Introduction. Today in the emergency services worldwide, there are increasing acts of violence and aggression towards ER nurses, and particularly, those involved in triage activities. But the rare tendency of nurses to denounce the violent episodes is a great hindrance to understanding this phenomenon in all its implications. Recently, some studies have been initiated to address this problem in Italy. Aim. The target of this work was to present the results of the recording of violent episodes over a period of 16 months (Workplace Violence) in Triage, monitored by the SC in the ER of the Perugia General Hospital. Materials and Methods. Following the awareness campaign on the theme of aggression and the policy of “no tolerance” for abuses launched in May 2009, among the various initiatives was also the monitoring of critical relationships in the Triage sector, and an Aggressions Data Chart composed of 16 items. Results. From 28/05/2010 to 29/09/2012 a number of 19 violent episodes were registered (equivalent to 1.2 episodes/month) by 8 nurses out of 34 (23.5%). In 67% of the cases the aggressor was the patient, and in the remaining 33% it was the person accompanying the patient. The violence was 95% verbal and 5% physical. The most “dangerous” days were Saturday and Sunday – days in which the user/operator relationship is greater. There was a reverse relation between priority code and “aggressiveness” – in 58% of episodes that occurred the assigned code was White, for 37% it was Green, for 5% it was Yellow, and none were coded Red. On the contrary, no linear correlation was evidenced with regard to waiting times in the triage area. The effect on those in the waiting room was prevalently one of disapproval in 50% of the cases, no reaction in 44% and reactions in 6%. Lastly, the final resolution showed a dichotomic trend inasmuch as in 42% of the cases, the event was resolved by the triage nurse himself, in 42% the law enforcers were called to intervene, whereas the intervention of the coordinating nurse or a colleague assigned to “mediation” tasks (8%) and recourse to the in-house peacekeeping team (8%) were the less utilized solutions. Conclusions. The data on violent episodes offer numerous points for analysis and reflection. The low number of cases on one hand signaled out the failure to denounce, as underlined in literature (estimated to be around 80%), but on the other hand makes us hope that it may also signify the efficacy of multi directional interventions implemented in the Perugia Hospital’s ER.
Wellbeing in the Workplace and critical relational factors in the triage department: results of a 16-month monitoring period
Ramacciati Nicola
;
2013-01-01
Abstract
Introduction. Today in the emergency services worldwide, there are increasing acts of violence and aggression towards ER nurses, and particularly, those involved in triage activities. But the rare tendency of nurses to denounce the violent episodes is a great hindrance to understanding this phenomenon in all its implications. Recently, some studies have been initiated to address this problem in Italy. Aim. The target of this work was to present the results of the recording of violent episodes over a period of 16 months (Workplace Violence) in Triage, monitored by the SC in the ER of the Perugia General Hospital. Materials and Methods. Following the awareness campaign on the theme of aggression and the policy of “no tolerance” for abuses launched in May 2009, among the various initiatives was also the monitoring of critical relationships in the Triage sector, and an Aggressions Data Chart composed of 16 items. Results. From 28/05/2010 to 29/09/2012 a number of 19 violent episodes were registered (equivalent to 1.2 episodes/month) by 8 nurses out of 34 (23.5%). In 67% of the cases the aggressor was the patient, and in the remaining 33% it was the person accompanying the patient. The violence was 95% verbal and 5% physical. The most “dangerous” days were Saturday and Sunday – days in which the user/operator relationship is greater. There was a reverse relation between priority code and “aggressiveness” – in 58% of episodes that occurred the assigned code was White, for 37% it was Green, for 5% it was Yellow, and none were coded Red. On the contrary, no linear correlation was evidenced with regard to waiting times in the triage area. The effect on those in the waiting room was prevalently one of disapproval in 50% of the cases, no reaction in 44% and reactions in 6%. Lastly, the final resolution showed a dichotomic trend inasmuch as in 42% of the cases, the event was resolved by the triage nurse himself, in 42% the law enforcers were called to intervene, whereas the intervention of the coordinating nurse or a colleague assigned to “mediation” tasks (8%) and recourse to the in-house peacekeeping team (8%) were the less utilized solutions. Conclusions. The data on violent episodes offer numerous points for analysis and reflection. The low number of cases on one hand signaled out the failure to denounce, as underlined in literature (estimated to be around 80%), but on the other hand makes us hope that it may also signify the efficacy of multi directional interventions implemented in the Perugia Hospital’s ER.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
