Documented episodes of security presence in the clinical notes: a comparison with security records

Mrs Jill Duncan1, Mr Scott  Trudgett1, Dr Nathan Brown1,5, Mr James Hughes1,4, Dr David  Rosengren1,5, Dr Julia Crilly2,3
1Royal Brisbane and Womens Hosptal, Herston , Australia, 2Gold Coast Health, Qld , Australia, Southport, Gold Coast, Australia, 3Griffith University, Southport, Gold Coast, Australia, 4Queensland University of Technology, Kelvin Grove, Brisbane, Australia, 5University of Queensland, St Lucia, Brisbane, Australia

Background: Emergency departments (ED) are high risk settings for workplace violence (WPV). Almost half of the episodes of WPV in the ED are perpetrated by patients under the influence of substance misuse. A culture of underreporting of WPV exists in the ED. WPV has a significant impact, affecting staff, patients and visitors to healthcare settings. Communication of this risk is essential for the management of these patients and safety of all who enter the healthcare facility.
Aim: The aim of this study was to compare the documented presence of security in the clinical notes to security records to identify if reporting differences exist.
Methods: This retrospective observational study involved the analysis of ED data, security data and medical record data for alcohol-related patient presentations made to a level six tertiary referral ED in Queensland, Australia between April 2016 and August 2017. The documented security presence was compared between security records and ED records.
Results: Of the 680 alcohol-related ED presentations reviewed, there was considerable difference in reporting of security presence: 10.2 % reported in the security data, 3.4% reported in the clinical notes.
Conclusion: The limited documentation of WPV in the clinical notes has potential ramifications for members of the multi-disciplinary team in terms of risk management of these patients. Findings demonstrate a need to continue with organisationally supported strategies to minimise WPV and improve safety for staff and visitors to healthcare facilities.

Jill is an experienced Registered Nurse who has worked across many specialities at many different levels. The last eight years of her career she has worked in the Emergency and Trauma Centre at the Royal Brisbane and Women’s Hospital. She is currently working in a Clinical Nurse Researcher position, exploring the impact of alcohol related presentations on the emergency department as part of a multisite study.