Occupational safety across jobs and shifts in emergency departments in Denmark

Abstract

This paper explores whether occupational safety and health (OSH) risk perceptions, behaviour and exposure differ among Emergency Department (ED) doctors, nurses and medical secretaries, and whether observed safe working conditions and behaviour in EDs vary across work shifts. Staff from four public hospital-based EDs completed a survey regarding safety climate, risk behavior, work pressure, exposure to and reporting of injuries, violence and threats. Furthermore, safety observations of working conditions (e.g. order and tidiness) and behavior (e.g. discarding hypodermic needles) were carried out during day, evening and night shifts. Rates of self-reported violence and threats in ED doctors and nurses were two to three times greater than rates seen for doctors and nurses at hospitals in general. However, ED respondents perceived a greater managerial focus on certain aspects of the safety climate. Work pressure and lack of time (among doctors and nurses) and social pressure (among medical secretaries) were the primary reasons given for taking OSH risks. If OSH incidents (e.g. injuries or violence) were not reported, it was often because the process was perceived as too laborious, and some incidents were considered ‘part of the job’. Observations of order and tidiness in the EDs showed a gradual lower score in safety conditions from the day to the evening and night shift. Multifaceted and integrated interventions for educating and training ED personnel need to take into account their varying risk exposures, perceptions and behaviors in creating and sustaining an efficient, safe and healthy working environment.