2018 Research Forum

Security and Safety in the Emergency Department

Investigator/Presenter Team: Bridget Martinez RN, Spencer Carter RN, Cassandra Fincher RN, Lacie Thuren RN, Melissa Coter, RN, Zach Burk RN, Dannon Akins RN, Erica Zebrowski RN, Natalie Espericueta RN, Paige Coffee RN, and Leslie Martinez RN Departmental Sponsor: Pamela Gavin RN BSN; NRP Coordinator Bridget Martinez RN 1 , Spencer Carter RN 1 , Cassandra Fincher RN 1 , Lacie Thuren RN 1 , Melissa Coter, RN 1 , Zach Burk RN 1 , Dannon Akins RN 1 , Erica Zebrowski RN 1 , Natalie Espericueta RN 1 , Paige Coffee RN 1 , and Leslie Martinez RN 1 1 Cohort 1, Nurse Residency Program INTRODUCTION The effects of violence in a hospital setting can not only directly harm patients and staff physically/ emotionally but can impact the ability of the nursing staff to care safely for patients, which places nurses in a vulnerable position. The clinical staff’s exposure to violence with perceived limited resources makes this a provocative topic for emergency nursing. Trauma centers can be at risk for violence in the workplace; the type of injuries received, such as gunshot wounds, stabbings and assaults combined with staff ability to handle visitors and intruders from those events increases staff exposure to violence. Bakersfield has a much higher crime rate than the national average (Neighborhood Scout, 2017). PURPOSE To identify safety and security concerns in the Emergency Department through review of current literature and a multi-disciplinary survey of staff. METHOD Staff were asked to complete an opinion survey. The survey items are not tested for validity and reliability: • Staff members include part-time and full-time nurses, patient care technicians, security personnel, and administrative personnel • The survey contained 5 opinion questions and the 6th option offered space for comments or suggestions. RESULTS 70 staff members participated; 66 returned completed surveys. 74% of survey takers have feared for patient safety, 63% of survey takers have been physically assaulted, 20% believe current security measures are adequate, 98% believe better training and equipment would benefit security and a sense of safety. 70% of survey takers have had security staff respond in a timely manner while 89% have had nursing staff respond in a timely manner. DISCUSSION Perceptions of lack of security and safety in the emergency department at Kern Medical were confirmed by the results of the study with 74% of participants stating they have feared for patient safety and 98% stating greater training and/or security/safety measures should be taken to improve the current measures in place. CONCLUSIONS Safety and security staff needs are best addressed through the chain of command, with the project team providing as much evidence of the need for improved safety measures as they can. Also for consideration is to increase ProAct training, increase security rounding, weapon screening by metal detectors, and increase reporting of safety concerns to leadership.

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