A Quality Improvement Project to Enhance Emergency Nurse Workplace Violence Reporting

Introduction: Workplace violence (WPV) is a pervasive, perpetual, and underreported problem in the emergency department. Nurses suffer devasting physical and psychological consequences due to WPV exposure. Understanding WPV is challenging due to nurse underreporting. Improvement in capturing WPV cases can help drive data-informed, sustainable solutions to WPV prevention. The purpose of this project was to better capture the full extent of WPV in the emergency department through enhanced nurse WPV reporting.
Methods: In collaboration with ED nurses and management, the project team used a multi-interventional approach and designed a feasible electronic reporting instrument to capture WPV events in real-time by reducing nurse reporting barriers. Participating nurses accessed the instrument by scanning a QR code with their mobile phones, strategically located on wall flyers and individual name badge stickers. Data was collected using Qualtrics software and analyzed using SPSS Statistics, which summarized the descriptive statistics.
Results: Two months post-implementation, the electronic reporting instrument recorded 94 QR code scans and 59 WPV reports, resulting in a 1,080% increase in ED WPV reporting compared to the previous two months pre-implementation. The 59 WPV reports were comprised by 78% registered nurses, 19% emergency medical technicians, and 3% other healthcare workers. WPV events were most frequent from 1201-1800 located in treatment rooms (37%), triage (29%), waiting room (19%), behavioral health section (15%), and hallway (12%).
Discussion: A multi-interventional approach and feasible, readily available electronic reporting instrument enhanced ED WPV reporting and facilitated a better capture of ED WPV. Despite nurse underreporting still likely occurring, an emergence of WPV data trends can provide data-driven solutions in WPV prevention. Continued efforts to reduce the barriers that inhibit reporting are needed to foster a safe and supportive culture surrounding WPV reporting.