Health care workers in emergency departments (EDs) face frequent violence from agitated patients, according to a study published in Academic Emergency Medicine (AEM).
The study, titled “Prevalence of violence against health care workers among agitated patients in an urban emergency department,” was presented at the SAEM Annual Meeting in Phoenix, Arizona, in May 2024. It provides one of the most detailed prospective looks at workplace violence in the ED and highlights the risks faced daily by health care workers.
Researchers analyzed data from two prospective studies of patients treated in a dedicated ED unit for intoxication. Agitation was defined using the altered mental status scale, where scores range from ?4 (coma) to +4 (most agitated).
Trained observers stationed in the ED 24/7 documented incidents of verbal abuse, threats, and violent acts. These observations were then compared against formal hospital reports to assess underreporting.
From 17,873 encounters screened, researchers found that one in five encounters with agitated patients involved assault—including threats or violent acts—while nearly two in five involved verbal abuse.
Most incidents were linked to alcohol or drug intoxication. Yet, the study revealed that these events are significantly underreported, with fewer than 1% of verbal abuse cases and just over half of violent acts formally reported to hospitals.
The study highlights the frequent, yet underreported, occurrence of verbal abuse, threats, and violent acts in EDs. The findings underscore the urgent need for better reporting systems and stronger protections for frontline staff.
More information:
Samuel A. Boes et al, Prevalence of violence against health care workers among agitated patients in an urban emergency department, Academic Emergency Medicine (2025). DOI: 10.1111/acem.70045
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Society for Academic Emergency Medicine
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