A researcher who spent nearly 300 hours observing patients in an accident and emergency department has developed a method for identifying possible flashpoints, according to the latest Journal of Advanced Nursing.
Lauretta Luck, who carried out her research at the University of Western Sydney, Australia, points out that the STAMP violence assessment framework could have much wider applications than just hospitals.
STAMP - which stands for Staring and eye contact, Tone and volume of voice, Anxiety, Mumbling and Pacing -- could be used by any professionals in potentially violent situations, such as law enforcement and social services.
The five-month research project was carried out in a 33-bedded emergency department in a public hospital serving a large rural, remote and metropolitan community in Australia.
It serves a multi-cultural community, which includes a high number of tourists and seasonal workers as well as a large metropolitan population.
Luck carried out 290 hours of observation and interviewed 20 Registered Nurses who agreed to take part in the study.
"During my time in the department there were 16 violent episodes aimed at staff taking part in the study" says Luck. "Because I was on the spot I was able to obtain feedback from them while the event was still fresh in their minds. They were able to tell me how they perceived the event and how they tried to handle it.
"Many more episodes were observed during the study period and I was keen to note how staff managed to defuse potentially violent episodes".
Key findings of the study, co-authored by Professor Debra Jackson (University of Western Sydney) and Professor Kim Usher (James Cook University), included:
"Violence towards healthcare staff and other professionals such as police officers and social security staff are an increasing part of daily life" says Luck.
"We feel that the STAMP system provides an easy to remember checklist that can be used in a wide range of potentially stressful situations to provide an initial indication of possible violence.
"Recognising the early signs that can lead to a violent episode can give staff the time they need to defuse the situation before it escalates.
"STAMP also provides a basic framework that can be developed by healthcare organisations and other agencies -- using research, observation and experience - to meet their own specific needs."
Reference: STAMP: components of observable behaviour that indicate potential for patient violence in emergency departments. Luck L, Jackson D and Usher K. Journal of Advanced Nursing. 59.1 pp 11-19.
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