Staff Perception of Workplace Violence in the ED: Implementing Egress Education and Cue Recognition
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University of Kentucky UKnowledge DNP Projects College of Nursing 2019 Staff Perception of Workplace Violence in the ED: Implementing Egress Education and Cue Recognition Kelsey Jobe University of Kentucky, [email protected] Right click to open a feedback form in a new tab to let us know how this document benefits ou.y Recommended Citation Jobe, Kelsey, "Staff Perception of Workplace Violence in the ED: Implementing Egress Education and Cue Recognition" (2019). DNP Projects. 302. https://uknowledge.uky.edu/dnp_etds/302 This Practice Inquiry Project is brought to you for free and open access by the College of Nursing at UKnowledge. It has been accepted for inclusion in DNP Projects by an authorized administrator of UKnowledge. For more information, please contact [email protected]. Staff Perception of Workplace Violence in the ED: Implementing Egress Education and Cue Recognition Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice at the University of Kentucky By: Kelsey Jobe, BSN, RN Lexington, Kentucky 2019 Abstract Purpose: The purpose of this DNP project was to examine staff perception of workplace violence before and after an educational intervention provided to bedside staff members in the ED of a Level-1 trauma center. The project focused on assessing the impact of an educational intervention on staff perception of WPV related to safety and overall awareness. Methods: This project was a single site project designed to examine the impact of an educational intervention using egress education and cue recognition in the ED setting using a pre- and post- survey. The survey examined staff perception of safety related to WPV before and after receiving education on effective routes of egress throughout the ED and cue recognition. The purpose behind the education implemented was to promote awareness, improve recognition of escalating behaviors, and mitigate the potential for violent behavior. Surveys were used to determine effectiveness of the intervention on staff perceptions of personal safety while working. The project examined cross-sectional survey responses obtained from bedside nurses and other healthcare providers that work within the emergency department of a Level I Trauma Center. Results: A total of 87 staff members completed the pre-survey and 79 staff members completed the post-survey following the egress education and cue recognition. 81% of project participants reported experiencing some form (Verbal and/or Physical) of WPV while working in the ED. Staff perception based on survey responses did not demonstrate a need for exit strategy education implementation (p = 0.79). Discussion: WPV in the ED occurs at an alarming rate, yet despite the evidence, the rate of violence experience by healthcare workers continues to rise. It is imperative to implement effective training programs for staff, however, more studies need to be conducted on effective strategies of training and relevant content that effectively reduce acts of WPV in the healthcare setting. ii Acknowledgements I would like to thank my clinical mentor, Dr. Patricia K. Howard, who has been my number one mentor and has guided me through my project. Without your support my final defense would not be where it is today. You are my role model and a mentor to nurses and students all across the country. You take on so much and somehow never fail to help guide those that come to you and ensure they have every opportunity to be the best they can be. I would also like to thank my advisor, Dr. Jean Edward, because without your time and participation in my defense, this would not be possible. You will never know how much it means to me that you believed in me and my goal. Your support and dedication to my success has been invaluable to me. You took me on as a student and guided me in every aspect to accomplish what I have worked so hard for over the last four years. Lastly, to the staff and faculty members at the University of Kentucky College of Nursing, I cannot thank you all enough for the large role you played in me fulfilling my dream to become an acute care nurse practitioner and achieving my DNP degree. iii Dedication My DNP project is dedicated to all emergency department staff members who have been subjected to acts of workplace violence and my hope is that this project contributes to making a significant impact for emergency departments and hospitals across the country. I would also like to dedicate this project to my parents and sister, who always believed in me and taught me to follow my dreams no matter how long it may take or how difficult it may seem. Lastly, to my friends who continually supported me and gave encouragement throughout the whole process. iv Table of Contents Abstract ........................................................................................................................................... ii Acknowledgements ........................................................................................................................ iii Introduction ..................................................................................................................................... 1 Background ..................................................................................................................................... 2 Purpose ............................................................................................................................................ 4 Theoretical Framework ................................................................................................................... 5 Methods .......................................................................................................................................... 6 Design ...................................................................................................................................... 6 Setting ...................................................................................................................................... 6 Sample ..................................................................................................................................... 6 Congruence .............................................................................................................................. 7 Facilitators and Barriers ........................................................................................................... 7 Measures .................................................................................................................................. 8 Educational Intervention .......................................................................................................... 9 Data Collection ...................................................................................................................... 10 Data Analysis ......................................................................................................................... 10 Results ........................................................................................................................................... 11 Sample Characteristics .......................................................................................................... 11 WPV Experience and Reporting Characteristics ................................................................... 11 Staff Training Characteristics ................................................................................................ 12 Staff Preparedness Characteristics ......................................................................................... 13 Staff Suggestions and Key Themes Characteristics .............................................................. 15 Discussion ..................................................................................................................................... 16 Implications for Practice, Education, and Future Research .......................................................... 18 Limitations .................................................................................................................................... 20 Conclusion .................................................................................................................................... 21 References ..................................................................................................................................... 23 Appendices .................................................................................................................................... 26 v Appendix A: Letter of Support .............................................................................................. 26 Appendix B: Nursing Research Council Approval Letter ..................................................... 27 Appendix C: Cover Letter ..................................................................................................... 28 Appendix D: IRB Approval ................................................................................................... 29 Appendix E: Survey Tool ...................................................................................................... 30 Tables ............................................................................................................................................ 35 Table 1: Demographics Table for Sample Population........................................................... 35 Table