Management of the aggressive emergency department patient: Non-pharmacological perspectives and evidence base

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dc.contributor.authorArdagh MW
dc.contributor.authorMorrison R
dc.contributor.authorGrainger PC
dc.contributor.authorRichardson, Sandra
dc.date.accessioned2022-08-14T23:17:13Z
dc.date.available2022-08-14T23:17:13Z
dc.date.issued2019en
dc.date.updated2022-05-16T00:06:09Z
dc.description.abstractIntroduction: Aggression in the Emergency Department (ED) remains an ongoing issue, described as reaching epidemic proportions, with an impact on staff recruitment, retention, and ability to provide quality care. Most literature has focused on the definition (or lack of) core concepts, efforts to quantify the phenomenon or provide an epidemiological profile. Relatively little offers evidence-based interventions or evaluations of the same. Aim: To identify the range of suggested practices and the evidence base for currently recommended actions relating to the management of the aggressive Emergency Department patient. Methods: A meta-synthesis of existing reviews of violence and aggression in the acute health-care setting, including management of the aggressive patient, was undertaken. This provided the context for critical consideration of the management of this patient group in the ED and implications for clinical practice. Results: An initial outline of issues was followed by a systematic search and 15 reviews were further assessed. Commonly identified interventions are grouped around educational, interpersonal, environmental, and physical responses. These actions can be focused in terms of overall responses to the wider issues of violence and aggression, targeted at the pre-event, event, or post-event phase in terms of strategies; however, there is a very limited evidence base to show the effectiveness of strategies suggested. Clinical Implications: The lack of evidence-based intervention strategies leaves clinicians in a difficult situation, often enacting practices based on anecdote rather than evidence. Local solutions to local problems are occurring in a pragmatic manner, but there needs to be clarification and integration of workable processes for evaluating and disseminating best practice. Conclusion: There is limited evidence reporting on interventional studies, in addition to identification of the need for high quality longitudinal and evaluation studies to determine the efficacy of those responses that have been identified.en
dc.identifier.citationRichardson SK, Ardagh MW, Morrison R, Grainger PC (2019). Management of the aggressive emergency department patient: Non-pharmacological perspectives and evidence base. Open Access Emergency Medicine. 11. 271-290.en
dc.identifier.doihttp://doi.org/10.2147/OAEM.S192884
dc.identifier.issn1179-1500
dc.identifier.urihttps://hdl.handle.net/10092/104181
dc.languageeng
dc.language.isoenen
dc.publisherInforma UK Limiteden
dc.rightsAll rights reserved unless otherwise stateden
dc.rights.urihttp://hdl.handle.net/10092/17651en
dc.subjectaggressive patienten
dc.subjectmanagement of violenceen
dc.subjectemergency departmenten
dc.subjectviolence and aggressionen
dc.subject.anzsrc1103 Clinical Sciencesen
dc.subject.anzsrcFields of Research::42 - Health sciences::4203 - Health services and systems::420306 - Health care administrationen
dc.subject.anzsrcFields of Research::32 - Biomedical and clinical sciences::3202 - Clinical sciences::320207 - Emergency medicineen
dc.subject.anzsrcFields of Research::42 - Health sciences::4203 - Health services and systems::420309 - Health managementen
dc.subject.anzsrcFields of Research::35 - Commerce, management, tourism and services::3505 - Human resources and industrial relations::350505 - Occupational and workplace health and safetyen
dc.titleManagement of the aggressive emergency department patient: Non-pharmacological perspectives and evidence baseen
dc.typeJournal Articleen
uc.collegeFaculty of Health
uc.departmentSchool of Health Sciences
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