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Jeff Aldridge
SAI, Inc.
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Workplace violence is a significant, growing and widespread concern nationwide. Our Emergency Departments are by no means immune to acts of violence. Emergency Medicine professionals know the direct negative impact violence has on the quality of patient care, their employees and staff retention. Emergency Medicine providers across the country continue to voice concern for their safety in this volatile work environment.

Recent studies consistently show that verbal abuse, threats and assaults are common in our hospital Emergency Departments. For example, in a recent survey of Emergency Department nurses in Pennsylvania, 97% reported verbal abuse, 94% had received physical threats, and 66% reported being physically assaulted. Substance abuse and psychiatric disorders were identified as being among the main contributing factors. Another survey identified nurses as the most frequent targets of assault in the healthcare setting with the greatest number of assaults (25%) occurring in Emergency Departments. In this survey, of the 51 nurse homicides reported, 23% occurred in the ED. Less than 3.6% of nurses surveyed felt safe from the possibility of violence in their Emergency Department.

The Joint Commission (JCAHO) has classified Emergency Departments as a Sensitive Area. Hospitals and emergency care facilities should have a well defined policy that addresses access control and identification requirements for anyone visiting the ED. The policy should address who is authorized to visit with the patient, number of visitors allowed, age requirements. It should also describe exceptions to the policy, and detail the responsibility for enforcement and reporting violent acts.

Underreporting is problematic. A recent Emergency Nurses Association study revealed that 82% of nurses surveyed have been assaulted sometime during their career, yet a significant number of these assaults were not reported. This occurs primarily because they believe that threats, assaults, and abuse, are “part of their job”. Additionally ED employees are often reluctant to report incidents out of their concerns over upsetting family members, lack of time or training, as well as concerns for their personal safety. Incidents in which a patient or visitor brings a weapon into the ED are also underreported, according to studies.

A contributing factor to underreporting is the how violence is identified by individuals from facility to facility. For example, even though verbal abuse is common in the Emergency Department setting, it is not often included in most studies even though it can have a significant, long-lasting negative effect on employees and staff.

Summary:  Emergency Department security is of paramount importance for your hospital.  A comprehensive security assessment can identify relative strengths and weaknesses in your program, and recommend proactive measures to insure the highest possible level of security for staff, employees, patients and visitors.   High-tech equipment and state-of-the art security equipment can be an integral component of your overall security, but these modern additions do not obviate the need for sound security policies and protocols reinforced with education and training.  A viable CPI program is recommended as a means of coping with and deescalating potential violent situations in your ED.


Jeff Aldridge, CPP, President

Security Assessments International, Inc.

The process for engaging an SAI security professional begins with the submission of a RFP.   Whether your hospital or healthcare organization is preparing for a Joint Commission survey, fulfilling its annual risk assessment requirements, has security related issues and concerns, or is looking for an independent review of your Security Management Program, SAI's professional consulting services are taylored to meet your specific needs. Click for Details


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