Open AccessEffect of low-cost interventions to reduce the incidence of violent events in two public sector tertiary-care emergency departments, Pakistan
Author(s) -
Shiraz Shaikh,
Hamid Shahzad,
Mirwais Khan,
Lubna Baig,
Seemin Jamali,
Ibrahim Hashmi,
Athar Hussain,
Uzma Qadri,
Lubna Mazharullah,
Samina Zaib
Publication year - 2022
Publication title -
eastern mediterranean health journal/eastern mediterranean health journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.442
H-Index - 47
eISSN - 1687-1634
pISSN - 1020-3397
DOI - 10.26719/emhj.22.026
Subject(s) - psychological intervention , medicine , health care , incidence (geometry) , occupational safety and health , emergency department , intervention (counseling) , suicide prevention , public health , injury prevention , poison control , medical emergency , emergency medicine , environmental health , nursing , physics , pathology , optics , economics , economic growth
Background: Violence against health care workers has been widely reported in Pakistan. Aims: This study, from September 2019 to April 2020, aimed to determine the effect of low-cost interventions to reduce violent events in two tertiary-care emergency departments in Karachi and Peshawar, Pakistan. Methods. In phase one, a surveillance system was established in each department and information on violent events was recorded for three months. In phase two, low-cost interventions designed to reduce violent events were introduced, e.g. awareness-raising material on violence for patients, training for health care workers and visitor identification cards. Violent events were then recorded for another three months and the percentage difference in number of violent events was calculated. Results: In Karachi, 256 violent events occurred before the intervention and 225 after the intervention, a 12.1% reduction. Physical violence events decreased significantly by 42.9% (P = 0.044). The number of events perpetrated by health care workers decreased by 61.9% (P = 0.016) while those perpetrated by patients decreased only by 5.7% (P = 0.538). In Peshawar,90 violent events occurred before the intervention and 45 events after, a 50.0% reduction (P = 0.009). The number of events perpetrated by health care workers was the same in both phases. Events perpetrated by patients or their companions decreased significantly by 59.72% (P = 0.001). Conclusion: Violence against health care workers can be reduced significantly by improving their prevention and de-escalation skills. Client educational interventions, supplemented with hospital regulations and patient guidance, can also help reduce the incidence of violent events.