Incidence and factors associated with substance abuse and patient-related violence in the emergency department: a literature review

© 2018 College of Emergency Nursing Australasia Background: The level of workplace violence in emergency departments worldwide has reached an alarming level. Substance abuse is thought to play a major part in the escalation of aggressive and violent behaviour and is suspected to be responsible for the majority of violent escalations in the emergency department. The aim of this scoping review was (1) to investigate the incidence of workplace violence in the emergency department, their association to substance abuse and (2) to identify factors associated with workplace violence such as perpetrator characteristics and environmental factors. Design: Scoping review. Methods: Literature search was conducted using electronic databases. The review of the literature extended from 1997 to 2018 to provide an understanding of the topic of interest. Results: The search initially revealed 1901 articles. After comprehensive examination of the abstracts and removal of duplicates this was reduced to 14. Incidence of workplace violence accounted for 5.5 per 1000 or less of emergency department presentations. Substance abuse was closely related to workplace violence in the extracted literature. Several themes were identified in the context of substance abuse and workplace violence in the emergency department, including perpetrator characteristics, physical and psychosocial factors. Conclusion: Substance abuse was found to be a primary factor linked to workplace violence in the emergency departments. Interventional studies are warranted, focusing on prevention of workplace violence and management of abuse and intoxicated patients in the emergency department.