According to a study, high levels of violence and aggression towards staff in the Christchurch emergency department were not properly recorded or dealt with, as victims were often too exhausted to complete lengthy reports.
The collaborative study, ‘Challenging the culture of Emergency Department violence and aggression’ by Canterbury District Health Board (CDHB), University of Canterbury and University of Otago was published in the New Zealand Medical Journal on Friday.
It assessed reports of violence and assault during a “May – it’s not OK” campaign period each year, from 2014 to 2020.
During the campaign, there was a focus on department-wide violence and aggression, and reminders to staff to report any incidents.
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The study found significantly higher levels of reported violence and aggression during the May period, compared to the rest of the year.
The most consistently reported event was verbal abuse, which combined with verbal threats accounted for an average of 69% of all reports.
Cases of physical threats or assaults accounted for approximately 20% of all reports.
In the majority of reports, a patient was the perpetrator, with intoxication and mental illness being identified as the most common “associated factors”.
Men were more likely to be abusers than women, and people in their twenties were consistently the most likely age group to incite violence and aggression.
During the May audit period, the number of reports remained relatively stable over the seven years, with an average of 87, but in other months the number dropped to 5.
This despite an overall increase in the number of people presenting to the emergency room during the period.
Lead author, University of Canterbury researcher and senior lecturer Dr Sandra Richardson said the stable rate of reporting throughout the study period may be due to more staff feeling too exhausted to record incidents.
“Our staff are so overworked at the moment, they are understaffed and overworked and if you come to the end of the day and need to complete a Safety First report, that’s what’s going to be filed .”
Reporting of incidents, including verbal abuse, verbal threats, physical assault, physical intimidation, sexual innuendo and/or threats, sexual assault, property damage and the use of a weapon, has changed over the study period from paper forms to an online system.
Despite some improvements, reporting was still taking too much of staff time, with the process taking at least 30 minutes and some staff having to find an available computer first.
Richardson said the study findings applied to emergency departments and other public health services across New Zealand, with understaffing a major contributor to the problem.
She said violence and aggression was a contributing factor to staff choosing to leave the profession.
“We know from national and international studies that an environment characterized by violence and aggression will impact recruitment and retention.”