Evaluation of the Manifestation of Patient Aggresivity in an Emergency Department (ASAU)

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 Overview

• Status: Completed
• Conditions: Emergency Room

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.

• Study Type: Observational
• Enrollment (Actual): 30

Contacts and Locations

Study Locations

• France
  • Nîmes Cedex 09, France, 30029
    • CHRU de Nîmes - Hôpital Universitaire Carémeau

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Persons manifesting violence (and their victims) according to a pre-determined list of watched-for events will be observed.

Description

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

Study Plan

How is the study designed?

Design Details

• Observational Models: Ecologic or Community
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Violent events; People in this group were observed to manifest violence.
Victims; People in this group are the victims of the other group.

What is the study measuring?

Primary Outcome Measures

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

Secondary Outcome Measures

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

Collaborators and Investigators

• Sponsor: Centre Hospitalier Universitaire de Nīmes
• Investigators: Principal Investigator: Muriel Chazel, CHRU de Nîmes - Hôpital Universitaire Carémeau

Study record dates

Study Major Dates

• Study Start: November 1, 2015
• Primary Completion (Actual): November 1, 2016
• Study Completion (Actual): November 1, 2016

Study Registration Dates

• First Submitted: April 15, 2014
• First Submitted That Met QC Criteria: April 15, 2014
• First Posted (Estimate): April 16, 2014

Study Record Updates

• Last Update Posted (Estimate): December 1, 2016
• Last Update Submitted That Met QC Criteria: November 30, 2016
• Last Verified: November 1, 2016

More Information

Terms related to this study

• Keywords: Violence
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Emergencies
• Other Study ID Numbers: PHRIP/2013/MC-01; 1739572 v 0 (Other Identifier: CNIL number)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No