 87% of whom had experienced physical violence by patients and 64% by relatives. 97% had been confronted with verbal violence by patients and 94% by relatives. Violence by relatives had a negative effect on perceived stress. High resilience or effective preparation of employees for potential attacks was shown to have a protective effect with regard to the burnout risk and perceived stress. Therefore, management staff play a major role in preventing violence and its impact on employees.