Prevalence of Violence Against Health Care Workers Among Agitated Patients in an Urban Emergency Department

Prevalence of Violence Against Health Care Workers Among Agitated Patients in an Urban Emergency Department

Samuel A. Boes, Jon B. Cole, Michael A. Puskarich, James R. Miner, Sarah K. S. Knack, Matthew E. Prekker, Brian E. Driver
 Academic Emergency Medicine, April 24, 2025
 DOI: Pending

🚨 Conclusions:

Violence against HCWs—including threats and physical acts—is common in encounters with agitated ED patients, especially those with intoxication, but is severely underreported, particularly verbal abuse.

🔍 Methods:

  • Design: Secondary analysis of two prospective observational studies.

  • Setting: Urban ED intoxication monitoring area.

  • Definition of Agitation: Altered Mental Status Scale score of +1 to +4.

  • Outcomes Measured:

    • Verbal abuse

    • Threat of violence

    • Violent act

    • Assault (threat or act per state statute)

    • Formal reporting rates

đź“Š Results:

  • Encounters screened: 17,873

  • Agitated patients: 4,609 (25.8%)

  • With intoxication: 4,108 (89.1%)

  • Assaults (threat or act): 937 (20.3%)

    • Threat of violence: 802 (17.4%)

    • Violent act: 362 (7.9%)

  • Verbal abuse: 1,786 (38.8%)

  • Reporting:

    • Verbal abuse: 0.5% formally reported

    • Violent acts: 61.9% reported

Boes, S.A., Cole, J.B., Puskarich, M.A., Miner, J.R., Knack, S.K., Prekker, M.E. and Driver, B.E., 2025. Prevalence of violence against health care workers among agitated patients in an urban emergency department. Academic Emergency Medicine.

Back to blog