Arron Smith

Project title: A multidisciplinary evaluation of perceptions of workplace violence prevention in the Emergency Department: A qualitative research study.

Degree: MPH | Program: Occupational and Environmental Medicine (OEM) | Project type: Thesis/Dissertation
Completed in: 2022 | Faculty advisor: Luke Mease


Aim – The primary aim of this study is to direct future research and guide interventions for the prevention of workplace violence [WPV] in the emergency department [ED] using a multidisciplinary approach and qualitative evidence of perceived facilitators and barriers of WPV.

Background – WPV is a global public health concern that has a significant detrimental impact in healthcare and nursing with physical, psychological, and organizational consequences.

Methods – Qualitative evaluation of 45 multidisciplinary semi-structured individual interviews from two urban hospital-based EDs. Data analysis was conducted applying the consensual qualitative research method.

Results – Four main themes were identified in the interview data that pertain to the perception of WPV prevention. These include work environment, exposure and health, prevention policies and practices, and work resources. These themes expound upon the perception that violence is unavoidable, and that informal training is unable to provide adequate protection. The cumulative effects of WPV and the perceived lack of managerial commitment to prevent the violence affects productivity and job satisfaction. Conclusions – The work environment of the ED poses unique challenges to preventing WPV. The data suggest hospitals would benefit from increasing management education and commitment toward installing a WPV prevention program, focused on implementing interventions to change WPV prevention culture. Further research is recommended to identify management violence prevention practices and interventions focused on the ED setting.

Implications for Nursing Management – Results of this study strongly suggest that managements’ commitment to resource, implement, and evaluate a WPV prevention program is a driving force in altering the culture surrounding WPV, leading to increased staff involvement, safety, reporting, and retention. The perception that management prioritizes safety, health, and well-being are a cultural force multiplier for preventive actions at the employee level. Furthermore, the investment in training managers and high-exposure staff improves outcomes and changes the culture of violence from ‘part of the job’ to one of ‘prevention and safety’.