Interventions to Address and Prevent Violence Toward Health Care Workers in the Emergency Department

Key Messages

• Seven relevant systematic reviews (SRs) regarding interventions to address and prevent violence in the emergency department (ED) were identified. However, these SRs had a broad focus, and the included studies that were relevant for this current report were few and were generally of low quality.
• Findings were inconsistent regarding education and training interventions for preventing violence in the ED; most relevant primary studies within identified SRs showed there was no difference in the occurrence of violence with interventions including education and training, and a few primary studies reported a reduction in the occurrence violence with interventions including education and training; however, statistical significance of the difference was not reported.
• Pharmacological interventions with haloperidol, lorazepam, droperidol, risperidone, olanzapine, or quetiapine were effective in reducing aggressive behaviour and side effects were generally minimal.
• Implementation of restraint documentation tools was associated with decrease in use of physical restraints to manage aggressive behaviour, and complications were minimal when physical restraints were used for a short duration.
• These findings need to be interpreted with caution considering the limitations such as limited quantity and quality of evidence, and lack of details regarding the characteristics of the population.
• No evidence-based guidelines were identified.