Enough is enough: Alcohol-related occupational violence and aggression in emergency departments in Australia and New Zealand

Abstract

Objective: To determine the extent of alcohol-related violence in EDs throughout Australia and New Zealand and the impact this has had on ED staff. Methods: A mixed methods, cross-sectional, online survey of ED staff working in Australia and New Zealand conducted between 1 August and 11 September 2022 measuring the frequency of physical or verbal alcohol-related aggression from patients and their relatives/carers; changes to the frequency of alcohol-related occupational violence over the preceding 5 years; the impact of COVID-19 on these presentations; and the perceived impact on ED function and staff well-being. Results: A total of 1284 ED staff responded, with almost all (97.9%) reporting having experienced verbal aggression and 92.7% experienced physical aggression from alcohol-affected patients at some point over the preceding 12 months. Alcohol-related presentations were significantly associated with negatively impacting patient wait times (86.1%), the care of other patients (87.5%) and other patients in the waiting room (94.6%). A large majority of ED staff also noted that these presentations negatively impacted staff wellness (82.4%), workload (93.1%) and job satisfaction (78.9%). Most (68.2%) believed that the issue of alcohol-related violence had worsened over the preceding 5 years and 46.7% believed that COVID-19 specifically has worsened the incidence of alcohol-related violence in the ED. Conclusion: Alcohol-related occupational violence and aggression is experienced by almost all ED staff and the prevalence is perceived to be increasing. It results in negative impacts on both staff well-being, the care of other patients and ED function.