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Practice Improvement|Articles in Press

Introducing a Digital Occupational Violence Risk Assessment Tool Into an Emergency Department: A Pilot Implementation Study

Published:March 03, 2023DOI:https://doi.org/10.1016/j.jen.2023.01.007

      Abstract

      Introduction

      Occupational violence in emergency departments is prevalent and detrimental to staff and health services. There is an urgent call for solutions; accordingly, this study describes the implementation and early impacts of the digital Queensland Occupational Violence Patient Risk Assessment Tool (kwov-pro).

      Methods

      Since December 7, 2021, emergency nurses have been using the Queensland Occupational Violence Patient Risk Assessment Tool to assess 3 occupational violence risk factors in patients: aggression history, behaviors, and clinical presentation. Violence risk then is categorized as low (0 risk factors), moderate (1 risk factor), or high (2-3 risk factors). An important feature of this digital innovation is the alert and flagging system for high-risk patients. Underpinned by the Implementation Strategies for Evidence-Based Practice Guide, from November 2021 to March 2022 we progressively mobilized a range of strategies, including e-learning, implementation drivers, and regular communications. Early impacts measured were the percentage of nurses who completed their e-learning, the proportion of patients assessed using the Queensland Occupational Violence Patient Risk Assessment Tool, and the number of reported violent incidents in the emergency department.

      Results

      Overall, 149 of 195 (76%) of emergency nurses completed their e-learning. Further, adherence to Queensland Occupational Violence Patient Risk Assessment Tool was good, with 65% of patients assessed for risk of violence at least once. Since implementing the Queensland Occupational Violence Patient Risk Assessment Tool, there has been a progressive decrease in violent incidents reported in the emergency department.

      Discussion

      Using a combination of strategies, the Queensland Occupational Violence Patient Risk Assessment Tool was successfully implemented in the emergency department with the indication that it could reduce the number of incidents of occupational violence. The work herein provides a foundation for future translation and robust evaluation of the Queensland Occupational Violence Patient Risk Assessment Tool in emergency departments.

      Key words

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      Biography

      C.J. Cabilan is a Clinical Research Officer, Emergency Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; and Adjunct Lecturer, School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia, Queensland, Australia. Twitter: @cjcabilan. ORCID: http://orcid.org/0000-0001-8465-8026.

      Biography

      Joshua McRae was a Clinical Nurse Consultant, Clinical Informatics and Data Analytics, Office of the Chief Clinical Information Officer, Clinical Excellence Queensland, Brisbane, Queensland, Australia. Twitter: @JoshuaMcRae15.

      Biography

      Katherine Ganzon is a Registered Nurse, Emergency Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.

      Biography

      Casey Appo is a Registered Nurse, Emergency Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.

      Biography

      Stefanie Rogers is a Nurse Educator, Emergency Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.

      Biography

      Madeline O’Sullivan is a Registered Nurse, Emergency Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.

      Biography

      Robert Eley is an Academic Research Manager, Emergency Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; and Faculty of Medicine, Southside Clinical Unit, The University of Queensland, St Lucia, Queensland, Australia. ORCID: http://orcid.org/0000-0003-0856-4313.

      Biography

      Centaine Snoswell is a Health Economics Research Fellow, Center for Online Health, Center for Health Services Research, The University of Queensland, Woolloongabba, Queensland, Australia. Twitter: @CSnoswell. ORCID: http://orcid.org/0000-0002-4298-9369.

      Biography

      Amy Johnston is a Nurse Researcher, Emergency Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; and Honorary Senior Lecturer, School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia, Queensland, Australia. Twitter: @amynbjohnston1. ORCID: http://orcid.org/0000-0002-9979-997X.