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

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.