A systematic review of the literature: workplace violence in the emergency department.

AIMS AND OBJECTIVES To synthesise the body of literature on workplace violence in the emergency department and to identify characteristics of intervention studies that are the basis for guiding best practice modelling in the clinical setting. The research question addressed was what are the characteristics and findings of studies since 2004 on workplace violence in the emergency department? BACKGROUND Emergency departments are prone to increased incidents of workplace violence. Workplace violence in the health care setting has become a hot topic of policy, political debate and research in recent years. Despite the research that has been carried out in this area, little consensus exists as to what are the best practices for mitigating violence in this setting. Design.  Systematic literature review. METHODS Search using four online databases, including MEDLINE, CINAHL, PsycINFO and the Dissertations and Theses Full Text Database. RESULTS Most research focused on the incidence rates of workplace violence in the emergency department and effects on staff. There was a significant lack of intervention studies to provide a framework for guiding evidence-based practice. Themes of under-reporting violence, barriers and attitudes towards reporting, description and characterisation of incidents of violence, predisposing factors and the concept of safety or lack of fear were all major content areas addressed in the literature. CONCLUSIONS Incidence of workplace violence in the emergency department has been well documented in numerous published studies. Emergency department workers are exposed to significant rates of physical and verbal abuse. Under-reporting of workplace violence in the emergency department is common and contributes to the difficulty in accurately tracking violence. RELEVANCE TO CLINICAL PRACTICE Future research must move beyond descriptive studies to include more advanced research methods. Few practice-guiding implications can be gained from this body of research because of the lack of intervention studies.