Violence in the emergency department: a quantitative survey study of healthcare providers in India

Tania Ahluwalia; Sukhpreet Singh; Navvin Gandhi; Serkan Toy; Katherine Douglass; Janice Blanchard; Kevin Davey

doi:10.1186/s12245-024-00653-x

Violence in the emergency department: a quantitative survey study of healthcare providers in India

Int J Emerg Med. 2024 Jul 3;17(1):83. doi: 10.1186/s12245-024-00653-x.

Authors

Tania Ahluwalia¹, Sukhpreet Singh², Navvin Gandhi³, Serkan Toy⁴, Katherine Douglass⁵, Janice Blanchard⁵, Kevin Davey⁵

Affiliations

¹ Children's National Health System, Division of Emergency Medicine, 111 Michigan Avenue, Washington, DC, 20010, USA. tahluwalia@childrensnational.org.
² Max Healthcare Saket, Delhi, India.
³ Meenakshi Mission Hospital and Research Center, Madurai, India.
⁴ Departments of Basic Science Education & Health Systems and Implementation Science, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
⁵ Department of Emergency Medicine, George Washington University School of Medicine & Health Sciences, Washington, DC, USA.

Abstract

Background: Workplace violence (WPV) in Emergency Departments (EDs) is an increasingly recognized challenge healthcare providers face in low-resource settings. While studies have highlighted the increased prevalence of WPV in healthcare, most of the existing research has been conducted in developed countries with established laws and repercussions for violence against healthcare providers. More data on WPV against ED providers practicing in low-resource settings is necessary to understand these providers' unique challenges.

Objective: This study aims to gain insight into the incidence and characteristics of WPV among ED healthcare providers in India.

Methods: This study was conducted at two EDs in geographically distinct regions of India. A survey was designed to assess violence in EDs among healthcare providers. Surveys were distributed to ED workplace providers, completed by hand, and returned anonymously. Data was entered and stored in the RedCAP database to facilitate analysis.

Results: Two hundred surveys were completed by physicians, nurses, and paramedics in Indian EDs. Most reported events involved verbal abuse (68%), followed by physical abuse (26%), outside confrontation (17%), and stalking (5%). By far, the most common perpetrators of violence against healthcare workers were bystanders including patient family members or other accompanying individuals. Notably, reporting was limited, with most cases conveyed to ED or hospital administration.

Conclusion: These results underscore the prevalence of WPV among Indian ED healthcare providers. High rates of verbal abuse followed by physical abuse are of concern. Most perpetrators of WPV against healthcare providers in this study were patient family members or bystanders rather than the patients themselves. It is imperative to prioritize implementing prevention strategies to create safer work environments for healthcare workers.

Keywords: Developing emergency care systems; Healthcare workplace violence; India; Violence against Healthcare workers.