Assessing the Perceived Prevalence and Reporting Practices of Type II Workplace Violence in the BIDMC Emergency Department




Boyd, Kirsten, “Assessing the Perceived Prevalence and Reporting Practices of Type II Workplace Violence in the BIDMC Emergency Department,” Scholar@Simmons, accessed April 4, 2020,


Assessing the Perceived Prevalence and Reporting Practices of Type II Workplace Violence in the BIDMC Emergency Department


Boyd, Kirsten




Problem: Workplace violence (WPV) is a recognized safety concern in Emergency Departments nationally. Type II WPV is an act or threat of violence (verbal, physical, stalking, harassment) from a patient or family member, towards an employee. Violence in the Emergency Care setting is a significant occupational risk for clinicians and is recognized in some states as a violent crime. To understand the problem, events must be reported. The purpose of this practice inquiry project was to measure the clinicians experience and likelihood to report events before and after a series of interventions.

Significance: Upon reviewing the voluntarily reported WPV data at the Beth Israel Deaconess Medical Center (BIDMC), reporting in the Emergency Department (ED) was low compared to other areas in the medical center. ED environments are especially vulnerable to violence due to stress, wait times, and medical factors for patients.

Methods: In order to better appreciate the actual prevalence of Type II WPV a survey was offered to all clinicians in the BIDMC ED. The survey was voluntary and contained both quantitative and qualitative questions sent to all clinicians and unlicensed staff in the ED at BIDMC. A series of interventions were implemented and the same group was resurveyed to measure change. The interventions included the implementation of a violence response team, standardizing a quality assurance multidisciplinary review of all WPV cases, violence prevention rounds with social work to engage in conversations, and educational enhancements.

Findings: The initial survey resulted in a 68% response rate. Of those who responded, 41% were nurses. ED staff and physicians reported that over their past seven shifts, 53% of respondents experienced or witnessed verbal/emotional violence and 24% of respondents experienced or witnessed physical violence. Of the 139 respondents who reported that they had witnessed or experienced one or more types of violence within their past 7 shifts, only 17% had reported it in the voluntary reporting system. Reasons for not reporting in order of rank included: (1) 85% replied “it’s part of the job”, (2) 61% replied they did not expect anyone to do anything about it, (3) 56% replied it was due to the patient condition (demented or ill), and (4) 42% replied they did not have time. The pre-survey served as an assessment tool as well as educational information as it helped to inform clinicians about what constitutes violence and let the respondents know that the data we received would be utilized to help inform the resources that are needed to create a safer environment for staff and patients. Following the interventions, a post-survey was conducted and although some of the results did not shift greatly, the comments from the respondents validated the focus of this project as important to staff, patients and visitor safety.

Keywords: emergency nurse, workplace violence, type II violence, emergency department violence, violence prevention culture, and workplace violence interventions.


Simmons College (Boston, Mass.)


1 PDF (81 Pages)




Doctoral Dissertations