Response to Occupational Violence Emergencies: Introducing the ROVE clinician

Mr Carl Shannon1, Mr Benjamin Learmont1
1Princess Alexandra Hospital Emergency Departmetn, Woolloongabba, Australia

Occupational violence (OV) directed against Emergency Department (ED) staff, usually carried out by patients and/or their significant others, is increasingly common(1, 2). OV incidents can have detrimental impacts on staff wellbeing and professional satisfaction, patient care and on the healthcare organisation (3). To date, most research has focused on defining the problem rather than developing and implementing ameliorative measures (4). This presentation will present a unique collaborative clinical response to OV emergencies in the ED and associated inpatient units; the implementation of a Response to Occupational Violence Emergencies (ROVE) clinician. The presentation will outline how the ROVE clinician model of care enables direct and timely provision of clinical expertise, education and consultancy to staff and patients around three key areas of service provision. i) Alerts, including identification and documentation of patient risk factors, in the integrated electronic medical record (iEMR) in multiple databases including security, patient and staff notifications and mental health care (CIMHA), can help ensure provision of an appropriate level of supervision for patients. ii) Direct support and assistance with implementation of behavioural management plans, including hands-on staff education and training, as well as application of an advanced scope of clinical practice, can mitigate risks to patients, staff and others. The use of nurse-initiated diazepam and nurse-initiated droperidol in the ED are part of this extended scope of clinical practice. iii) ROVE clinicians can also expedite accurate documentation of episodes of OV to enable effective escalation to divisional executives. Ongoing quality evaluation of the model suggests that it is enhancing management of patient care in this busy ED and that it is a model that could be applied in many EDs to reduce the detrimental impacts of violent episodes in healthcare facilities.

Carl Shannon has worked at the PA Emergency Department for the past eleven years for the last 6 years in the role of Clinical Nurse Consultant. Currently he is employed as the project manager for the R.O.V.E responding to occupational violence project. Personal key achievements include: leading the nursing team through the implementation of the electronic medical record and the relocation to a new department. Carl has a particular interest in the prevention of occupational violence and has a passion to implement change in the clinical setting.

Benjamin Learmont  is a Clinical Nurse Consultant with over 9 years experience working in an Emergency Department. For the past 7 years he has been working in an adult only tertiary trauma hospital. In this time ben has developed a passion for Toxicology and Occupational Violence. Ben has recently been involved in a new role Responding to Occupational Violence Emergencies (ROVE) within the hospital to improve the prevention, response and reporting. In his spare time he practices his verbal de-escalation skills on his pet talking parrot.