Prepare for the Worst

De-escalation Training Arms Hospitalists With Measures to Calm Agitated Patients

Karen Appold


The Hospitalist. 2015;19(3):30-31. 

In This Article

How Bad Is It?

According to the Emergency Nurses Association's Institute for Emergency Nursing Research, violence is especially prevalent in the ED; about 11% of ED nurses report being physically assaulted each week. The agency states that the data is most likely grossly underreported, since reporting is voluntary.[1]

Healthcare workers in psychiatric wards are the most likely to suffer an injury caused by an agitated patient, Dr. Zeller says. Of those, nurses are the ones most commonly affected, followed by physicians.

"But agitation-related assaults and injuries can happen just about anywhere in a hospital," he adds.

According to a study conducted by the Emergency Nurses Association, pushing/grabbing and yelling/shouting were the most prevalent types of violence. Eighty percent of cases occurred in the patient's room.[2] Dr. Zeller says that the most common injuries are those resulting from being struck, kicked or punched, or knocked down. Injuries include heavy bruising, sprains, and broken bones.

Dr. Zeller says it's difficult to quantify exactly what types and costs of injuries occur. Injuries related to agitation are known to cause staff to miss work frequently. "That can cost a lot in terms of lost hours and replacement wages, as well as medical care for the injured party," he says.