Developing a validated occupational violence risk assessment tool for use in Australian EDs; Engaging with end-users

Ms CJ Cabilan1, Dr Rob Eley1,3, Dr Amy Johnston1,2

1Princess Alexandra Hospital, Department Of Emergency Medicine, Brisbane, Australia, 2University of Queensland, School of Nursing Midwifery and Social Work, Brisbane, Australia, 3University of Queensland, School of Medicine, Brisbane, Australia

Early detection of risk factors for occupational violence (OV) could mitigate incidences of OV in emergency departments (EDs) and enable more directed targeting of safety resources. For the purposes of early detection and intervention, OV risk assessment are best done at triage, the start of a hospital care journey. While a systematic review of evidence around key indicators of OV points to several potential recommendations surrounding risk assessment and tool development (1), it is imperative that further research be informed by end-users – triage nurses. Therefore, the objective of this qualitative study was to ascertain triage nurses’ perceptions of the potential components of an OV risk assessment tool, focusing on feasibility, potential impact and challenges to its implementation. The study was conducted according to the COREQ guidelines. Data were collected from focus groups and semi-structured interviews with 15 triage nurses of a major public ED. Data were analysed inductively using Braun and Clarke’s thematic analysis technique and research team consensus. Five themes were identified pertaining to: i) Assessing; Gathering and synthesising diverse pieces of information to inform decisions about OV risk, ii) Acting; Deciding, documenting and communicating OV risk, iii) Standardising; The clinical need to standardise and communicate risk iv) Supporting; Eliminating the subjectivity or ad hoc nature of OV risk assessment and supporting staff decisions independent of previous experience v) Challenges around implementation of such an OV risk assessment tool. These data will inform ongoing development of a risk assessment tool to inform resource allocation and enhance staff and patient safety in Australian EDs.


  1. Cabilan C.J., Morales S, Johnston A.N.B. Occupational violence risk factors and risk assessment tools in the emergency department: A scoping review. Emergency Medicine Australasia. In press.


Dr Amy Johnston currently holds a conjoint position between Metro South Hospital and Health Service, Department of Emergency Medicine (based at Princess Alexandra Hospital) and the School of Nursing, Midwifery and Social Work, University of Queensland. For the past 5 years she has worked across the academic and ED healthcare environments to conduct her own research as well as supporting clinicians, particularly nurses, to develop the skills and confidence they need to participate in and conduct research projects relevant to their clinical work. She has a heartfelt and passionate commitment to evidence-based practice in emergency departments and to helping clinicians describe and evaluate the amazing innovations they implement. Her wide experience has helped her develop a broading national and international profile. She has co-authored in excess of 80 publications and supported 3 PhD candidates to completion with another 7 currently working towards their PhD qualifications. Her H-index is 17 (Scopus), google scholar is 21, with i10 index of 27.