Aggression and violence in the emergency department: A qualitative study exploring the perspectives of frontline healthcare professionals

Abstract

Background: Aggression and violence (AV) towards frontline healthcare professionals (FHPs) represent a rapidly increasing strain on hospitals, impacting clinician mental health and the provision of patient care. Little is known about the perceptions of healthcare professionals on current aggression management practices. Aim: This study aimed to investigate the perceptions of FHPs on AV in hospital emergency departments (EDs). Methods: Eight semi-structured focus groups consisting of 6–10 participants from five hospital EDs were held. Participants included medical doctors, nurses, and work health safety staff. Focus groups were audio-recorded and transcribed before undergoing thematic analysis. Findings: Four main themes were identified: (i) workplace AV in healthcare are increasing in frequency and difficulty to manage, (ii) local strategies in place to manage workplace AV are perceived to be insufficient, (iii) systemic issues exacerbate the consequences of workplace AV, and (iv) staff feel inadequately equipped to manage the impact of workplace AV on their own well-being. Discussion: There are substantial perceived barriers to the effective management of workplace aggressive and violent behaviour within Australian hospital EDs. Participants suggest perceived increases in the prevalence of aggressive incidents and systemic issues surrounding incident reporting and follow-up exacerbate existing deficiencies in workplace AV management. Conclusion: Further research into risk reduction strategies, investigation of targeted interventions to better prepare staff, and improved reporting processes and pathways are needed to mitigate fallout of workplace exposures to AV in the ED.