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The following is a summary of “Prevalence of violence against health care workers among agitated patients in an urban emergency department,” published in the April 2025 issue of Academic Emergency Medicine by Boes et al. 

Researchers conducted a retrospective study to describe the prevalence of violence against health care workers among agitated individuals in an emergency department (ED).  

They assessed individuals in an ED area designated for monitoring individuals with intoxication. Patients with agitation were included and defined as a score of +1 or higher on the Altered Mental Status Scale (−4 [coma] to 0 [normal] to +4 [most agitated]). Trained observers stationed in the ED 24/7 documented incidents involving verbal abuse, threats, or physical violence against health care workers. The primary outcome was assault, based on state statute (threat of violence or violent act) and compared the observed incidents to those officially reported to the hospital.  

The results showed that among 17,873 screened encounters, 4,609 (25.8%) involved individuals with agitation, and 4,108 (89.1%) of these included alcohol or drug intoxication. Assaults occurred in 937 encounters (20.3%, 95% CI 19.1%–21.5%), including 802 (17.4%, 95% CI 16.3%–18.5%) with threats and 362 (7.9%, 95% CI 7.1%–8.7%) with physical violence. Verbal abuse was documented in 1,786 encounters (38.8%, 95% CI 37.3%–40.2%). Formal reporting occurred in only 9 of 1,786 (0.5%) verbal abuse cases and 224 of 362 (61.9%) violent incidents.  

Investigators concluded that verbal abuse, threats of assault, and violent acts frequently occurred and were underreported in patients admitted to ED with agitation. 

Source: onlinelibrary.wiley.com/doi/10.1111/acem.70045