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Abstract
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Violence towards staff within Emergency Departments (ED) is increasing and there are a number of studies outlining the frequency and impact of such events. Emergency Departments are facing this new challenge with a dangerous combination of long waiting times, alcohol or drug consumption or psychiatric disorders. The post-covid era has led to higher demand, longer waits and increased anxiety amongst the public which has only exacerbated the problem of violent incidents towards staff. Violence is perceived as verbal and physical by staff and often reporting such incidents can be seen as time consuming, laborious and pointless [1]. The requirement for security in the ED has become a sad reality, and the presence of trained staff to provide protection, support and de-escalate challenging situations in the ED are seen as an essential part of the establishment. However, these staffs are often not included as part of the team within ED. Solutions to the problems faced by violent activity in our EDs are not well evaluated.
Gupta [2] and colleagues undertook a study evaluating the role of security services in the ED of one major trauma centre in Canada. They reviewed the call database developed by their Security Services over a 4 year period and analysed the activity recorded both for patient-related or more routine incidents. The incidents were categorised into 6 groups. The authors also analysed the data from month to month and by time of day. They found that almost 20% of calls related to ED incidents, and of these, the majority related to providing assistance for staff with patients or visitors who may need restraining, prevented from leaving or being escorted from the premises. Over the period of time studied, the number of calls per 1000 visits increased steadily. Whilst a single-site study with some limits to the data analysis undertaken, this study demonstrates the key role that security plays in supporting the activity of the ED, ensuring the safety of staff and patients. Examining records such as those collected by security services provides a greater insight into the day-to-day work undertaken in maintaining a safe working environment in the ED. Much of these tasks probably go unnoticed and would not be seen as responding to a violent event, but nevertheless contribute to ensuring a presence is delivering a minimum standard in EDs.
This study provokes thinking about the importance of such roles, the training required for staff undertaking them in a high volume and high acuity environment such as the ED, and the importance of inclusion within the wider ED team. These types of studies can help to direct where training should be developed for maximum benefit to the ED and wider hospital, and can inform the key skills required by security and other staff to provide support and protection. Predictably there is also little research into these roles in EDs and how they contribute to improving the safety of these environments...
Language: en |