Aggression and violence against frontline workers in hospital emergency departments (EDs) is on the rise.
In-hospital assaults in Australia have increased by 60 per cent in Victoria, 48 per cent in Queensland and 44 per cent in New South Wales from 2015 to 2018.
This is according to new research from Edith Cowan University (ECU), aimed at investigating the perceptions of frontline healthcare professionals on aggression and violence (AV) in EDs. The results show that current strategies in place to manage the issue are perceived to be insufficient.
Participants included medical doctors, nurses and work health safety staff, many of whom said they feel inadequately equipped to manage the impact of workplace AV on their own well-being.
The study held focus groups with a number of these staff across five Perth EDs to uncover the factors influencing the likelihood of AV could include drug and alcohol use, mental illness and psychiatric disorders. Understaffing and overcrowding in the triage area of the Eds also contribute as they result in longer wait times and communication barriers.
“Participants in our study in Perth were overwhelmingly telling us that the occurrence of violence is on the increase. It is not a matter of if, but when,” said PhD candidate Mr Joshua Johnson from ECU’s Simulation and Immersive Digital Technology Group.
“Additionally, our participants were telling us that the style of violence has become more aggressive in nature. Over the last 20 or so years, it has progressed from verbal or occasional physical abuse, where someone might be throwing a cup at a front-line worker, to the assaults we’re seeing now.”
While some of the training that staff receive at hospitals to manage this AV is well-received, Johnson says that a number of these initiatives are perceived to be ineffective. Some study participants reported they only received two hours of training once every year, and it was only lecture-based.
“This training could also happen during very busy work periods, meaning that staff are unable to step away from their duties, or it takes place on days when staff are not at work, meaning they have to attend the training on their day off,” said Johnson.
“There appears to be quite a large variation in the quality of training that is being delivered at different hospitals, as well as the frequency of this training. There is a definite need for hospitals to focus on reducing those barriers to accessing effective training, and a standardised delivery of training should be investigated.”
Adding to the issue, study participants noted the current incident reporting process for instances of AV is ineffective as it requires staff to take time away from their duties, resulting in a backlog of work.
Study participants identified exposure to AV in the workplace often leaves frontline workers with increased levels of stress resulting in burnout, a reduction in job performance, and an ultimate choice to leave the profession due to impacts on their own mental health.
The rise in AV represents a continued pattern of behaviour seen against nursing staff in a 2017 study conducted with members of the College of Emergency Nurses’ Australasia. It stated 87 per cent of nurses surveyed reported experiencing patient-related violence.
A recent survey of Queensland’s health workers by the Australian Workers Union found that close to 70 per cent of staff had either been assaulted or witnessed an assault in the workplace.