A study led by Rochester, Minn.-based Mayo Clinic found that patient violence often begins in out-of-hospital settings and continues into the ED and other inpatient units.
The study, published June 18 in Annals of Emergency Medicine, analyzed 206 out-of-hospital, 868 ED and 3,561 non-ED hospital violent encounters between December 2022 and November 2023. Patients who exhibited violence in out-of-hospital encounters were compared to those exhibiting violence within the hospital. Violent patient encounters included verbal abuse, physical assault and threats.
Here are five study findings.
1. Of the 2,791 violent encounters, 28.1% continued into a second care setting, 12.6% into a third, and 7.5% into a fourth.
2. The setting with the highest rate of violence was out-of-hospital at 18.02 events per 10 patient encounter hours, followed by the ED with 0.35 events.
3. Of patients who were violent in out-of-hospital settings, 41.7% were violent again in the hospital, and 26.2% were violent in the ED.
4. Out-of-hospital violence occurred in 0.78 per 100 encounters, compared to ED violence at 1.06 per 100 encounters and non-ED hospital violence at 6.37 per 100 encounters.
5. Younger patients were more likely to have incidence of violence in the ED compared to patients older than 65, with younger patients having a 24.5% incidence rate compared to 3.7% in the ED. However, on the general hospital floor, older patients had higher incidence rates, at 54.1% versus 21.1%
