UW Hospital Leads Effort to Improve Emergency Department Safety
MADISON, Wis. - When the number of violent incidents in its emergency department began to increase, a University of Wisconsin Hospital and Clinics team including nurses developed an innovative security program now credited with improving safety for staff, patients and visitors.
Its development and evaluation of the emergency-department (ED) program is described in a recent edition of the Journal of Emergency Nursing. The interdisciplinary team included nursing leadership and front-line nursing staff.
A 2002 report by the Centers for Disease Control said emergency departments are thought to be the most frequent location for violence in health care. And nurses are among the most frequent targets.
"Nurses specifically are at most risk," said Susan Rees, director of nursing quality, regulatory compliance, employee labor relations and facility planning. "In fact, the International Council of Nurses says nurses are three times more likely to experience violence than any other professional group."
A 2007 survey by the Emergency Nurses Association showed that 86 percent of respondents had experienced workplace violence and 20 percent said that they frequently experienced violence in the ER.
In the emergency department in 2006, hospital staff and leadership saw an uptick in violent incidents and some incidents involved staff injuries. A team with broad-based representation formed to come up with a comprehensive security program.
The data show that while there were several injuries reported by ED staff in the two-year period before program implementation, there was only one reported staff member injury and no injury-related staff absences after the safety program was introduced.
The UW Hospital ED safety program uses a color-coded system that shows the current security status with lights in strategic places in the department. When incidents like behavioral problems, victims of violent crime, surge-capacity issues, gang activity, multivictim trauma and high-profile community events suggest a higher level of risk for violence, a team of physician, nursing and security leaders briefly huddles to discuss changing the department's status from green (business as usual) to yellow (potential for disruptive behavior) to red (potential for loss of control of any part of the ED) When security status changes, a three-second alarm and change in light color alert staff to the new situation.
"The training may not prevent unexpected violent outbursts, but staff are better able to identify people at risk of individual violent behavior and know when to cue a potential change in security status," said Tami Morin, ED clinical nurse manager.
A recent study published by DOTMed Business News shows that even though there has been a spike in violent attacks against nurses, the attacks and injuries are "overlooked and underreported," signaling a need for stricter hospital reporting and safety programs.
Date Published: 12/01/2010