Evaluation of the Manifestation of Patient Aggresivity in an Emergency Department

Overview

The main objective of this study is to determine the average total number of violent events per observation period occurring in the emergency department at the Nîmes University Hospital. The list of violent events is pre-determined and based on a series of interviews with emergency department staff.

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: November 2016

Detailed Description

This observational study will take place via a representative sample of 90 observation periods. One observation period consists of 7.5 consecutive hours between two team rotations during the day and 10 consecutive hours at night. These observational periods include the moment when health-care teams are debriefed during a shift-change, which we suspect to be a sensitive time point. Observation periods are randomly selected over a period of 1 year, and stratified for time of day (morning, afternoon, evening), day of the week and month. The secondary objectives of the observation phase are to identify factors associated with the average number of violent events per work period (number of patients attending the emergency department, time of staff debriefing during shift change, time of day, week or weekend, individual patient characteristics (gender, age, patient or accompanying a patient, waiting time from arrival in the emergency room to emergency consultation, reason for consultation), characteristics of victims of violence, characteristics of the health care team …) The anticipated total number of violent events is unknown at the beginning of the study; we indicated '50' as a guess.

Arms, Groups and Cohorts

  • Violent events
    • People in this group were observed to manifest violence.
  • Victims
    • People in this group are the victims of the other group.

Clinical Trial Outcome Measures

Primary Measures

  • The number of violent events occuring per work period
    • Time Frame: Baseline to end of period (maximum of 10 hours)

Secondary Measures

  • Date
    • Time Frame: Baseline (hour 0)
  • Day of the week
    • Time Frame: Baseline (hour 0)
  • Time at the beginning of the observation period
    • Time Frame: Baseline (hour 0)
  • Number of male nurses present in the department
    • Time Frame: Baseline to end of observation period (maximum 10 hours)
  • Number of female nurses present in the department
    • Time Frame: Baseline to end of observation period (maximum 10 hours)
  • Number of nursing assistants present in the department
    • Time Frame: Baseline to end of observation period (maximum 10 hours)
  • Number of doctors present in the department
    • Time Frame: Baseline to end of observation period (maximum 10 hours)
  • Number of patients present in the department
    • Time Frame: Baseline (hour 0)
  • Number of accompaning persons (bringing in patients) present in the department
    • Time Frame: Baseline (hour 0)
  • Number of accompaning persons (bringing in patients) present in the waiting room
    • Time Frame: Baseline (hour 0)
  • Number of patients present in the department
    • Time Frame: End of observation period (maximum 10 hours)
  • Number of accompaning persons (bringing in patients) present in the department
    • Time Frame: End of observation period (maximum 10 hours)
  • Number of accompaning persons (bringing in patients) present in the waiting room
    • Time Frame: End of observation period (maximum 10 hours)
  • Time of day at the beginning of a staff debriefing during a shift change.
    • Time Frame: During an observation period (maximum 10 hours)
  • Time of day at the end of a staff debriefing during a shift change.
    • Time Frame: During an observation period (maximum 10 hours)
  • Time at the beginning of a violent event
    • Time Frame: During an observation period (maximum 10 hours)
    • To be recorded for each event for each person manifesting violence.
  • Time at the end of a violent event
    • Time Frame: During an observation period (maximum 10 hours)
    • To be recorded for each event for each person manifesting violence.
  • Was the event correctly declared according to current procedures? yes/no
    • Time Frame: During an observation period (maximum 10 hours)
    • To be recorded for each event for each person manifesting violence.
  • Sex (m/f)
    • Time Frame: During an observation period (maximum 10 hours)
    • To be recorded for each event for each person manifesting violence.
  • Is the person a patient or a person accompanying a patient?
    • Time Frame: During an observation period (maximum 10 hours)
    • To be recorded for each event for each person manifesting violence.
  • Reason why the patient is coming to the emergency department.
    • Time Frame: During an observation period (maximum 10 hours)
    • To be recorded for each event for each person manifesting violence.
  • Time (delay) patient has been waiting before manifestation of violence.
    • Time Frame: During an observation period (maximum 10 hours)
    • To be recorded for each event for each person manifesting violence.
  • Age (years)
    • Time Frame: During an observation period (maximum 10 hours)
    • To be recorded for each event for each victim of a person manifesting violence.
  • Sex (m/f)
    • Time Frame: During an observation period (maximum 10 hours)
    • To be recorded for each event for each victim of a person manifesting violence.
  • Years of work experience
    • Time Frame: During an observation period (maximum 10 hours)
    • To be recorded for each event for each victim of a person manifesting violence.
  • Professional category
    • Time Frame: During an observation period (maximum 10 hours)
    • To be recorded for each event for each victim of a person manifesting violence.
  • Presence/absence of difference in what was observed and what the victim remembers
    • Time Frame: 72 hours after a violent event
  • Violence severity scale
    • Time Frame: During an observation period (maximum 10 hours)
    • To be recorded for each event for each person manifesting violence.

Participating in This Clinical Trial

Inclusion Criteria

  • Persons manifesting violence according to a pre-determined list of watched-for events will be observed – The victims of the above-mentioned violence will also be observed and interviewed Exclusion Criteria:

  • Persons not manifesting violence according to a pre-determined list of watched-for events

Gender Eligibility: All

Minimum Age: N/A

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Centre Hospitalier Universitaire de Nīmes
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Muriel Chazel, Principal Investigator, CHRU de Nîmes – Hôpital Universitaire Carémeau

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